A groundbreaking study led by researchers from Penn State College of Medicine and the University of Wisconsin-Madison has revealed that mindfulness and cognitive behavioral therapy (CBT) can offer significant, long-term relief for adults suffering from chronic low back pain, particularly those who have been relying on opioids. The study, published in JAMA Network Open, demonstrates that these behavioral therapies not only reduce pain but also improve physical function, quality of life, and lower opioid use over time.
Chronic low back pain, which affects one in four Americans, is a leading cause of disability worldwide. Despite numerous treatments available, many individuals continue to struggle with inadequate pain relief, often resorting to opioids—drugs that carry a risk of addiction. More than 80% of people with chronic pain wish for more effective treatment options, highlighting the critical need for better solutions.
The study, the largest of its kind to compare mindfulness and CBT for opioid-treated chronic pain, involved 770 participants across three U.S. sites. Each participant had been suffering from moderate-to-severe pain, had limited mobility, and had not found relief from previous treatments. For eight weeks, participants were divided into two groups: one trained in mindfulness techniques and the other in CBT. Both therapies were conducted in therapist-led, two-hour group sessions. Participants were also encouraged to practice these techniques independently for 30 minutes a day.
Mindfulness involves focusing on bodily sensations to gain control over pain responses, while CBT helps individuals identify and alter negative thought patterns related to pain. The results were striking. By the end of the study, participants in both groups reported reduced pain levels, decreased opioid usage, and improved physical and mental health. These benefits persisted for up to 12 months.
Aleksandra Zgierska, the study’s lead author and a professor at Penn State College of Medicine, emphasized that both mindfulness and CBT are safe and effective, offering lasting improvements for those with chronic pain. “These evidence-based therapies should become a standard part of care for patients dealing with chronic low back pain,” she said.
The study also highlights a shift in how we view chronic pain management. While it’s commonly perceived as a physical condition requiring physical interventions, researchers are increasingly recognizing the value of psychological therapies. “People think of chronic pain as a purely physical condition, but behavioral therapies are an effective way to manage it,” said Eric Garland, senior author of the study.
Unlike previous trials, which were often small and short-term, this study followed participants over a longer period, providing more comprehensive data on the long-term benefits of these therapies. In fact, the study’s partnership with a diverse advisory panel—comprising clinicians, advocates, and patients—helped ensure that the research addressed real-world needs and produced results that were meaningful for both patients and healthcare providers.
Despite their effectiveness, the therapies are not seen as a “cure” but as valuable tools to help patients manage their pain more effectively. “Mindfulness and CBT are tools that can enhance your ability to cope with chronic pain and lead a more fulfilling life,” said Christin Veasley, co-author and founder of the Chronic Pain Research Alliance.
For participants, these therapies offered more than just pain relief. “The goal of pain management is to improve quality of life, increase function, and reduce suffering,” said Penney Cowan, founder of the American Chronic Pain Association. “This study provides hope—it shows that you can live with pain and still improve your quality of life.”
Overall, the research provides strong evidence that mindfulness and CBT are not only effective treatments for chronic low back pain but also offer a promising alternative to opioid reliance. These therapies, which empower patients to take control of their pain, could play a key role in addressing the opioid crisis while improving the lives of millions of chronic pain sufferers.
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