There are now many preventive and therapeutic methods based on mindfulness and meditation. Jon Kabat-Zinn developed mindfulness-based stress reduction (MBSR). In the meantime, several variants have been developed, such as mindfulness-based cognitive therapy (MBCT) and mindfulness-based pain management (MBPM). These are all examples of mindfulness-based interventions (MBI).
Chronic low back pain is one of the most common types of pain in adults. A recent review in the journal Pain Medicine explores whether meditation-based therapies are an alternative treatment option.
To do this, you have to know: MBSR, for example, mixes different methods. So it is by no means only the classical mindfulness meditation in the traditional sitting posture that is carried out. Other postures are also adopted, depending on individual needs. The so-called body scan often takes place in a lying position, and yoga exercises are also completed in a wide variety of starting positions.
Currently, patients with low back pain are often offered injections, painkillers or anti-inflammatory drugs - with still questionable effectiveness. Lin et al. have now investigated the applicability and effectiveness of meditation-based therapies for pain management.
They conducted a systematic review with meta-analysis and included randomised controlled trials. The primary outcomes were pain intensity, quality of life and pain-related disability; the secondary outcomes were subjective distress or anxiety and impairment due to pain.
The authors searched the PubMed, Embase and Cochrane databases for studies published up to July 2021. They included a total of 12 randomised controlled trials involving 1,153 patients. In 10 of the trials, meditation-based therapies reduced back pain intensity statistically significantly compared to therapies without meditation. In 7 of the studies, meditation-based therapies statistically significantly reduced pain interference compared to therapies without meditation. In 3 studies, meditation-based therapies significantly improved patients' quality of life compared to no meditation.
In conclusion, the researchers find that meditation-based therapies provide a safe and effective alternative approach to the management of chronic low back pain.
In this study, the term "meditation-based therapy" is used to summarise various therapies and programmes and to look at them in an overarching way.
A fundamental idea in mindfulness meditation from the Buddhist tradition is that there are two different kinds of "suffering": the first simply consists of the sensation; it is unavoidable for human beings. The "second suffering" arises from mental resistance, the negative evaluation of the suffering, for example of a pain. This "second suffering" is avoidable or reducible.
These basic ideas from the Buddhist tradition are confirmed by modern neuroscience: Pain is first of all only a sensory perception. A receptor in the tissue signals tissue damage or the threat of tissue damage. However, it has now been discovered that our expectations, ideas, evaluations decide how we subjectively perceive this sensation, i.e. how the sensations are processed in the brain. This is one explanation for the positive effect of, for example, mindfulness meditation, which many pain patients report.
Of course, pain patients should adopt a position for the meditative exercise that does not aggravate their pain. In principle, mindfulness meditation can be done in any posture, even in motion. Of course, the more upright or moving the posture, the more difficult it is to focus attention. On the other hand, in more "comfortable" positions it is more difficult to stay focused and awake.
Lin TH et al.: Meditation-based therapy for chronic low back pain management: a systematic review and meta-analysis of randomized controlled trials. Pain Med. 2022 Feb 28: pnac037. doi: 10.1093/pm/pnac037 . Epub ahead of print. PMID: 35226059.
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Meditation teacher, journalist and Cochrane member with a focus on evidence-based naturopathy