What is lumbar spine pain

Randomized controlled study on the effectiveness of meditation for chronic unspecific lumbar spine pain (lumbar spine syndrome)

Background: Persistent pain in the lumbar spine area is a frequent cause of visits to the doctor in Germany and can lead to incapacity for work and the use of rehabilitation services. In terms of therapy, in addition to conservative approaches (analgesics, physiotherapy), multimodal therapy concepts with components of psychotherapy and relaxation therapy are increasingly being investigated. Meditation, as part of Mind-Body Medicine (MBM), has not yet been largely developed in terms of its application for chronic back pain. In the present study, meditation for chronic, unspecific lumbar spine pain was compared to conventional, light physiotherapeutic exercises. METHODS: The randomized study group consisted of 68 participants (18-75 years) with back pain. The average pain intensity was at least 40 mm on the visual analog scale (VAS), the pain duration was more than 3 months. The intervention group received meditation group meetings with a meditation teacher (1 / week) over 8 weeks. For informational purposes, the control group received a so-called self-care book with the current standard of the conventional back school. The main target parameter was the change in pain intensity as an average value over the last 7 days. The evaluation took place after the end of the intervention (8 weeks) using the VAS, measured at 2 measuring points (start of study and end of intervention). The main outcome parameter was tested for confirmation for the intention-to-treat collective (ITT), and in a second step for the per-protocol population (PP). Secondary target parameters included questionnaires to record stress perception, quality of life and mood (CPSS, SF-36, POMS, HADS). Results: At the beginning of the study, the main target parameter, the average pain intensity, had a mean value of 59.3 ± 13.9 mm in the meditation group and 52.9 ± 11.8 mm in the control group. During the intervention period, there was an analogous decrease in the pain intensity of the back pain given at the beginning of the study in both groups. The adjusted mean value after 8 weeks of meditation was 40.8 ± 21.8 mm in the meditation group and 37.3 ± 18.2 mm in the control group (95% CI -11.6; 8.8). Compared to the control group, there was no statistical group difference in favor of the meditation group (p = 0.758). With regard to the secondary target parameters, the meditation group showed a significant improvement in terms of health-related stress perception (CPSS) after 4 and 8 weeks of the intervention period. Summary: Based on the examined results, no significant group difference of the main target parameter, the average pain intensity of the last 7 days, could be measured. Meditation was shown to be effective in the treatment of patients with chronic non-specific back pain in the lumbar spine area in the present study, although not superior to a light conventional back school. The importance of meditation with regard to the possibilities of a therapeutic use of meditative techniques for chronic non-specific back pain requires further research in this area.

Background: In Germany, chronic unspecific back pain is a frequent cause for patients to seek medical treatment and is thus a burden for social and healthcare services. Besides conservative therapy approaches (analgetics, physiotherapy), multimodal therapy concepts are of growing interest which combine elements of psychotherapy and relaxation techniques. One approach is meditation, which has not yet been fully validated as a treatment for chronic unspecific back pain. This study evaluated the efficacy of meditation for patients with chronic unspecific back pain between meditation technique compared to conventional therapy. Methodology: In a randomized trial, 68 patients (18-75 years old) with chronic back pain were included. Inclusion criteria were: a) Average pain intensity over the last seven days above 40 mm (Visual analog scale = VAS), b) pain duration longer than 3 months. The intervention-group had group meetings over 8 weeks (1 / week) with a meditation teacher. The control group received a self-care book with light, conventional exercise for the spine. The primary outcome measure was average pain intensity over the last seven days on VAS after 8 weeks. Evaluation was performed on VAS at two time points (start of study, end of intervention). The primary outcome measure was tested in a confirmatory fashion in an intention-to-treat analysis (ITT), in a second analysis in the per-protocol-population (PP). Subjective stress perception, quality of live and emotional stability of the participants were evaluated as secondary outcome measures. Results: Average pain intensity at the start of the study was 59.3 mm (adjusted mean; sd ± 13.9 mm) in the meditation group and 52.9 mm (sd: ± 11.8 mm) in the control group. Both groups showed similar reduction of pain from the beginning until the end of the trial. The adjusted pain intensity in the meditation-group reduced to 40.8 mm (sd: ± 21.8 mm) and in the control-group to 37.3 mm (sd: ± 18.2 mm; 95% KI -11.6; 8.8). Compared to the control group, no significant differences were found (p = 0.758). For the secondary outcomes, positive differences favoring the mediation group were found in stress perception (CPSS), which showed significant differences after 4 and 8 weeks. Conclusion: Although meditation reduced pain intensity in patients with chronic unspecific low back pain, light conventional physical exercise in the control group achieved very similar results. Further research is required on meditation techniques in terms of their medical impact, their application on back pain and how they could be applied most effectively.