A Mind-Body Program for Older Adults With Chronic Low Back Pain

Approximately 100 million individuals in the United States suffer from chronic pain. Pain is prevalent in 52.9% of the older adult population ages 65 and older. Of the 52.9% experiencing pain, 30.3% were experiencing chronic back pain. Analgesics commonly cause severe adverse effects in older adults. Because of this prevalent drug therapy problem, nonpharmacologic treatments must often be utilized for effective management of chronic low back pain.

An experimental study was conducted among 282 patients with low chronic back pain 65 years or older. The goal of this study was to assess the effectiveness of a mind-body program at increasing function and reducing pain. The patients received an 8-week group program followed by 6 monthly sessions. The program was modeled on the Mindfulness-Based Stress Reduction program. This program took regular activities such as sitting, walking, and lying down and transformed then into meditation through breathing exercises and mindful awareness of thoughts and sensations. Compared with the control group, those receiving this mind-body treatment improved short-term function and long-term current and most severe pain.

The trial did not yield sustained results in treatment of lower chronic back pain, suggesting that future development of this intervention should focus on durability. This article was particularly of interest to me because it combined two of my interest in medicine with my interest in meditation. I often use meditation as a form of stress relief, and it is intriguing to see that meditation could also be used in pain management. Prescription pain medication is not the answer  for every patient and it is very often over-prescribed. I believe that is important for pharmacists to be aware of other pain management methods and share these methods with their patients. Although I do not believe that meditation alone is the answer, I think that a combination of medication therapy and meditation could be a very effective treatment for a lot of patients suffering from chronic pain.

JAMA Intern Med. Published online February 22, 2016.

Link to article

2 thoughts on “A Mind-Body Program for Older Adults With Chronic Low Back Pain”

  1. I think the most important takeaway from this article is that we as pharmacists could definitely benefit from expanding our knowledge to include not only medicine but also alternative medicine like meditation. Since meditation isn’t well studied in primary literature, it is usually not taught in a medical school or pharmacy school curriculum. By studying the effects of alternative medicine in more structured and controlled studies, we could gather more evidence of its effects. Once this evidence is gathered, we could incorporate it more into our practice and be able to help patients without prescribing them every medication available.

  2. I agree with your thoughts on this study. It’s very interesting, and I think more studies should be done on non-pharmacological management of pain considering the drug therapy problems involved with conventional analgesics. I think this also relates to patients’ medication experiences. As pharmacists, we will likely encounter patients who have beliefs that make them more inclined to meditate rather than take pills.
    As a side note, I’m not surprised that there may be a connection between mind and body in terms of pain. Studies have shown connections between depression and pain. I have a personal anecdote with a course I once took that focused on reducing tension/ pain by being more mindful and aware of daily body movements, and I definitely noticed some benefit.
    That being said, alternative approaches would be more difficult to implement and would be more time consuming for patients, so adherence could be a problem. Also, some patients face intense pain and need immediate, strong interventions. This study included patients with low chronic back pain, so I’m curious how it would work with those who have greater levels of pain.

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