Responding rather than reacting to back pain

Doran, N. J. (2014). Experiencing Wellness Within Illness: Exploring a Mindfulness-Based Approach to Chronic Back Pain. Qualitative Health Research, 1049732314529662. From the Abstract.

I explore how mindfulness-based techniques affect perceptions and management of back pain and discuss these findings in relation to embodiment theory and liminality. Sixteen volunteers attending… for persistent back pain took part in this study.

The theme of “embodied awareness” formed the core category, as all participants reported a change in their experience of pain. Such embodied changes are described in relation to five subthemes: unpacking the pain experience, changing relationship to pain, letting go of the label, self-compassion and acceptance, and wellness within illness.

Learning to respond rather than react, and living moment by moment enabled participants to replace a cycle of suffering with one of acceptance. Rather than fearing pain, participants found ways to move through it and live with it. Although some expressed finding a sense of wellness despite ongoing pain, all participants reported greater acceptance and a better quality of life.

MBI for physical conditions: evaluating levels of evidence

Carlson, L. E. (2012). Mindfulness-based interventions for physical conditions: a narrative review evaluating levels of evidence. ISRN psychiatry. Article ID 651583. Full text.

Research on mindfulness-based interventions (MBIs) for treating symptoms of a wide range of medical conditions has proliferated in recent decades. Mindfulness is the cultivation of nonjudgmental awareness in the present moment. It is both a practice and a way of being in the world. based cognitive therapy (MBCT).

This paper begins with a discussion of the phenomenological experience of coping with a chronic and potentially life-threatening illness, followed by a theoretical discussion of the application of mindfulness in these situations. The literature evaluating MBIs within medical conditions is then comprehensively reviewed, applying a levels of evidence rating framework within each major condition. The bulk of the research looked at diagnoses of cancer, pain conditions (chronic pain, low back pain, fibromyalgia, and rheumatoid arthritis), cardiovascular disease, diabetes, human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), and irritable bowel syndrome.

Most outcomes assessed are psychological in nature and show substantial benefit, although some physical and disease-related parameters have also been evaluated. The field would benefit from more adequately powered randomized controlled trials utilizing active comparison groups and assessing the moderating role of patient characteristics and program “dose” in determining outcomes.

Loving-kindess meditation beneficial in reducing back pain and anger

Carson, J. W., et al. (2005). Loving-Kindness Meditation for Chronic Low Back Pain Results From a Pilot Trial. Journal of Holistic Nursing, 23(3), 287-304Full text.

Purpose: Loving-kindness meditation has been used for centuries in the Buddhist tradition to develop love and transform anger into compassion. This pilot study tested an 8-week loving-kindness program for chronic low back pain patients.

Method: Patients (N = 43) were randomly assigned to the intervention or standard care. Standardized measures assessed patients’ pain, anger, and psychological distress.

Findings: Post and follow-up analyses showed significant improvements in pain and psychological distress in the loving-kindness group, but no changes in the usual care group. Multilevel analyses of daily data showed that more loving-kindness practice on a given day was related to lower pain that day and lower anger the next day.

Conclusions: Preliminary results suggest that the loving-kindness program can be beneficial in reducing pain, anger, and psychological  distress in patients with persistent low back pain. Clinicians may find loving-kindness meditation helpful in the treatment of patients with persistent pain.