• The authors of this meta-analysis evaluated the efficacy of mindfulness-based stress reduction (MBSR) for the treatment of low-back pain. There was an association between MBSR and improved pain and physical functioning in the short-term, but this was not sustained. There was no impact on disability, mental health, pain acceptance, and mindfulness. There were no adverse events related to MBSR.
• MBSR may produce short-term improvements in pain and functioning in patients with low-back pain, but the effects are not durable.

Abstract

BACKGROUND

Mindfulness-based stress reduction (MBSR) is frequently used to treat pain-related conditions, but its effects on low back pain are uncertain.

PURPOSE

To assess the efficacy and safety of MBSR in patients with low back pain.

DATA SOURCES

Searches of MEDLINE/PubMed, Scopus, the Cochrane Library, and PsycINFO to 15 June 2016.

STUDY SELECTION

Randomized controlled trials (RCTs) that compared MBSR with usual care or an active comparator and assessed pain intensity or pain-related disability as a primary outcome in patients with low back pain.

DATA EXTRACTION

Two reviewers independently extracted data on study characteristics, patients, interventions, outcome measures, and results at short- and long-term follow-up. Risk of bias was assessed using the Cochrane risk-of-bias tool.

DATA SYNTHESIS

Seven RCTs involving 864 patients with low back pain were eligible for review. Compared with usual care, MBSR was associated with short-term improvements in pain intensity (4 RCTs; mean difference [MD], -0.96 point on a numerical rating scale [95% CI, -1.64 to -0.34 point]; standardized mean difference [SMD], -0.48 point [CI, -0.82 to -0.14 point]) and physical functioning (2 RCTs; MD, 2.50 [CI, 0.90 to 4.10 point]; SMD, 0.25 [CI, 0.09 to 0.41 point]) that were not sustained in the long term. Between-group differences in disability, mental health, pain acceptance, and mindfulness were not significant at short- or long-term follow-up. Compared with an active comparator, MBSR was not associated with significant differences in short- or long-term outcomes. No serious adverse events were reported.

LIMITATION

The number of eligible RCTs was limited; only 3 evaluated MBSR against an active comparator.

CONCLUSION

Mindfulness-based stress reduction may be associated with short-term effects on pain intensity and physical functioning. Long-term RCTs that compare MBSR versus active treatments are needed in order to best understand the role of MBSR in the management of low back pain.

Journal Abstract

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