By John M. de Castro, Ph.D.
“MBSR is a practice that can help you “turn the volume down” on the perception of back pain by teaching you to look into the pain, and being with the experience and not resisting it so much. Looking into our emotional reactivity to it. Focusing on the present, rather than being bitter about the past or worried about the future about your back pain, helps you take ownership of the situation (i.e., accept your pain), and ultimately, find creative solutions for pain relief. It trains you to be in control of your mind, not for your mind to control you.” – Mark Neenan
Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse and addiction. Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects.
Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. So, it would seem reasonable to project that mindfulness practices would be helpful in pain management. Indeed, these practices have been shown to be safe and beneficial in pain management in general and Yoga and mindfulness has been shown to specifically improve back pain. Mindfulness Based Stress Reductions (MBSR) programs contain both yoga and mindfulness practices. So, it would seem reasonable to project that MBSR practice would improve emotion regulation and thereby be beneficial for back pain.
In today’s Research News article “Brain and behavior changes associated with an abbreviated 4-week mindfulness-based stress reduction course in back pain patients”
or see below.
Braden and colleagues investigate the effectiveness of a 4-week program of Mindfulness Based Stress Reductions (MBSR) for the treatment of low back pain. They randomly assigned patients with chronic low back pain to either an MBSR or reading control group. They found that only the MBSR group reported a significant decrease in low back pain and the somatic-affective aspects of depression following the MBSR training. In addition, they performed functional magnetic imaging of the brains of the patients, both before and after training, during a task designed to induce emotions. They found that after MBSR training there was increased activity in response to emotions in the subgenual Anterior Cingulate Cortex and the ventrolateral Prefrontal Cortex. Both of these areas have been associated with emotion regulation processing.
Hence the results suggest that a 4-week MBSR training program can be effective for the relief of low back pain and the improvement in emotions. The results suggest that the improvements may have been due to changes in brain processing of emotions produced by the MBSR training. Unfortunately, at a one year follow up the reductions in pain and depression were not maintained. This suggests that an abbreviated program of 4 weeks of MBSR (the standard program is 8-weeks) may be able to improve the patients but not sufficient to produce lasting effects. It remains to be shown if the standard 8-week program can produce more lasting effects. Regardless, the findings provide support for further research into the utility of MBSR training for the treatment of chronic low back pain.
So, mindfully control back pain.
“Mindfulness soothes the circuits that amplify secondary pain and you can see this process happening in a brain scanner. In effect, mindfulness teaches you how to turn down the volume control on your pain. And as you do so, any anxiety, stress and depression that you may be feeling begins to melt away too. Your body can then relax and begin to heal.” – Danny Penman
CMCS – Center for Mindfulness and Contemplative Studies
Study Summary
Braden BB, Pipe TB, Smith R, Glaspy TK, Deatherage BR, Baxter LC. Brain and behavior changes associated with an abbreviated 4-week mindfulness-based stress reduction course in back pain patients. Brain Behav. 2016 Feb 16:e00443. [Epub ahead of print]
Abstract
INTRODUCTION: Mindfulness-based stress reduction (MBSR) reduces depression, anxiety, and pain for people suffering from a variety of illnesses, and there is a growing need to understand the neurobiological networks implicated in self-reported psychological change as a result of training. Combining complementary and alternative treatments such as MBSR with other therapies is helpful; however, the time commitment of the traditional 8-week course may impede accessibility. This pilot study aimed to (1) determine if an abbreviated MBSR course improves symptoms in chronic back pain patients and (2) examine the neural and behavioral correlates of MBSR treatment.
METHODS: Participants were assigned to 4 weeks of weekly MBSR training (n = 12) or a control group (stress reduction reading; n = 11). Self-report ratings and task-based functional MRI were obtained prior to, and after, MBSR training, or at a yoked time point in the control group.
RESULTS: While both groups showed significant improvement in total depression symptoms, only the MBSR group significantly improved in back pain and somatic-affective depression symptoms. The MBSR group also uniquely showed significant increases in regional frontal lobe hemodynamic activity associated with gaining awareness to changes in one’s emotional state.
CONCLUSIONS: An abbreviated MBSR course may be an effective complementary intervention that specifically improves back pain symptoms and frontal lobe regulation of emotional awareness, while the traditional 8-week course may be necessary to detect unique improvements in total anxiety and cognitive aspects of depression.
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