While health club classes such as pilates may help people suffering from back pain, combining them with mindfulness-based activities could improve results even further according to recent research.

Mindfulness-based stress reduction focuses on increasing awareness and acceptance of moment-to-moment experiences, including physical discomfort and difficult emotions.

A study published in the The Journal of the American Medical Association in March* showed that, among adults with chronic lower back pain, both mindfulness-based stress reduction and cognitive behavioural therapy resulted in greater reduction in pain when compared with usual care.

Mindful interventions
Daniel C Cherkin and colleagues at the Group Health Research Institute in Seattle, US, randomly assigned 342 adults aged 20 to 70 years with chronic lower back pain to receive mindfulness-based stress reduction, cognitive behavioural therapy, or usual care.

Cognitive behavioural therapy (training to change pain-related thoughts and behaviours) and mindfulness-based stress reduction (training in mindfulness meditation and yoga) were delivered in eight weekly two-hour groups. ‘Usual care’ included whatever other treatment, if any, the participants received. Average age of the participants was 49 years; the average duration of back pain was 7.3 years.

Meaningful improvement
The researchers found that, at 26 weeks, the percentage of participants with clinically meaningful improvement on a measure of functional limitations was higher for those who received mindfulness-based stress reduction (61 per cent) and cognitive behavioural therapy (58 per cent) than for usual care (44 per cent). The authors wrote: “The effects were moderate in size, which has been typical of evidence-based treatments recommended for chronic low back pain....These findings suggest that mindfulness-based stress reduction may be an effective treatment option for patients with chronic low back pain.”

Jennifer A Haythornthwaite and Madhav Goyal of Johns Hopkins University School of Medicine, Baltimore, US, wrote that the challenge is how to ensure that these mind-body interventions are available.

“Most physicians encounter numerous obstacles in finding appropriate referrals for mind-body therapies that their patients can access and afford,” they said. “High-quality studies such as the clinical trial by Cherkin et al create a compelling argument for ensuring that an evidence-based healthcare system should provide access to affordable mind-body therapies.”

A recent study from Case Western Reserve University in Cleveland, Ohio, US, also found that mindfulness in the workplace is shown to improve employee focus, attention and behaviour.

* Cherkin, DC et al. Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioural Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Lower Back Pain. JAMA, March 2016