Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial
Objective. To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP). Design. 26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone). Setting. Outpatient...
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| Veröffentlicht in: | Pain medicine (Malden, Mass.) Mass.), 2016-10, Vol.17 (10), p.1865-1881 |
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| creator | Zgierska, Aleksandra E. Burzinski, Cindy A. Cox, Jennifer Kloke, John Stegner, Aaron Cook, Dane B. Singles, Janice Mirgain, Shilagh Coe, Christopher L. Bačkonja, Miroslav |
| description | Objective. To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP).
Design. 26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone).
Setting. Outpatient.
Subjects. Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months.
Methods. The intervention comprised eight weekly group sessions (meditation and CLBP-specific CBT components) and 30 minutes/day, 6 days/week of at-home practice. Outcome measures were collected at baseline, 8, and 26 weeks: primary-pain severity (Brief Pain Inventory) and function/disability (Oswestry Disability Index); secondary-pain acceptance, opioid dose, pain sensitivity to thermal stimuli, and serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein).
Results. Thirty-five (21 experimental, 14 control) participants were enrolled and completed the study. They were 51.8 ± 9.7 years old, 80% female, with severe CLBP-related disability (66.7 ± 11.4), moderate pain severity (5.8 ± 1.4), and taking 148.3 ± 129.2 mg/day of MED. Results of the intention-to-treat analysis showed that, compared with controls, the meditation-CBT group reduced pain severity ratings during the study (P = 0.045), with between-group difference in score change reaching 1 point at 26 weeks (95% Confidence Interval: 0.2,1.9; Cohen’s d = 0.86), and decreased pain sensitivity to thermal stimuli (P < 0.05), without adverse events. Exploratory analyses suggested a relationship between the extent of meditation practice and the magnitude of intervention benefits.
Conclusions. Meditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP. |
| doi_str_mv | 10.1093/pm/pnw006 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5063022</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/pm/pnw006</oup_id><sourcerecordid>1826656907</sourcerecordid><originalsourceid>FETCH-LOGICAL-c432t-acc0157550dd96628882760104cc927d990037f74e4c211386fff8d2a89ab7633</originalsourceid><addsrcrecordid>eNp9kstu1DAUhiMEoqWw4AWQJVjAItSXxHG6QKIjCpWmatUOa8u1T2ZcEjvYSarh_XgvPBcqYMHKts7nz_-xTpa9JPg9wTU77rvj3t1jzB9lh6SkPC84qx7v95RV5UH2LMY7jAkvBHuaHVBecyFKfJj9vLDONGPrIEZ0AcYOarDeIeUMmvmls4OdAJ3CSk3WB9WixQqC6tfo3A0QJnBb-hrMqCGiK2UduoEJgh3WW8cNuLhxbM6pdtlbb02-CKAGSC-sgndWo7m_R6dKf9sKTtCVbf2AzlIy65YRNcF3SKHr5POd_bG5590QfNum7SJY1T7PnjSqjfBivx5lX88-LWZf8vnl5_PZx3muC0aHXGmNSVmVJTam5pwKIWjFMcGF1jWtTF1jzKqmKqDQlBAmeNM0wlAlanVbccaOsg87bz_edmB0aj_9ieyD7VRYS6-s_Lvi7Eou_SRLzBmmNAne7gXBfx8hDrKzUUPbKgd-jJIIynnJa1wl9PU_6J0fg0vtSVKLMuWvSp6odztKBx9jgOYhDMFyMxyy7-RuOBL76s_0D-TvaUjAmx3gx_4_nl-ea8Xk</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1985966756</pqid></control><display><type>article</type><title>Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Zgierska, Aleksandra E. ; Burzinski, Cindy A. ; Cox, Jennifer ; Kloke, John ; Stegner, Aaron ; Cook, Dane B. ; Singles, Janice ; Mirgain, Shilagh ; Coe, Christopher L. ; Bačkonja, Miroslav</creator><creatorcontrib>Zgierska, Aleksandra E. ; Burzinski, Cindy A. ; Cox, Jennifer ; Kloke, John ; Stegner, Aaron ; Cook, Dane B. ; Singles, Janice ; Mirgain, Shilagh ; Coe, Christopher L. ; Bačkonja, Miroslav</creatorcontrib><description>Objective. To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP).
Design. 26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone).
Setting. Outpatient.
Subjects. Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months.
Methods. The intervention comprised eight weekly group sessions (meditation and CLBP-specific CBT components) and 30 minutes/day, 6 days/week of at-home practice. Outcome measures were collected at baseline, 8, and 26 weeks: primary-pain severity (Brief Pain Inventory) and function/disability (Oswestry Disability Index); secondary-pain acceptance, opioid dose, pain sensitivity to thermal stimuli, and serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein).
Results. Thirty-five (21 experimental, 14 control) participants were enrolled and completed the study. They were 51.8 ± 9.7 years old, 80% female, with severe CLBP-related disability (66.7 ± 11.4), moderate pain severity (5.8 ± 1.4), and taking 148.3 ± 129.2 mg/day of MED. Results of the intention-to-treat analysis showed that, compared with controls, the meditation-CBT group reduced pain severity ratings during the study (P = 0.045), with between-group difference in score change reaching 1 point at 26 weeks (95% Confidence Interval: 0.2,1.9; Cohen’s d = 0.86), and decreased pain sensitivity to thermal stimuli (P < 0.05), without adverse events. Exploratory analyses suggested a relationship between the extent of meditation practice and the magnitude of intervention benefits.
Conclusions. Meditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP.</description><identifier>ISSN: 1526-2375</identifier><identifier>EISSN: 1526-4637</identifier><identifier>DOI: 10.1093/pm/pnw006</identifier><identifier>PMID: 26968850</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Analgesics, Opioid - administration & dosage ; Back pain ; Behavior modification ; C-reactive protein ; Chronic Pain - diagnosis ; Chronic Pain - psychology ; Chronic Pain - therapy ; Clinical trials ; Cognitive ability ; Cognitive behavioral therapy ; Cognitive therapy ; Cognitive Therapy - methods ; Evidence-based medicine ; Female ; Hot Temperature - adverse effects ; Humans ; Interferon ; Interleukins ; Low back pain ; Low Back Pain - diagnosis ; Low Back Pain - psychology ; Low Back Pain - therapy ; Male ; Meditation ; Meditation - methods ; Meditation - psychology ; Middle Aged ; Mindfulness ; Mindfulness - methods ; Morphine ; Motivation ; Narcotics ; Opioids ; OPIOIDS, SUBSTANCE ABUSE & ADDICTIONS SECTION ; Pain ; Pain Measurement - methods ; Pain Measurement - psychology ; Pilot Projects ; Severity of Illness Index ; Single-Blind Method ; Thermal stimuli ; Treatment Outcome ; Tumor necrosis factor-α</subject><ispartof>Pain medicine (Malden, Mass.), 2016-10, Vol.17 (10), p.1865-1881</ispartof><rights>2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2016</rights><rights>2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><rights>Copyright © 2016 American Academy of Pain Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c432t-acc0157550dd96628882760104cc927d990037f74e4c211386fff8d2a89ab7633</citedby><cites>FETCH-LOGICAL-c432t-acc0157550dd96628882760104cc927d990037f74e4c211386fff8d2a89ab7633</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26968850$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zgierska, Aleksandra E.</creatorcontrib><creatorcontrib>Burzinski, Cindy A.</creatorcontrib><creatorcontrib>Cox, Jennifer</creatorcontrib><creatorcontrib>Kloke, John</creatorcontrib><creatorcontrib>Stegner, Aaron</creatorcontrib><creatorcontrib>Cook, Dane B.</creatorcontrib><creatorcontrib>Singles, Janice</creatorcontrib><creatorcontrib>Mirgain, Shilagh</creatorcontrib><creatorcontrib>Coe, Christopher L.</creatorcontrib><creatorcontrib>Bačkonja, Miroslav</creatorcontrib><title>Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial</title><title>Pain medicine (Malden, Mass.)</title><addtitle>Pain Med</addtitle><description>Objective. To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP).
Design. 26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone).
Setting. Outpatient.
Subjects. Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months.
Methods. The intervention comprised eight weekly group sessions (meditation and CLBP-specific CBT components) and 30 minutes/day, 6 days/week of at-home practice. Outcome measures were collected at baseline, 8, and 26 weeks: primary-pain severity (Brief Pain Inventory) and function/disability (Oswestry Disability Index); secondary-pain acceptance, opioid dose, pain sensitivity to thermal stimuli, and serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein).
Results. Thirty-five (21 experimental, 14 control) participants were enrolled and completed the study. They were 51.8 ± 9.7 years old, 80% female, with severe CLBP-related disability (66.7 ± 11.4), moderate pain severity (5.8 ± 1.4), and taking 148.3 ± 129.2 mg/day of MED. Results of the intention-to-treat analysis showed that, compared with controls, the meditation-CBT group reduced pain severity ratings during the study (P = 0.045), with between-group difference in score change reaching 1 point at 26 weeks (95% Confidence Interval: 0.2,1.9; Cohen’s d = 0.86), and decreased pain sensitivity to thermal stimuli (P < 0.05), without adverse events. Exploratory analyses suggested a relationship between the extent of meditation practice and the magnitude of intervention benefits.
Conclusions. Meditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP.</description><subject>Adult</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Back pain</subject><subject>Behavior modification</subject><subject>C-reactive protein</subject><subject>Chronic Pain - diagnosis</subject><subject>Chronic Pain - psychology</subject><subject>Chronic Pain - therapy</subject><subject>Clinical trials</subject><subject>Cognitive ability</subject><subject>Cognitive behavioral therapy</subject><subject>Cognitive therapy</subject><subject>Cognitive Therapy - methods</subject><subject>Evidence-based medicine</subject><subject>Female</subject><subject>Hot Temperature - adverse effects</subject><subject>Humans</subject><subject>Interferon</subject><subject>Interleukins</subject><subject>Low back pain</subject><subject>Low Back Pain - diagnosis</subject><subject>Low Back Pain - psychology</subject><subject>Low Back Pain - therapy</subject><subject>Male</subject><subject>Meditation</subject><subject>Meditation - methods</subject><subject>Meditation - psychology</subject><subject>Middle Aged</subject><subject>Mindfulness</subject><subject>Mindfulness - methods</subject><subject>Morphine</subject><subject>Motivation</subject><subject>Narcotics</subject><subject>Opioids</subject><subject>OPIOIDS, SUBSTANCE ABUSE & ADDICTIONS SECTION</subject><subject>Pain</subject><subject>Pain Measurement - methods</subject><subject>Pain Measurement - psychology</subject><subject>Pilot Projects</subject><subject>Severity of Illness Index</subject><subject>Single-Blind Method</subject><subject>Thermal stimuli</subject><subject>Treatment Outcome</subject><subject>Tumor necrosis factor-α</subject><issn>1526-2375</issn><issn>1526-4637</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kstu1DAUhiMEoqWw4AWQJVjAItSXxHG6QKIjCpWmatUOa8u1T2ZcEjvYSarh_XgvPBcqYMHKts7nz_-xTpa9JPg9wTU77rvj3t1jzB9lh6SkPC84qx7v95RV5UH2LMY7jAkvBHuaHVBecyFKfJj9vLDONGPrIEZ0AcYOarDeIeUMmvmls4OdAJ3CSk3WB9WixQqC6tfo3A0QJnBb-hrMqCGiK2UduoEJgh3WW8cNuLhxbM6pdtlbb02-CKAGSC-sgndWo7m_R6dKf9sKTtCVbf2AzlIy65YRNcF3SKHr5POd_bG5590QfNum7SJY1T7PnjSqjfBivx5lX88-LWZf8vnl5_PZx3muC0aHXGmNSVmVJTam5pwKIWjFMcGF1jWtTF1jzKqmKqDQlBAmeNM0wlAlanVbccaOsg87bz_edmB0aj_9ieyD7VRYS6-s_Lvi7Eou_SRLzBmmNAne7gXBfx8hDrKzUUPbKgd-jJIIynnJa1wl9PU_6J0fg0vtSVKLMuWvSp6odztKBx9jgOYhDMFyMxyy7-RuOBL76s_0D-TvaUjAmx3gx_4_nl-ea8Xk</recordid><startdate>20161001</startdate><enddate>20161001</enddate><creator>Zgierska, Aleksandra E.</creator><creator>Burzinski, Cindy A.</creator><creator>Cox, Jennifer</creator><creator>Kloke, John</creator><creator>Stegner, Aaron</creator><creator>Cook, Dane B.</creator><creator>Singles, Janice</creator><creator>Mirgain, Shilagh</creator><creator>Coe, Christopher L.</creator><creator>Bačkonja, Miroslav</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20161001</creationdate><title>Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial</title><author>Zgierska, Aleksandra E. ; Burzinski, Cindy A. ; Cox, Jennifer ; Kloke, John ; Stegner, Aaron ; Cook, Dane B. ; Singles, Janice ; Mirgain, Shilagh ; Coe, Christopher L. ; Bačkonja, Miroslav</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c432t-acc0157550dd96628882760104cc927d990037f74e4c211386fff8d2a89ab7633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Analgesics, Opioid - administration & dosage</topic><topic>Back pain</topic><topic>Behavior modification</topic><topic>C-reactive protein</topic><topic>Chronic Pain - diagnosis</topic><topic>Chronic Pain - psychology</topic><topic>Chronic Pain - therapy</topic><topic>Clinical trials</topic><topic>Cognitive ability</topic><topic>Cognitive behavioral therapy</topic><topic>Cognitive therapy</topic><topic>Cognitive Therapy - methods</topic><topic>Evidence-based medicine</topic><topic>Female</topic><topic>Hot Temperature - adverse effects</topic><topic>Humans</topic><topic>Interferon</topic><topic>Interleukins</topic><topic>Low back pain</topic><topic>Low Back Pain - diagnosis</topic><topic>Low Back Pain - psychology</topic><topic>Low Back Pain - therapy</topic><topic>Male</topic><topic>Meditation</topic><topic>Meditation - methods</topic><topic>Meditation - psychology</topic><topic>Middle Aged</topic><topic>Mindfulness</topic><topic>Mindfulness - methods</topic><topic>Morphine</topic><topic>Motivation</topic><topic>Narcotics</topic><topic>Opioids</topic><topic>OPIOIDS, SUBSTANCE ABUSE & ADDICTIONS SECTION</topic><topic>Pain</topic><topic>Pain Measurement - methods</topic><topic>Pain Measurement - psychology</topic><topic>Pilot Projects</topic><topic>Severity of Illness Index</topic><topic>Single-Blind Method</topic><topic>Thermal stimuli</topic><topic>Treatment Outcome</topic><topic>Tumor necrosis factor-α</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zgierska, Aleksandra E.</creatorcontrib><creatorcontrib>Burzinski, Cindy A.</creatorcontrib><creatorcontrib>Cox, Jennifer</creatorcontrib><creatorcontrib>Kloke, John</creatorcontrib><creatorcontrib>Stegner, Aaron</creatorcontrib><creatorcontrib>Cook, Dane B.</creatorcontrib><creatorcontrib>Singles, Janice</creatorcontrib><creatorcontrib>Mirgain, Shilagh</creatorcontrib><creatorcontrib>Coe, Christopher L.</creatorcontrib><creatorcontrib>Bačkonja, Miroslav</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pain medicine (Malden, Mass.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zgierska, Aleksandra E.</au><au>Burzinski, Cindy A.</au><au>Cox, Jennifer</au><au>Kloke, John</au><au>Stegner, Aaron</au><au>Cook, Dane B.</au><au>Singles, Janice</au><au>Mirgain, Shilagh</au><au>Coe, Christopher L.</au><au>Bačkonja, Miroslav</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial</atitle><jtitle>Pain medicine (Malden, Mass.)</jtitle><addtitle>Pain Med</addtitle><date>2016-10-01</date><risdate>2016</risdate><volume>17</volume><issue>10</issue><spage>1865</spage><epage>1881</epage><pages>1865-1881</pages><issn>1526-2375</issn><eissn>1526-4637</eissn><abstract>Objective. To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP).
Design. 26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone).
Setting. Outpatient.
Subjects. Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months.
Methods. The intervention comprised eight weekly group sessions (meditation and CLBP-specific CBT components) and 30 minutes/day, 6 days/week of at-home practice. Outcome measures were collected at baseline, 8, and 26 weeks: primary-pain severity (Brief Pain Inventory) and function/disability (Oswestry Disability Index); secondary-pain acceptance, opioid dose, pain sensitivity to thermal stimuli, and serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein).
Results. Thirty-five (21 experimental, 14 control) participants were enrolled and completed the study. They were 51.8 ± 9.7 years old, 80% female, with severe CLBP-related disability (66.7 ± 11.4), moderate pain severity (5.8 ± 1.4), and taking 148.3 ± 129.2 mg/day of MED. Results of the intention-to-treat analysis showed that, compared with controls, the meditation-CBT group reduced pain severity ratings during the study (P = 0.045), with between-group difference in score change reaching 1 point at 26 weeks (95% Confidence Interval: 0.2,1.9; Cohen’s d = 0.86), and decreased pain sensitivity to thermal stimuli (P < 0.05), without adverse events. Exploratory analyses suggested a relationship between the extent of meditation practice and the magnitude of intervention benefits.
Conclusions. Meditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>26968850</pmid><doi>10.1093/pm/pnw006</doi><tpages>17</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Pain medicine (Malden, Mass.), 2016-10, Vol.17 (10), p.1865-1881 |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Adult Analgesics, Opioid - administration & dosage Back pain Behavior modification C-reactive protein Chronic Pain - diagnosis Chronic Pain - psychology Chronic Pain - therapy Clinical trials Cognitive ability Cognitive behavioral therapy Cognitive therapy Cognitive Therapy - methods Evidence-based medicine Female Hot Temperature - adverse effects Humans Interferon Interleukins Low back pain Low Back Pain - diagnosis Low Back Pain - psychology Low Back Pain - therapy Male Meditation Meditation - methods Meditation - psychology Middle Aged Mindfulness Mindfulness - methods Morphine Motivation Narcotics Opioids OPIOIDS, SUBSTANCE ABUSE & ADDICTIONS SECTION Pain Pain Measurement - methods Pain Measurement - psychology Pilot Projects Severity of Illness Index Single-Blind Method Thermal stimuli Treatment Outcome Tumor necrosis factor-α |
| title | Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial |
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