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.
abstract: To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP).
  
  
  
  26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone).
  
  
  
  Outpatient.
  
  
  
  Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months.
  
  
  
  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).
  
  
  
  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.
  
  
  
  Meditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP.
authors.affiliation: Department of *Family Medicine and Community Health, aleksandra.zgierska@fammed.wisc.edu.
authors.forename: Aleksandra E
authors.initials: AE
authors.lastname: Zgierska
authors.affiliation: Department of *Family Medicine and Community Health.
authors.forename: Cindy A
authors.initials: CA
authors.lastname: Burzinski
authors.affiliation: Department of *Family Medicine and Community Health.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cox
authors.affiliation: Department of Biostatistics and Medical Informatics.
authors.forename: John
authors.initials: J
authors.lastname: Kloke
authors.affiliation: Department of Research Service, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin.|Department of Department of Kinesiology, School of Education, University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: Aaron
authors.initials: A
authors.lastname: Stegner
authors.affiliation: Department of Research Service, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin.|Department of Department of Kinesiology, School of Education, University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: Dane B
authors.initials: DB
authors.lastname: Cook
authors.affiliation: Department of Orthopedics and Rehabilitation.
authors.forename: Janice
authors.initials: J
authors.lastname: Singles
authors.affiliation: Department of Orthopedics and Rehabilitation.
authors.forename: Shilagh
authors.initials: S
authors.lastname: Mirgain
authors.affiliation: Department of Harlow Center for Biological Psychology, University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Coe
authors.affiliation: Department of Neurology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison,Wisconsin.|Department of **PRAHS Clinical Research Company Lifetree, Salt Lake City, Utah, USA.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Bačkonja
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D059350:Chronic Pain / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D008297:Male; D019122:Meditation / Q000379:methods* / Q000523:psychology; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D010147:Pain Measurement / Q000379:methods / Q000523:psychology; D010865:Pilot Projects; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid
keywords: Chronic Low Back Pain; Cognitive Behavioral Therapy; Long-Term Opioid Therapy; Mindfulness Meditation