Chronic low back pain is a major health problem, affecting about one in four Americans. It’s the leading cause of disability worldwide, and many people find that current treatments just don’t work.
Over 80% of people with long-term back pain wish there were better options. Without relief, many turn to opioids, which carry serious risks, including addiction.
Now, a team of researchers from Penn State College of Medicine and the University of Wisconsin-Madison has found a promising alternative.
In a new study, they discovered that two non-drug treatments — mindfulness and cognitive behavioral therapy (CBT) — can help people manage their chronic back pain, improve their quality of life, and reduce their need for opioids. These benefits lasted for up to a year after the treatment.
The study, published in JAMA Network Open, followed 770 adults with moderate-to-severe back pain who had been using opioids daily for at least three months. These participants had tried many treatments before without success. The study was conducted in three U.S. cities: Madison, Boston, and Salt Lake City.
Participants were randomly assigned to either a mindfulness group or a CBT group. Both groups attended eight weeks of therapist-led, two-hour sessions.
The mindfulness group learned to observe pain and other body sensations without reacting negatively, while the CBT group focused on changing negative thoughts and developing coping skills. Participants were also asked to practice at home for 30 minutes a day, six days a week, and to keep following their usual medical care.
Although they weren’t asked to reduce their pain medication, many people ended up doing so. Both groups showed long-term improvements in pain levels, daily functioning, and quality of life. Participants also reduced their opioid use over time, simply by using the new skills they learned to cope with pain more effectively.
The researchers say this study is the largest so far to compare mindfulness and CBT for chronic pain in people who are already taking opioids. It’s also one of the few to track patients for a full year after treatment. The results suggest that these therapies are safe, effective, and worth offering as standard options for managing chronic back pain.
Pain expert Dr. Aleksandra Zgierska, who led the study, said that behavioral therapies like mindfulness and CBT should be part of the care available to people with chronic pain. Dr. Bruce Barrett, a co-lead of the study, pointed out that most people in the study had serious back pain and had been on opioids for a long time — and still saw real improvements.
Pain management specialists say that chronic pain is complicated, and people need a mix of tools to manage it. Mindfulness and CBT don’t just treat pain directly — they help people change how they relate to pain, reducing stress and suffering. This, in turn, can lead to better physical functioning and less need for medication.
Patients in the study reported that they felt more in control of their pain. Some even chose to reduce their opioid use on their own. The study shows that even small habits — like taking a mindful breath before reaching for medication — can make a big difference.
Experts say this kind of treatment offers hope. While it’s not a cure, it gives people tools to live better, even with pain. These techniques can be useful for many different kinds of chronic pain and may help people at all stages of their pain journey.
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The study is published in JAMA Network Open.
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