Table 14Chronic low back pain: mindfulness-based stress reduction

Author, Year, Followup, Pain Duration, Study QualityInterventionPopulationFunction and Pain OutcomesOther Outcomes

Banth, 2015

1 month

Duration of pain: ≥6 months

Poor

A. Mindfulness-based stress reduction (n=24)

8 1.5-hour sessions over 8 weeks

B. Usual care (n=24)

48 of 88 patients were analyzed, n for each group

A vs. B ()

Age: 40 years

Female: 100%

Baseline function:

McGill Pain questionnaire total score (0-45): 26.08 vs. 26.71

A vs. B

1 month

McGill Pain questionnaire total score (0-45): 13.58 vs. 23.60

A vs. B

1 month

SF-12 Mental component (0-100): 31.54 (4.3) vs. 24.29 (5.2)

SF-12 Physical component (0-100): 28.08 (4.2) vs. 21.08 (3.3)

Cherkin, 2016

Herman, 2017

Cherkin, 2017 (2 year data from Cherkin, 2016)

22 months

Duration of pain: >3 months (>1 year in 80% of patients)

Fair

A. Mindfulness-based stress reduction (n=116), 8 2-hour sessions over 8 weeks (optional 6 hour retreat)

B. Usual care (n=113)

A vs. B

50 vs. 49 years

Female: 61% vs. 77%

Baseline modified (0-23): 11.8 vs. 10.9

Baseline pain bothersomeness (0-10): 6.1 vs. 6.0

A vs. B

4.5 months

Modified (0-23), mean change from baseline: −4.33 (95% −5.16 to −3.51) vs. −2.96 (95% CI −3.79 to −2.14)

Pain bothersomeness (0-10), mean change from baseline: −1.48 (95% −1.86 to −1.11) vs. −0.84 (95% CI −1.21 to −0.46)

≥30% improvement in : 60.5% (95% 52.0 to 70.3) vs. 44.1% (95% CI 35.9to 54.2)

≥30% improvement in pain bothersomeness: 43.6% (95% 35.6 to 53.3) vs. 26.6% (95% CI 19.8 to 35.9)

10 months

Modified , mean change from baseline:−5.3 (95% −6.16to −4.43) vs. −4.78 (95% CI −5.67to −3.89) vs. −3.43 (95% CI −4.33 to −2.52)

Pain bothersomeness, mean change from baseline: −1.95 (95% −2.32 to −1.59) vs. −1.10 (95% CI −1.48 to −0.71)

≥30% improvement in : 68.6% (95% 60.3 to 78.1) vs. 48.6% (95% CI 40.3 to 58.6)

≥30% improvement in pain bothersomeness: 48.5% (95% 40.3 to 58.3) vs. 31.0% (95% CI 23.8 to 40.3)

22 months

Modified (0-23): −4.09 (95% −5.08 to −3.10) vs. −2.74 (95% CI−3.81to −1.68)

≥30% improvement in modified : 55.4% (95% 46.9 to 65.5) vs. 42.05% (95% CI 33.8 to 52.2)

Pain bothersomeness: −1.57 (95% −1.97 to −1.17) vs. −1.25 (95% CI −1.69 to −0.81

≥30% improvement in pain bothersomeness: 41.2% (95% 33.2 to 51.0) vs. 31.1% (95% CI 23.9 to 40.5)

A vs. B

4.5 months

SF-12 MCS, mean change from baseline (0-100): 0.45 (95% −0.85 to 1.76) vs. 2.13 (95% CI 0.86 to 3.40) vs. −1.11 (95% CI −2.39 to 0.17)

SF-12 PCS, mean change from baseline (0-100): 3.58 (95% 2.15 to 5.01) vs. 3.27 (95% CI 2.09 to 4.44)

Used medications for : 43.4% (95% 35.9to 52.6) vs. 54.2 (95% CI 46.2 to 63.6)

10 months

SF-12 MCS, mean change from baseline: 2.01 (95% 0.74 to 3.28) vs. 0.75 (95% CI −0.58 to 2.08)

SF-12 PCS, mean change from baseline: 3.87 (95% 2.55 to 5.19) vs. 2.93 (95% CI 1.70 to 4.16)

Used medications for : 46.8% (95% 39.2 to 55.9) vs. 52.9% (95% CI 45.1 to 62.0)

Total costs: $5,580 (95% $3,465, $8,343) vs. $6,304 (95% CI $4,193, $9,805)

Morone, 2009

4 months

Duration of pain: Mean 9.4 to 11 years

Fair

A. Mindfulness-based stress reduction (n=16), 8 1.5-hour sessions over 8 weeks

B. Attention control (education) (n=19)

A vs. B

Age 78 vs. 73 years

Female: 69% vs. 58%

Baseline : 8.8 vs. 11.3

Baseline McGill Pain Questionnaire Current Pain (0-10): 2.9 vs. 4.4

A vs. B

4 months

: 7.6 (95% 6.2 to 8.7) vs. 10.0 (95% CI 8.7 to 11.2)

McGill Pain Questionnaire Total Score (0-45): 12.4 (95% 10.4 to 14.6) vs. 12.0 (95% CI 10.2 to 13.7)

McGill Pain Questionnaire Current Pain (0-10): 2.3 (95% 1.6 to 2.8) vs. 3.7 (95% CI 3.1 to 4.3)

A vs. B

4 months

SF-36 Pain Score (10-62): 41.4 (95% 39.8 to 43.1) vs. 40.5 (95% CI 38.7 to 42.2)

Morone, 2016

4.5 months

Duration of pain: Mean 11 years

Fair

A. Mindfulness-based stress reduction (n=140), 8 1.5-hour sessions over 8 weeks, with 6 monthly booster sessions

B. Control, (health education) (n=142)

A vs. B

Age: 75 vs. 74 years

Female: 66% vs. 66%

Baseline (0-24): 15.6 vs. 15.4

Baseline Pain (0-20 ): 11.0 vs. 10.5

A vs. B

4.5 months

: 12.2 vs. 12.6, adjusted difference −0.4 (95% −1.5 to 0.7)

improved ≥2.5 points: 49.2% (58/117) vs. 48.9% (66/135), p=0.97

Pain (0-20 ): 9.5 vs. 10.6, adjusted difference −1.1 (95% −2.2 to −0.01)

Pain improved ≥30%: 36.7% (43/117) vs. 26.7% (36/135), p=0.09

A vs. B

4.5 months

SF-36 Global Health Composite (9-67): 42.4 vs. 41.2, adjusted difference 0.2 (95% −1.9 to 2.4)

SF-36 Physical Health Composite (20 to 65): 41.2 vs. 41.2, adjusted difference −0.1 (95% −1.9 to 1.8)

Zgierska, 2016

4.5 months

Duration of pain: Mean 14 years

Poor

A. Mindfulness-based stress reduction (n=21): 8 weekly 2 hour group sessions plus 30 minutes/day, 6 days/week of at home practice

B. Usual care (n=14)

Overall

Age: 51.8 years

Female: 80%

Baseline (0-100): 68.1 vs. 64.5

Baseline Brief Pain Inventory pain intensity (0-10): 6.3 vs. 4.9

Baseline Opioid dose 166.9 vs. 120.3

A vs. B

4.5 months

(0-100): −5.0 (95% 9.7 to 0.2) vs. 1.6 (95% CI −4.3 to 7.4)

Brief Pain Inventory pain intensity: −0.5 (95% −1.1 to 0.02) vs. 0.5 (95% CI 0.2 to 1.2)

A vs. B

4.5 months

Opioid dose (mg morphine equivalents): −10.1 (95% −35.5 to 15.2) vs. −0.2 (95% CI −31.4 to 30.9)

= confidence interval; MCS = Mental Component Summary; = not reported; = numeric rating scale; = Oswestry Disability Index; PCS = Physical Component Summary; = Roland-Morris Disability Questionnaire; SF-12 = Short-Form 12 Questionaire SF-36 = Short-Form 36 Questionnaire

a

Unless otherwise noted, followup time is calculated from the end of the treatment period

From: Results

Cover of Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update
Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update [Internet].
Comparative Effectiveness Review, No. 227.
Skelly AC, Chou R, Dettori JR, et al.

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