1. Mindfulness-based stress reduction may have short-term impact on pain intensity and physical functioning for low back pain patients.
2. Improvements for low back pain were not sustained in the long-term following mindfulness therapy.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Low back pain is a major cause of long-term disability. Lifetime prevalence for low back pain is approximately 75%. Despite the high prevalence of low back pain in our society, optimal clinical treatment is still unclear. Recently, mindfulness-based stress reduction (MBSR) interventions have been proposed as a potential complementary therapy to treat low back pain patients. The authors of this study aimed to conduct a systematic review to determine the efficacy and safety of MBSR in patients with low back pain. Overall, the observed that MBSR has few long-term impacts on low back pain relief. This study has several limitations. First, the number of eligible RCTs was small, especially in terms of follow-up analysis. Second, many of the trials included involved very few patients; only 3 studies included more than 40 patients per group. In general, the results of this study indicate that while MBSR interventions are associated with short-term improvements to low back pain, the effect is not clinically significant.
In-Depth [systematic review]: The authors conducted a systematic review and meta-analysis using the PRISMA guidelines and recommendations of the Cochrane collaboration. In total, MEDLINE/PubMed, Scopus, the Cochrane Library, and PsycINFO were searched to retrieve articles, of which 7 RCTs were included in the final analysis. Two independent reviewers assessed these texts, extracting data regarding study characteristics, sample characteristics, and characteristics of the intervention and comparison treatments. In general MBSR was associated with short-term improvements in pain intensity (4 RCTs; mean different -0.96 point on a numerical rating scale, 95%CI -1.64 to -0.34 point; standardized mean difference -0.48 point, 95%CI -0.82 to -0.14 point). Similar trends were also observed for physical functioning. No serious adverse events were recorded; however, the positive effects of MBSR were not long-term.
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