Effectiveness of focused meditation for patients with chronic low back pain-A randomized controlled clinical trial.
OBJECTIVE
We aimed to evaluate the effectiveness of an 8-week meditation program (focused meditation) in patients with chronic low-back pain.


METHODS
A randomized clinical trial was conducted on 68 patients (55 years;75% female) with chronic low-back pain who scored >40mm on a 100mm Visual-Analogue-Scale. Subjects were allocated to an 8-week meditation program (focused meditation) with weekly 75min classes or to a self-care exercise program with a wait-list offer for meditation. Both groups were instructed to practice at home. Outcomes were assessed baseline and after 4 and 8 weeks. The primary outcome measure was the change in mean back pain at rest after 8 weeks. Secondary outcomes included function, pain-related bothersomeness, perceived stress, quality-of-life (QOL), and psychological outcomes.


RESULTS
Twelve (meditation) and 4 (exercise) patients were lost to follow-up. The primary outcome, pain at rest after 8 weeks, was reduced from 59.3±13.9mm to 40.8±21.8mm with meditation vs. 52.9±11.8mm to 37.3±18.2mm with exercise (adjusted group difference: -1.4 (95%CI:11.6;8.8;p=n.s.) Perceived stress was significantly more reduced with meditation (p=0.011). No significant treatment effects were found for other secondary outcomes as pain-related bothersomeness, function, quality-of-life and psychological scores, although the meditation group consistently showed non-significant better improvements compared to the exercise group.


CONCLUSIONS
Focused meditation and self-care exercise lead to comparable, symptomatic improvements in patients with chronic low back pain. Future studies should include longer-term follow-ups and develop guided meditation programs to support compliance.
Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Center, Berlin, Germany; Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany. Electronic address: a.michalsen@immanuel.de.
Andreas
A
Michalsen
Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Center, Berlin, Germany; Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany.
Natalie
N
Kunz
Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Center, Berlin, Germany; Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany.
Michael
M
Jeitler
University Hospital Salzburg, Department for Psychiatry and Psychotherapy, Austria.
Stefan
S
Brunnhuber
Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Center, Berlin, Germany; Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany.
Larissa
L
Meier
Karl- and Veronica Carstens Foundation, Essen, Germany.
Rainer
R
Lüdtke
University Witten-Herdecke, Chair of Integrative Medicine, Witten, Germany.
Arndt
A
Büssing
Institute of Social Medicine, Epidemiology and Health Economics, Charité-University Medical Center, Berlin, Germany; Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany.
Christian
C
Kessler
D000368:Aged; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D019122:Meditation; D008875:Middle Aged; D010147:Pain Measurement; D016896:Treatment Outcome
Distress; Exercise; Low back pain; Meditation; Randomized trial