Back pain is one of the most common health problems in the world.
It affects millions of people, and in the United States, about one in four adults struggles with chronic low back pain.
This kind of pain is not only uncomfortable but also one of the leading causes of disability worldwide. People who live with long-term back pain often find that their daily life, work, and happiness are affected.
For many, the treatment options feel endless, but the relief is often temporary or not strong enough. Because of this, many people rely on opioid medications, which can be addictive and come with dangerous side effects. More than 80 percent of people with this condition wish there were better and safer ways to manage it.
A new study gives hope. Researchers from Penn State College of Medicine and the University of Wisconsin-Madison, along with other partners, found that two kinds of non-drug therapies—mindfulness training and cognitive behavioral therapy (CBT)—can make a real difference for people with long-term low back pain.
The research showed that both methods helped patients improve their physical abilities, reduce pain, lower their reliance on opioids, and feel better about their quality of life. These improvements lasted for as long as a year after the therapies began.
The results were published in JAMA Network Open. This is the largest study so far that has compared mindfulness with CBT for people with chronic back pain who were already using opioids. Unlike many earlier studies that followed people for only a short time, this study tracked participants for a full 12 months.
Chronic pain is complex. It is not only a physical problem but also affects emotions and thoughts. Chronic low back pain is the most common kind of long-term pain not related to cancer that is treated with opioids.
While earlier studies hinted that people might benefit from behavioral therapies like mindfulness or CBT, most of those studies were small and short-term. This new research stands out because of its size, careful design, and long follow-up.
Mindfulness is the practice of paying attention to the present moment in a calm, non-judging way. In this study, people in the mindfulness group learned how to notice their pain sensations without letting the pain control their mind or mood.
CBT, on the other hand, is a type of therapy that teaches people how to recognize and change negative thought patterns. For people with chronic pain, this means learning how to think differently about their pain and how to use coping skills to manage it better. Both approaches give patients tools they can continue to use long after the therapy sessions end.
The study included 770 adults across three cities in the United States: Madison, Wisconsin; Boston, Massachusetts; and Salt Lake City, Utah. All participants had moderate to severe back pain that limited their lives, had already tried many treatments, and were taking daily opioid medications for at least three months.
They were randomly placed into either the mindfulness group or the CBT group. Each group attended therapist-led, two-hour sessions once a week for eight weeks.
Participants were also encouraged to practice what they learned at home for 30 minutes a day, six days a week. They continued their usual medical care during the study and were not asked to lower their opioid use.
The results were encouraging. At the end of the study, both groups reported less pain, better physical function, and improved mental and physical well-being. Many participants also ended up lowering their opioid dose, even though they were not told to.
The benefits lasted through the entire 12-month period, showing that these therapies have long-term value. Importantly, the treatments were safe, with no harmful side effects.
One of the researchers, Dr. Aleksandra Zgierska from Penn State, said that both mindfulness and CBT should be considered standard treatment options for people with opioid-treated chronic back pain. Other experts agreed that these therapies give people tools to handle their pain more effectively.
Instead of only relying on medication or surgery, people can learn skills that allow them to take back control of their lives. For example, something as simple as taking a mindful breath before reaching for medication may help patients pause, think, and sometimes choose different coping methods.
The study also showed that people with chronic pain often build their own “toolbox” of coping strategies. Mindfulness and CBT can be added to that toolbox as powerful, safe, and long-lasting tools. These therapies are not cures, but they teach people how to live with pain in a way that reduces suffering and increases the ability to function.
In conclusion, this large and well-designed study shows that both mindfulness and CBT can give lasting relief for people with chronic low back pain who are using opioids.
The therapies not only helped reduce pain and improve daily life but also supported lower use of opioids. This research gives real hope to millions of people who are searching for safe and effective ways to manage their pain.
If you care about pain, please read studies about Chronic morphine use for cancer pain may increase bone loss and findings of Scientists find a new hope for chronic pain.
For more about pain, please read studies about What you need to know about diabetes and joint pain and findings of Understanding the connection between liver disease and joint pain.
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