Pain

Mindfulness is Associated with Lower Impact of Fibromyalgia and Greater Well-Being

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Mindfulness is Associated with Lower Impact of Fibromyalgia and Greater Well-Being

 

By John M. de Castro, Ph.D.

 

“people with fibromyalgia may have what’s called an “attentional bias” toward negative information that appeared to be linked to pain severity. . . mindfulness training may help manage this trait and therefore reduce pain.” – Adrienne Dellwo

 

Fibromyalgia is a mysterious disorder whose causes are unknown. It is very common affecting over 5 million people in the U.S., about 2% of the population with about 7 times more women affected than men. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. Fibromyalgia may also have morning stiffness, tingling or numbness in hands and feet, headaches, including migraines, irritable bowel syndrome, sleep disturbances, thinking and memory problems, and painful menstrual periods. The symptoms are so severe and debilitating that about half the patients are unable to perform routine daily functions and about a third have to stop work. Although it is not itself fatal, suicide rates are higher in fibromyalgia sufferers. Clearly, fibromyalgia greatly reduces the quality of life of its’ sufferers.

 

There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia. Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. So, mindfulness may reduce worry and catastrophizing and thereby reduce fibromyalgia pain and improve the quality of life.

 

In today’s Research News article “Mindfulness is associated with psychological health and moderates the impact of fibromyalgia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6545163/) Pleman and colleagues recruited adult patients diagnosed with fibromyalgia and had them complete measures of mindfulness, fibromyalgia impact, pain interference, symptom severity, anxiety, depression, perceived stress, coping strategies, health-related quality of life, self-efficacy, and walking ability.

 

They found that the higher the levels of mindfulness the lower the levels of fibromyalgia impact, pain interference, symptom severity, anxiety, depression, and perceived stress, and the higher the mental health related quality of life, coping, and self-efficacy. This was true also for the individual mindfulness facets of describing, acting-with-awareness, and non-judging. Hence, mindfulness was associated with better psychological health and lower overall impact of fibromyalgia.

 

These findings are correlational and as such causation cannot be determined. But prior research has shown that mindfulness training causes improvements in fibromyalgia. So, the present findings are probably due to a causal effect of being mindful on the psychological and physical impact of fibromyalgia and the quality of life of the patients. Hence, mindfulness can go a long way toward relieving the suffering of patients with fibromyalgia.

 

So, mindfulness is associated with lower impact of fibromyalgia and greater well-being.

 

“Often, individuals with fibromyalgia demonstrate a series of maladaptive coping strategies which in turn can lead to poor mental health; however mindfulness meditation has been shown to significantly improve this.” – Breathworks

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Pleman, B., Park, M., Han, X., Price, L. L., Bannuru, R. R., Harvey, W. F., Driban, J. B., & Wang, C. (2019). Mindfulness is associated with psychological health and moderates the impact of fibromyalgia. Clinical rheumatology, 38(6), 1737–1745. https://doi.org/10.1007/s10067-019-04436-1

 

Abstract

Objective

Previous studies suggest mindfulness is associated with pain and depression. However, its impact in individuals with fibromyalgia remains unclear. We examined associations between mindfulness and physical and psychological symptoms, pain interference, and quality of life in fibromyalgia patients.

Methods

We performed a cross-sectional analysis on baseline data from a fibromyalgia clinical trial. Mindfulness was assessed using the Five Facet Mindfulness Questionnaire (FFMQ). Pearson’s correlations and multivariable linear regression models were used to evaluate associations between mindfulness and fibromyalgia impact, pain interference, physical function, depression, anxiety, stress, self-efficacy, and health-related quality of life. We also examined whether mindfulness moderated associations between fibromyalgia impact and psychological outcomes.

Results

A total of 177 participants (age 52.0±12.2 (SD) years; 93.2% women; 58.8% white; body mass index 30.1±6.7 kg/m2; FFMQ score 131.3±20.7; Revised Fibromyalgia Impact Questionnaire score 57.0±19.4) were included. Higher total mindfulness was significantly associated with lower fibromyalgia impact (r=−0.25), pain interference (r=−0.31), stress (r=−0.56), anxiety (r=−0.58), depression (r=−0.54), and better mental health-related quality of life (r=0.57). Describing, Acting-with-awareness, and Non-judging facets of mindfulness were also associated with these outcomes. Mindfulness moderated the effect of fibromyalgia impact on anxiety (interaction P=0.01).

Conclusion

Higher mindfulness is associated with less pain interference, lower impact of fibromyalgia, and better psychological health and quality of life in people with fibromyalgia. Mindfulness moderates the influence of fibromyalgia impact on anxiety, suggesting mindfulness may alter how patients cope with fibromyalgia. Future studies should assess how mind-body therapies aiming to cultivate mindfulness may impact the well-being of patients with fibromyalgia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6545163/

 

Improve Fibromyalgia Symptoms with Qigong

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Improve Fibromyalgia Symptoms with Qigong

 

By John M. de Castro, Ph.D.

 

“Evidence is growing for the Traditional Chinese practice of qigong as a treatment for fibromyalgia..” – Adrienne Dellwo

 

Fibromyalgia is a mysterious disorder whose causes are unknown. It is very common affecting over 5 million people in the U.S., about 2% of the population with about 7 times more women affected than men. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. Fibromyalgia may also have morning stiffness, tingling or numbness in hands and feet, headaches, including migraines, irritable bowel syndrome, sleep disturbances, thinking and memory problems, and painful menstrual periods. The symptoms are so severe and debilitating that about half the patients are unable to perform routine daily functions and about a third have to stop work. Although it is not itself fatal, suicide rates are higher in fibromyalgia sufferers. Clearly, fibromyalgia greatly reduces the quality of life of its’ sufferers.

 

There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia. Qigong is an ancient Chinese practice involving mindfulness and gentle movements. They are easy to learn, safe, and gentle. So, it may be appropriate for patients with fibromyalgia where exercise can produce painful flares. This suggests that Qigong might also be effective. Qigong practice involves body movements and also breathing exercises and meditation. It is not known which of these components are essential to produce benefits,

 

In today’s Research News article “The therapeutic efficacy of Qigong exercise on the main symptoms of fibromyalgia: A pilot randomized clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235941/), Sarmento and colleagues recruited adult non-obese female patients with fibromyalgia and randomly assigned them to receive either Qigong practice or a sham Qigong control condition. They received 2 weekly 45-minute training sessions followed by 10 weeks of daily practice at home. Qigong practice consisted of “deep diaphragmatic breathing, mild body movements, and meditation, along with uttering six healing sounds.”  The sham Qigong practice consisted of the body movements only. They were measured before and after training for self-reported pain levels, pressure pain thresholds, fibromyalgia impact, sleep quality, fatigue, quality of life, depression, and anxiety.

 

They found that in comparison to baseline and the sham Qigong group the participants that practiced Qigong had significantly lower levels of self-reported pain, fibromyalgia impact, fatigue, depression, and anxiety and significantly higher pressure pain thresholds and levels of sleep quality. These results are very interesting in that they demonstrate that Qigong practice markedly improves the symptoms of fibromyalgia in women.

 

The results are also interesting in that they demonstrate that the body movements component of Qigong practice is not essential for the benefits. The fact that the exercise is not effective alone is not surprising as it’s been reported that exercise can actually increase the likelihood of a fibromyalgia flare. The results suggest that breath control and meditation are essential for Qigong practice to improve the symptoms of fibromyalgia. It would appear that the mindfulness components of Qigong practice are essential. Previous research has shown that mindfulness training can improve the symptoms of fibromyalgia. The present results further confirm the effectiveness of mindfulness in reducing the women’s suffering.

 

Fibromyalgia patients suffer greatly and to bring relief with a simple, gentle, safe practice is very important. Qigong is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Hence, Qigong practice would appear to be a wonderful effective treatment for the relief of the suffering of fibromyalgia patients.

 

So, improve fibromyalgia symptoms with qigong.

 

“qigong in fibromyalgia. . . . there are consistent benefits in pain, sleep, impact, and physical and mental function following the regimen, with benefits maintained at 4-6 months.” – Jane Sawynok

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Sarmento, C., Moon, S., Pfeifer, T., Smirnova, I. V., Colgrove, Y., Lai, S. M., & Liu, W. (2020). The therapeutic efficacy of Qigong exercise on the main symptoms of fibromyalgia: A pilot randomized clinical trial. Integrative medicine research, 9(4), 100416. https://doi.org/10.1016/j.imr.2020.100416

 

Abstract

Background

Some of the most debilitating symptoms of fibromyalgia (FM) include widespread chronic pain, sleep disturbances, chronic fatigue, anxiety, and depression. Yet, there is a lack of effective self-management exercise interventions capable of alleviating FM symptoms. The objective of this study is to examine the efficacy of a 10-week daily Qigong, a mind–body intervention program, on FM symptoms.

Methods

20 participants with FM were randomly assigned to Qigong (experimental) or sham-Qigong (control) groups, with participants blinded to the intervention allocation. The Qigong group practiced mild body movements synchronized with deep diaphragmatic breathing and meditation. The sham-Qigong group practiced only mild body movements. Both groups practiced the interventions two times per day at home, plus one weekly group practice session with a Qigong instructor. Primary outcomes were: pain changes measured by the Short-Form McGill Pain Questionnaire, a visual analog scale for pain, pressure pain threshold measured by a dolorimeter. Secondary outcomes were: the Revised Fibromyalgia Impact Questionnaire the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale and the Quality of Life Scale.

Results

The experimental group experienced greater clinical improvements when compared to the control group on the mean score differences of pain, sleep quality, chronic fatigue, anxiety, depression, and fibromyalgia impact, all being statistically significant at p < 0.05.

Conclusion

Daily practice of Qigong appears to have a positive impact on the main fibromyalgia symptoms that is beyond group interaction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235941/

 

Mindfulness Improves Physical Health

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Mindfulness Improves Physical Health

 

By John M. de Castro, Ph.D.

 

“mindfulness benefits our bodies, not just our minds.” – Jill Suttie

 

Mindfulness training has been shown to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness Training, Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

The evidence has been accumulating. So, it is reasonable to step back and summarize what has been learned and examine possible mechanism by which mindfulness may improve physical health. In today’s Research News article “Mindfulness Training and Physical Health: Mechanisms and Outcomes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613793/), Creswell and colleagues review and summarize the published controlled research studies on mindfulness effects on physical health.

 

They report that the published randomized controlled trials found that mindfulness training produced significant improvements in chronic pain management, including low back pain, arthritis, fibromyalgia. They also report that mindfulness training produced significant improvements in stress related health conditions, including psoriasis, post-traumatic stress disorder (PTSD), irritable bowel syndrome, type 2 diabetes, HIV progression, inflammatory responses, and even colds. Hence, mindfulness training appears to significantly improve the physical health of the individual.

 

They postulate that mindfulness training improves health primarily through improving the physiological, psychological, and behavioral responses to stress. They postulate that it affects the physiological stress responses by modulating the hypothalamic-pituitary-adrenal hormonal responses to stress.  They further postulate that it affects the psychological stress responses by improving the monitoring and acceptance of stress. Finally, they postulate that mindfulness training improves health behaviors including reduced smoking, and improved diet, sleep, and activity all of which promote health.

 

The review indicates that there is substantial evidence that mindfulness training is good for health and improves a wide range of physiological, psychological, and behavioral responses that contribute to good health. It appears that reactions to stress may be central to these benefits. Regardless, it is clear that mindfulness improves health.

 

So, mindfulness improves physical health.

 

“If greater well-being isn’t enough of an incentive, scientists have discovered that mindfulness techniques help improve physical health in a number of ways. Mindfulness can: help relieve stress, treat heart disease, lower blood pressure, reduce chronic pain, , improve sleep, and alleviate gastrointestinal difficulties.” – Harvard Health

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Creswell, J. D., Lindsay, E. K., Villalba, D. K., & Chin, B. (2019). Mindfulness Training and Physical Health: Mechanisms and Outcomes. Psychosomatic medicine, 81(3), 224–232. https://doi.org/10.1097/PSY.0000000000000675

 

Abstract

Objective:

There has been substantial research and public interest in mindfulness interventions, biological pathways, and health over the past two decades. This article reviews recent developments in understanding relationships between mindfulness interventions and physical health.

Methods:

A selective review was conducted with the goal of synthesizing conceptual and empirical relationships between mindfulness interventions and physical health outcomes.

Results:

Initial randomized controlled trials (RCTs) in this area suggest that mindfulness interventions can improve pain management outcomes among chronic pain populations, and there is preliminary evidence for mindfulness interventions improving specific stress-related disease outcomes in some patient populations (i.e., clinical colds, psoriasis, IBS, PTSD, diabetes, HIV). We offer a stress buffering framework for the observed beneficial effects of mindfulness interventions and summarize supporting biobehavioral and neuroimaging studies that provide plausible mechanistic pathways linking mindfulness interventions with positive physical health outcomes.

Conclusion:

We conclude with new opportunities for research and clinical implementations to consider in the next two decades.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613793/

 

Improve Headache Pain with Mindfulness

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Improve Headache Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a simple, effective method for managing migraines and reducing potential triggers.” – American Migraine Foundation

 

Headaches are the most common disorders of the nervous system. It has been estimated that 47% of the adult population have a headache at least once during the last year. Primary headaches do not result from other medical conditions and include migraine, tension, and cluster headaches. There are a wide variety of drugs that are prescribed for primary headache pain with varying success. Headaches are treated with pain relievers, ergotamine, blood pressure drugs such as propranolol, verapamil, antidepressants, antiseizure drugs, and muscle relaxants. Drugs, however, can have some problematic side effects particularly when used regularly and are ineffective for many sufferers.

 

Most practitioners consider lifestyle changes that help control stress and promote regular exercise to be an important part of headache treatment and prevention. Avoiding situations that trigger headaches is also vital. A number of research studies have reported that mindfulness training is an effective treatment for headache pain. But there is a need for further study.

 

In today’s Research News article “Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925538/), Namjoo and colleagues recruited adults with chronic primary headaches and randomly assigned them to receive 8 weekly 2-hour group sessions of either Mindfulness-Based Cognitive Therapy (MBCT) or an Attention Placebo Control condition. MBCT consists of mindfulness training and Cognitive Behavioral Therapy (CBT) and assigned homework. During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to headache pain. The Attention Placebo Control condition consists of therapist attention and empathy and group discussion. The patients were measured before and after training and 3 months later for pain, pain interference in everyday life, pain severity, and pain related cognitive processes.

 

A strength of the study is the Attention Placebo Control condition which is an excellent control condition that would be helpful in assessing placebo, attentional, and Hawthorne confounding effects. Even with this strong control condition, they found that at the 3-month follow up in comparison to the Attention Placebo Control condition the Mindfulness-Based Cognitive Therapy (MBCT) group had significant reductions in pain intensity, pain interference, pain reappraisal, and pain focus, and significant increases in pain openness. The reductions in pain interference and pain focus, and the increases in pain openness continued to improve from the end of training to the 3-month follow up.

 

These results suggest that Mindfulness-Based Cognitive Therapy (MBCT) is a safe, effective, and lasting treatment for primary headache, reducing pain and its interference in the daily activities of the patients. In addition, the results suggest that MBCT produces changes in the cognitive responses to the headache pain. It reduces pain focus suggesting that the patients pay less attention to the headache pain allowing them to attend to other aspects of their lives. It also increases the openness to pain such that they allow the pain to occur without fighting against it which can increase the pain. So, the study suggests that MBCT reduce primary headache symptoms and does so by improving the ways in which the patients think about and react to the pain.

 

So, improve headache pain with mindfulness.

 

“Mindfulness for Migraine is effective because it teaches the sympathetic nervous system to let go rather than running on fight-or-flight mode. This deep, internal relaxation of the nervous system fosters healing and helps protect the body from a Migraine attack.” – Susan Dawson Cook

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Namjoo, S., Borjali, A., Seirafi, M., & Assarzadegan, F. (2019). Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group. Anesthesiology and pain medicine, 9(5), e91927. doi:10.5812/aapm.91927

 

Abstract

Background

Mindfulness-based interventions have shown to be efficient in managing chronic pain. Cognitive factors play a prominent role in chronic pain complications and negative cognitive contents about pain are often the first issues targeted in cognitive-based therapies, which are known as first-line treatment of chronic pain over the past decades. Little, however, is known about the manner of thinking about pain or pain-related cognitive processing.

Objectives

Therefore, the purpose of this study was to investigate the effect of mindfulness-based cognitive therapy (MBCT) on pain-related cognitive processing and control of chronic pain in patients with primary headache.

Methods

A clinical trial was conducted in 2017 – 2018 on 85 Persian language patients with one type of primary headache selected through purposive sampling in Emam Hossein Hospital in Tehran province. To measure the variables of the study, we used the Brief Pain Inventory (BPI) and Pain-related Cognitive Processing Questionnaire (PCPQ). All data were analyzed by independent t-test and chi-square and longitudinal data were analyzed using linear mixed model analysis.

Results

Statistically significant time × group interactions were found in pain intensity (P < 0.001), pain interference (P < 0.001), as well as in three cognitive processing subscales including pain focus, pain distancing, and pain openness (P < 0.001). However, the results of pain diversion were not meaningful.

Conclusions

MBCT is a potentially efficacious approach for individuals with headache pain. Regulation and correction of cognitive processing are considered as effective cognitive coping strategies in MBCT treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925538/

 

Improve Emotional Response Inhibition in Patients with Chronic Pain and Opioid Use with Mindfulness

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Improve Emotional Response Inhibition in Patients with Chronic Pain and Opioid Use with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation could represent a viable alternative to opioid-based therapy for chronic pain, and may be useful in helping patients taper their use of high doses of opioid-acting agents.” – Hymie Anisman

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings to demonstrate that mindfulness practices, in general, are effective in treating pain. In today’s Research News article “Effects of Mindfulness-Oriented Recovery Enhancement Versus Social Support on Negative Affective Interference During Inhibitory Control Among Opioid-Treated Chronic Pain Patients: A Pilot Mechanistic Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735955/), Garland and colleagues examine the mechanisms by which mindfulness reduces perceived pain.

 

They recruited adult patients with non-cancer related chronic pain who were taking daily opioids. They were randomly assigned to receive 8-weeks of a Mindfulness-Oriented Recovery Enhancement (MORE) program or to an 8-week support groups meeting. Mindfulness-Oriented Recovery Enhancement (MORE) involves mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion. The patients were measured before and after treatment and 3 months later for pain severity and the mindfulness facet of nonreactivity. The patients also performed a go – no-go task. They viewed either neutral or pain related images in which was embedded either the letter “M” or “W”. They were asked to press a key a quickly as possible when the letter “M” was present.

 

They found that in comparison to baseline and the support group, after the mindfulness treatment there was a significant reduction in pain severity and increase in nonreactivity and improvement in go – no-go task accuracy. These changes were maintained 3 months after the completion of th treatment. In addition, they found that the higher the levels of nonreactivity and the greater the amount of meditation practice, the fewer errors occurred in the go – no-go task with pain-related images. In other words, the greater the improvement in response inhibition to emotional stimuli. Finally, they found that the greater the reductions in go – no-go task errors with pain related images, the greater the reduction in pain severity.

 

The results are complicated and so are the conclusions. Nevertheless, the results suggest that mindfulness training reduces pain severity and increases the mindfulness facet of nonreactivity. This suggests that the mindfulness training improves the patient’s ability to not react to pain stimuli and thereby reduce the perceived severity of the pain. This increase in nonreactivity would also explain why the patients didn’t react to pain related distractors in the go – no-go task and thereby improve their accuracy.

 

These results suggest that Mindfulness-Oriented Recovery Enhancement (MORE) enhances the chronic pain patient’s ability to inhibit emotional responses in the presence of pain related stimuli. This ability in turn reduces perceived pain. It remains to be seen if these improvements make it easier for the patients to wean off of opiates.

 

So, improve emotional response inhibition in patients with chronic pain and opioid use with mindfulness.

 

“Meditation teaches patients how to react to the pain. People are less inclined to have the ‘Ouch’ reaction, then they are able to control the emotional reaction to pain.” – Fadel Zeidan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

They are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Garland, E. L., Bryan, M. A., Priddy, S. E., Riquino, M. R., Froeliger, B., & Howard, M. O. (2019). Effects of Mindfulness-Oriented Recovery Enhancement Versus Social Support on Negative Affective Interference During Inhibitory Control Among Opioid-Treated Chronic Pain Patients: A Pilot Mechanistic Study. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 53(10), 865–876. doi:10.1093/abm/kay096

 

Abstract

Background

Among opioid-treated chronic pain patients, deficient response inhibition in the context of emotional distress may contribute to maladaptive pain coping and prescription opioid misuse. Interventions that aim to bolster cognitive control and reduce emotional reactivity (e.g., mindfulness) may remediate response inhibition deficits, with consequent clinical benefits.

Purpose

To test the hypothesis that a mindfulness-based intervention, Mindfulness-Oriented Recovery Enhancement (MORE), can reduce the impact of clinically relevant, negative affective interference on response inhibition function in an opioid-treated chronic pain sample.

Methods

We examined data from a controlled trial comparing adults with chronic pain and long-term prescription opioid use randomized to either MORE (n = 27) treatment or to an active support group comparison condition (n = 30). Participants completed an Emotional Go/NoGo Task at pre- and post-treatment, which measured response inhibition in neutral and clinically relevant, negative affective contexts (i.e., exposure to pain-related visual stimuli).

Results

Repeated-measures analysis of variance indicated that compared with the support group, participants in MORE evidenced significantly greater reductions from pre- to post-treatment in errors of commission on trials with pain-related distractors relative to trials with neutral distractors, group × time × condition F(1,55) = 4.14, p = .047, η2partial = .07. Mindfulness practice minutes and increased nonreactivity significantly predicted greater emotional response inhibition. A significant inverse association was observed between improvements in emotional response inhibition and treatment-related reductions in pain severity by 3-month follow-up.

Conclusions

Study results provide preliminary evidence that MORE enhances inhibitory control function in the context of negative emotional interference.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735955/

 

Improve the Symptoms of Diabetic Neuropathy with Mindfulness

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Improve the Symptoms of Diabetic Neuropathy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Daily mindfulness practice can be helpful for people living with chronic pain because sometimes there are negative or worrisome thoughts about the pain. These thoughts are normal, and can affect mood and increase pain. Being able to focus on relaxing the body, noticing the breath and body sensations as being there just as they are, can help manage pain, as well as reduce depression and anxiety symptoms.” – Mayo Clinic

 

Diabetes can lead to a very painful condition known as diabetic neuropathy. The high blood glucose levels associated with diabetes can damage nerves and result in a burning pain and numbness, particularly from the legs and feet. It affects the majority of long-term diabetes patients. This is not only painful but is also disruptive to the normal life functions of these patients. There are no cures, but diabetic neuropathy can be prevented by blood glucose control in the diabetic patient with a rigorous program of measured diet and exercise. Treatment for diabetic neuropathy usually involves pain management with drugs.

 

Mindfulness practices have been shown to help with pain management and with quality of life in diabetes patients. and has been shown to improve the symptoms of diabetic neuropathy. It is important, then, to continue studying the effectiveness of mindfulness practices for reducing pain and improving quality of life in patients with diabetic neuropathy.

 

In today’s Research News article “Mindfulness-Based Meditation Versus Progressive Relaxation Meditation: Impact on Chronic Pain in Older Female Patients With Diabetic Neuropathy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6757487/), Hussain and Said recruited elderly females with diabetes. They were randomly assigned to one of three condition, Mindfulness-Based Cognitive Therapy (MBCT), progressive muscle relaxation training, or a control condition consisting of 15 minutes of discussion and 20 minutes of quiet sitting. Treatment occurred twice a week for 8 weeks. MBCT consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to their neuropathy. The participants were measured before and after training for pain, analgesia, impression of change in their condition, and patient satisfaction.

 

They found that in comparison to baseline and the control group both the Mindfulness-Based Cognitive Therapy (MBCT) and progressive muscle relaxation groups had significant reductions in daily pain intensity and significant enhanced impression of change in their condition. In addition, the MBCT group had significant improvement in their satisfaction with treatment.

 

These results suggest that both Mindfulness-Based Cognitive Therapy (MBCT) and progressive muscle relaxation improve the daily pain of elderly female diabetic neuropathy patients and their perception of improvement in their condition. MBCT  would appear to be somewhat superior to progressive relaxation in improving the condition. This is important as these patients suffer greatly and the pain interferes with their ability to conduct their lives. The pain relief is most welcome.

 

So, improve the symptoms of diabetic neuropathy with mindfulness.

 

“in addition to improving pain, mindfulness also addresses the psychological consequences of chronic pain, including depression symptoms.” -0 Shanna Patterson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Hussain, N., & Said, A. (2019). Mindfulness-Based Meditation Versus Progressive Relaxation Meditation: Impact on Chronic Pain in Older Female Patients With Diabetic Neuropathy. Journal of evidence-based integrative medicine, 24, 2515690X19876599. doi:10.1177/2515690X19876599

 

Abstract

Chronic pain, the most common complication of diabetes, is treated with medication often to no avail. Our study aimed to compare the use of mindfulness meditation and progressive relaxation to reduce chronic pain in older females with diabetes. Methods The 105 study participants were divided randomly into 3 groups: Group MM (mindfulness meditation), Group CM (control meditation), and Group PM (progressive relaxation meditation). Assessment of analgesic effectiveness required changes in average daily pain Brief Pain Inventory (BPI) modified for painful diabetic peripheral neuropathy and Patient Global Impression of Change using descriptive statistics, Student’s t test, and analysis of variance where applicable. Results Both Groups MM and PM experienced significant (P < .05) reduction in average daily pain in last 24 hours at study end compared to baseline (28.7% and 39.7%, respectively). Group MM had more significant (P < .01) reduction of pain compared to control, a score of 5.2 ± 1.2 dropped to 3.0 ± 1.1 by week 12 of treatment. Groups MM and PM showed significant improvement in patients’ impression at study end, 75 ± 5.1% (n = 36) and 61 ± 6.5% (n = 32), respectively. In Group MM, patient satisfaction scores increased significantly (P < .05) to 3.8 ± 1.9 by week 12. Conclusion Integrative therapies such as mindfulness meditation can be part of a comprehensive pain management plan. Benefits include reduction of pain-related medication consumption, better treatment outcomes, improvement in comorbid conditions such as anxiety and depression as well as no risk of addiction or abuse.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6757487/

 

Improve Gulf War Illness in Veterans with Tai Chi

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Improve Gulf War Illness in Veterans with Tai Chi

 

By John M. de Castro, Ph.D.

 

“A prominent condition affecting Gulf War Veterans is a cluster of medically unexplained chronic symptoms that can include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems.” – US Department of Veterans Affairs

 

Engaging in warfare has many consequences to society and individuals, including the warriors themselves. Post-Traumatic Stress Disorder (PTSD) is a common problem among military veterans with between 11% to 20% of veterans who were involved in combat developing PTSD. There is a specific syndrome that has been identified in about 36% of veterans of the Persian Gulf war of 1991. The cluster of symptoms include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems.

 

It has been demonstrated that mindfulness training is effective for PTSD symptoms . In addition, Yoga practice is a mindfulness practice that has been shown to be helpful for PTSD. Mindful movement practices such as Tai Chi and Qigong have been found to be beneficial for individuals with a myriad of physical and psychological problems. This raises the possibility that Tai Chi practice may be beneficial for veterans suffering from Gulf War Illness.

 

In today’s Research News article “The Effects of Tai Chi Mind-Body Approach on the Mechanisms of Gulf War Illness: an Umbrella Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600798/), Reid and colleagues review and summarize the published research studies of the effectiveness of Tai Chi practice in relieving the symptoms of participants whose symptoms were similar to Gulf War Illness. They identified multiple randomized controlled trials and meta-analyses of Tai Chi practice for these symptoms.

 

They report that the published research indicates that Tai Chi practice significantly improves mood, sleep, global cognitive function, and respiratory function and significantly decreases insomnia, anxiety, depression, stress, and chronic pain. Hence Tai Chi practice has been shown to be effective in relieving symptoms that commonly occur in Gulf War Illness. This suggests that Tai Chi practice should be tried directly to treat veterans with Gulf War Syndrome. It remains for future research to test this hypothesis.

 

So, improve Gulf War Illness in veterans with Tai Chi.

 

“Mindfulness-based stress reduction may provide significant benefits to symptoms associated with Gulf War Illness in veterans.” – Laura Stiles

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Reid, K. F., Bannuru, R. R., Wang, C., Mori, D. L., & Niles, B. L. (2019). The Effects of Tai Chi Mind-Body Approach on the Mechanisms of Gulf War Illness: an Umbrella Review. Integrative medicine research, 8(3), 167–172. doi:10.1016/j.imr.2019.05.003

 

Abstract

Gulf War illness (GWI) is a chronic and multisymptom disorder affecting military veterans deployed to the 1991 Persian Gulf War. It is characterized by a range of acute and chronic symptoms, including but not limited to, fatigue, sleep disturbances, psychological problems, cognitive deficits, widespread pain, and respiratory and gastrointestinal difficulties. The prevalence of many of these chronic symptoms affecting Gulf War veterans occur at markedly elevated rates compared to nondeployed contemporary veterans. To date, no effective treatments for GWI have been identified. The overarching goal of this umbrella review was to critically evaluate the evidence for the potential of Tai Chi mind-body exercise to benefit and alleviate GWI symptomology. Based on the most prevalent GWI chronic symptoms and case definitions established by the Centers for Disease Control and Prevention and the Kansas Gulf War Veterans Health Initiative Program, we reviewed and summarized the evidence from 7 published systematic reviews and meta-analyses. Our findings suggest that Tai Chi may have the potential for distinct therapeutic benefits on the major prevalent symptoms of GWI. Future clinical trials are warranted to examine the feasibility, efficacy, durability and potential mechanisms of Tai Chi for improving health outcomes and relieving symptomology in GWI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600798/

 

Reduce Pain and Falls and Improve Mobility in the Elderly with Tai Chi

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Reduce Pain and Falls and Improve Mobility in the Elderly with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Solid research shows that tai chi can benefit people with osteoarthritis, rheumatoid arthritis, fibromyalgia, tension headache, and other ongoing, painful conditions.” – Harvard Health

 

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. The elderly also frequently suffer from chronic pain.

 

Pain involves both physical and psychological issues. Physically, exercise can be helpful in strengthening the body to prevent or relieve pain. Psychologically, the stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Tai Chi, Qigong, and yoga  are all exercises and mindfulness practices that have been found to be effective for pain.

 

In today’s Research News article “Tai Chi for older adults with chronic multisite pain: a randomized controlled pilot study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126990/), You and colleagues examine the ability of Tai Chi practice to reduce chronic pain in the elderly. They recruited elderly (>65 years of age) with multisite (2 or more) musculoskeletal pain who either had 1 or more falls in the last year or used a cane or walker. They were randomly assigned to receive 12 weeks, 2 hours, twice a week of either Tai Chi or light physical exercise. They were measured before and after training for acceptability of the exercises, chronic health conditions, pain, attention, executive function, physical function, gait, falls, and fear of falling. 83% of the elderly completed the study.

 

They found that in comparison to baseline the elderly who engaged in Tai Chi had significantly lower pain and pain interference with activities, improvements in gait, including stride and swing time, and decreased gait asymmetry, and decreased fear of falling, and fewer falls over the subsequent 9 months, while the light exercise group did not.

 

These are encouraging pilot results that are similar to other findings with Tai Chi with other types of patients. Unfortunately, because this was a small pilot study there were no statistically significant differences between the Tai Chi group and the light exercise group even though the Tai Chi groups was significantly improved relative to baseline whereas the light exercise group was not. But these results provide justification for performing a future large scale randomized controlled trial.

 

It’s important to note that Tai Chi is a gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice.

 

So, reduce pain and falls and improve mobility in the elderly with Tai Chi.

 

“Improved flexibility will reduce stiffness and help keep joints mobile. Stiffness causes pain; increase flexibility will relieve pain.  Tai Chi for Arthritis gently moves all joints, muscles and tendons throughout the body.” – Paul Lam

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

You, T., Ogawa, E. F., Thapa, S., Cai, Y., Zhang, H., Nagae, S., … Leveille, S. G. (2018). Tai Chi for older adults with chronic multisite pain: a randomized controlled pilot study. Aging clinical and experimental research, 30(11), 1335–1343. doi:10.1007/s40520-018-0922-0

 

Abstract

Background

Chronic pain is associated with poorer cognition and mobility, and fall risk in older adults.

Aims

To investigate the feasibility of a randomized trial of mind-body exercise (Tai Chi) versus light physical exercise in older adults with multisite pain.

Methods

Adults aged ≥ 65y with multisite pain who reported falling in the past year or current use of an assistive device were recruited from Boston area communities. Participants were randomized to either a Tai Chi or a light physical exercise program, offered twice weekly for 12 weeks. The primary outcomes were feasibility and acceptability. Secondary outcomes included pain characteristics, cognition, physical function, gait mobility, fear of falling, and fall frequency.

Results

Of 176 adults screened, 85 were eligible, and 54 consented and enrolled (average age 75±8y; 96.30% white; 75.93% female). The dropout rate was 18% for Tai Chi and 12% for light physical exercise. For those completing the study, exercise class attendance was 76% for Tai Chi and 82% for light physical exercise. There were no significant group differences in most secondary outcomes. Tai Chi significantly lowered pain severity (4.58±1.73 to 3.73±1.79, p<0.01) and pain interference (4.20±2.53 to 3.16±2.28, p<0.05), reduced fear of falling (90.82±9.59 to 96.84±10.67, p<0.05), and improved several single-task and dual-task gait variables, while light physical exercise did not change these measures

Discussion and Conclusions

This study demonstrated the feasibility and acceptability of conducting a larger randomized controlled trial in older adults with multisite pain. Study findings and challenges encountered will inform future research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126990/

 

Change the Brain to Reduce Chronic Pain with Mindfulness

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Change the Brain to Reduce Chronic Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“While many experts recommend mindfulness-based practices to manage pain, the goal of those practices is typically not to remove pain entirely, but to change your relationship with it so that you are able to experience relief and healing in the middle of uncomfortable physical sensations.” – Jon Kabat-Zinn

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings to demonstrate that mindfulness practices, in general, are effective in treating pain. Pain experiences are processed in the nervous system. So, it’s likely that mindfulness practices somehow alter the brain’s processing of pain. In today’s Research News article “The neural mechanisms of mindfulness-based pain relief: a functional magnetic resonance imaging-based review and primer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6728003/), Zeidan and colleagues review and summarize the published research studies on the changes in the brain that accompany the relief of chronic pain by mindfulness-based treatments.

 

They report that mindfulness appears to reduce pain by increasing attention to the present moment. High levels of mindfulness are associated with lower pain experiences with chronic conditions and that these levels are associated with less activity in the, so called, default mode network in the brain (consisting of the medial prefrontal cortex, posterior cingulate cortex/precuneus, inferior, and lateral temporal cortices). The default mode network is thought to underlie self-referential thinking and mind wandering.

 

The research also reports that short-term meditation reduces chronic pain and increases communications between cortical areas and the thalamus suggesting top down control of pain sensitivity. On the other hand, long-term meditation practice reduces chronic pain by deactivating prefrontal cortical areas and activating somatosensory cortical regions. This suggests that long-term meditation reduces cognitive appraisals of arising sensory events. Finally, the research suggests that the neural mechanisms of mindfulness-based pain relief are different than opioid pain relief suggesting that there are different mechanisms involved.

 

Obviously, much more research is needed. But there is an evolving picture of the changes in the brain that occur with mindfulness practices that produce relief of chronic pain. It is different from that of opioid pain relievers and primarily involves high level, cortical, neural systems associated with attention to stimuli and the thought processes that arise evaluating those stimuli. In other words, mindfulness-based practices affect pain processing at the highest levels of attention and thinking.

 

So, change the brain to reduce chronic pain with mindfulness.

 

“Chronic pain is frustrating and debilitating. The last thing we want to do is pay more attention to our pain. But that’s the premise behind mindfulness, a highly effective practice for chronic pain.” – Margarita Tartakovsky,

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Zeidan, F., Baumgartner, J. N., & Coghill, R. C. (2019). The neural mechanisms of mindfulness-based pain relief: a functional magnetic resonance imaging-based review and primer. Pain reports, 4(4), e759. doi:10.1097/PR9.0000000000000759

 

Abstract

The advent of neuroimaging methodologies, such as functional magnetic resonance imaging (fMRI), has significantly advanced our understanding of the neurophysiological processes supporting a wide spectrum of mind–body approaches to treat pain. A promising self-regulatory practice, mindfulness meditation, reliably alleviates experimentally induced and clinical pain. Yet, the neural mechanisms supporting mindfulness-based pain relief remain poorly characterized. The present review delineates evidence from a spectrum of fMRI studies showing that the neural mechanisms supporting mindfulness-induced pain attenuation differ across varying levels of meditative experience. After brief mindfulness-based mental training (ie, less than 10 hours of practice), mindfulness-based pain relief is associated with higher order (orbitofrontal cortex and rostral anterior cingulate cortex) regulation of low-level nociceptive neural targets (thalamus and primary somatosensory cortex), suggesting an engagement of unique, reappraisal mechanisms. By contrast, mindfulness-based pain relief after extensive training (greater than 1000 hours of practice) is associated with deactivation of prefrontal and greater activation of somatosensory cortical regions, demonstrating an ability to reduce appraisals of arising sensory events. We also describe recent findings showing that higher levels of dispositional mindfulness, in meditation-naïve individuals, are associated with lower pain and greater deactivation of the posterior cingulate cortex, a neural mechanism implicated in self-referential processes. A brief fMRI primer is presented describing appropriate steps and considerations to conduct studies combining mindfulness, pain, and fMRI. We postulate that the identification of the active analgesic neural substrates involved in mindfulness can be used to inform the development and optimization of behavioral therapies to specifically target pain, an important consideration for the ongoing opioid and chronic pain epidemic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6728003/

 

Improve Low Back Pain with Tai Chi Practice Alone or with Other Treatments

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Improve Low Back Pain with Tai Chi Practice Alone or with Other Treatments

 

By John M. de Castro, Ph.D.

 

“We would expect disability to improve because tai chi involves physical activity and exercise, and this would improve people’s ability to do physical tasks around the house, sports, work, etc.,” – Chris Maher

 

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, addiction, and fatal overdoses.

 

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. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Tai Chi is a mindfulness practice that is safe and gentle and has been shown to improve spinal health and reduce pain. The evidence is accumulating, so, it would seem reasonable to summarize what has been learned regarding the ability of Tai Chi practice to treat chronic low back pain.

 

In today’s Research News article “Effect of Tai Chi alone or as additional therapy on low back pain: Systematic review and meta-analysis of randomized controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750325/), Qin and colleagues review, summarize, and perform a met-analysis of the effectiveness of Tai Chi practice for the treatment of low back pain. They identified 10 randomized controlled trials employing a total of 959 participants.

 

They report that the studies found that Tai Chi practice either alone or in combination with other therapies significantly reduced low back pain level and the patient’s disability in comparison to control groups. Improvements in disability included pain intensity, personal care, lifting, walking, standing, sleeping, social life, and travelling. This summary makes it clear that Tai Chi practice is a safe and effective treatment for chronic low back pain.

 

Tai Chi is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent means to treat with chronic low back pain.

 

So, improve low back pain with Tai Chi practice alone or with other treatments.

 

“Tai chi helps with back pain in several ways. It strengthens the muscles in your abdomen and pelvic area that are crucial to supporting the lower back; it improves your balance and flexibility; and it makes you more aware of your posture when you sit, stand, and walk.” – Benjamin Kligler

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Qin, J., Zhang, Y., Wu, L., He, Z., Huang, J., Tao, J., & Chen, L. (2019). Effect of Tai Chi alone or as additional therapy on low back pain: Systematic review and meta-analysis of randomized controlled trials. Medicine, 98(37), e17099. doi:10.1097/MD.0000000000017099

 

Abstract

Background:

This is the first systematic review evaluating and statistically synthesis the current studies regarding the effects of Tai Chi on pain and disability in patients with low back pain (LBP).

Methods:

Seven electronic databases including PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang and VIP information from inception to early March 2019 were searched. The Physiotherapy Evidence Database (PEDro) Scale was used to assess quality of all included randomized controlled trials (RCTs). The pooled effect size (weight mean difference, WMD) and 95% confidence interval (CI) were calculated to determine the effect of Tai Chi on pain and disability among LBP patients based on random effects model.

Results:

The aggregated results of the meta-analysis suggested that Tai Chi significantly decreased pain (WMD = −1.27, 95%CI −1.50 to −1.04, P < .00001, I2 = 74%) and improve function disability, Oswestry disability index (ODI) subitems: pain intensity (WMD = −1.70, 95% CI −2.63 to −0.76, P = .0004, I2 = 89%); personal care (WMD = −1.93, 95% CI −2.86 to −1.00, P < .0001, I2 = 90%); lifting (WMD = −1.69, 95% CI −2.22 to −1.15, P < .0001, I2 = 66%); walking (WMD = −2.05, 95% CI −3.05 to −1.06, P < .0001, I2 = 88%); standing (WMD = −1.70, 95% CI −2.51 to −0.89, P < .0001, I2 = 84%); sleeping (WMD = −2.98, 95% CI −3.73 to −2.22, P < .00001, I2 = 80%); social life (WMD = −2.06, 95% CI −2.77 to −1.35, P < 0.00001, I2 = 80%) and traveling (WMD = −2.20, 95% CI −3.21 to −1.19, P < .0001, I2 = 90%), Japanese Orthopedic Association (JOA) score (WMD = 7.22, 95% CI 5.59–8.86, P < .00001, I2 = 0%), Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36) physical functioning (WMD = 3.30, 95% CI 1.92–4.68, P < .00001), and Roland-Morris Disability Questionnaire (RMDQ) (WMD = −2.19, 95% CI −2.56 to −1.82, P < .00001).

Conclusion:

We drew a cautious conclusion that Tai Chi alone or as additional therapy with routine physical therapy may decrease pain and improve function disability for patients with LBP. Further trials are needed to be conducted with our suggestions mentioned in the systematic review.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750325/