Mindfulness is best described as non-judgmental awareness of thoughts, emotions, sensations, and behaviors. It is traditionally practiced as formal sitting meditation which is then advanced to all aspects of daily life. (e.g. mindful walking, mindful eating, mindful speech, etc).
Mindfulness is being utilized in the therapeutic setting, primarily by psychologists for helping individuals deal with traumatic and/or emotional events. In addition, mindfulness training is now being used in schools to help with attentiveness, work environments to help with stress, and in sports to help athletes improve sports performance.
But what about physical pain? Can mindfulness be utilized to help individuals who are experiencing physical pain, like lower back pain and neck pain? Well, yes and no.
Let’s review and interpret the evidence.
Studies are limited, and many of them focus on lower back pain in particular, since it is a major health concern affecting about 80% of the population over time. The research is mostly inconclusive.
For example, through Anheyer et. al’s, systematic analysis of the research, it was concluded that there appears to be short-term pain relief when implementing a mindfulness practice for lower back pain, but no apparent long-term relief was noted. It appears to make sense, as mindfulness is really a way to accept the presence of the pain and our relationship to it; however, in and of itself, it is not a physical intervention to a physical problem, as are hands-on treatment and therapeutic exercise.
Another study by Cramer et. al, found that there is evidence that mindfulness can help with pain acceptance, but again, no long term improvement in pain and function were seen with mindfulness alone.
So how is short-term pain reduction and pain acceptance useful for the treatment of pain, one might ask? Despite the findings, does mindfulness have a place in the treatment of physical pain? The answer still seems to be a resounding “Yes!” when we look at it in the right perspective.
Pain is a complicated animal and chronic pain is notoriously complicated. For example, even the most potent pain medications have only shown to have a pain reducing effect of 30%-40% in less than 50% of people (Turk et. al 2002). Therefore, mindfulness, a non-pharmaceutical intervention that shows pain reduction, is of extreme benefit.
The real benefit in the treatment setting, is that pain reduction and pain acceptance through mindfulness, often times helps patients take more appropriate action regarding their pain. They are more likely to commit to the type of care that offers long-term benefits when it comes to pain and especially function, such as hands-on care and corrective exercises. They are better able to endure the ebbs and flows of improvements, which are not always linear. Negative self-talk, often seen during pain and injury, tends to diminish when mindfulness is being practiced. In summary, they are better able to accept pain and commit to progress.
Turk, Dennis C. “Clinical Effectiveness and Cost-Effectiveness of Treatments for Patients With Chronic Pain.” The Clinical Journal of Pain, vol. 18, no. 6, 2002, pp. 355–365., doi:10.1097/00002508-200211000-00003.
Anheyer, Dennis, et al. “Mindfulness-Based Stress Reduction for Treating Low Back Pain.” Annals of Internal Medicine, vol. 166, no. 11, 2017, p. 799., doi:10.7326/m16-1997.
Chiesa, Alberto, and Alessandro Serretti. “Mindfulness-Based Interventions for Chronic Pain: A Systematic Review of the Evidence.” The Journal of Alternative and Complementary Medicine, vol. 17, no. 1, 2011, pp. 83–93.
Cramer, Holger, et al. “Mindfulness-Based stress reduction for low back pain. A systematic review.” BMC Complementary and Alternative Medicine, vol. 12, no. 1, 2012, doi:10.1186/1472-6882-12-162.
Morone, Natalia E., et al. “A Mind–Body Program for Older Adults with Chronic Low Back Pain: Results of a Pilot Study.” Pain Medicine, vol. 10, no. 8, 2009, pp. 1395–1407., doi:10.1111/j.1526-4637.2009.00746.x.