Does the Type of Meditation Matter?
The German study used jyoti meditation, which is a type of focused meditation that uses a mantra to help an individual with relocating attention from the painful area in the body to one of relaxation. Dr Morone used a combination of body scanning meditation while lying down, sitting meditation, and walking meditation. Dr Cherkin used a combination of meditation, body scanning, and yoga. All seem equally effective.1-3
“Mindfulness practices include conventional meditation, open awareness, use of a mantra, and even centered prayer in religious practice. It is hard to say which is better. What is more important is that the type of meditation is one that is comfortable for the patient,” says Dr Morone.
“MBSR has been around for 3 decades. It is common and structured. The exact type of mind-body technique you use is probably not important as long as the patient sees it as credible, they are open to it, and the teacher is competent,” adds Dr Cherkin.
Does the Type of Patient Matter?
One drawback mentioned in Dr Cherkin’s study was that a significant percentage of patients did not attend all the meditation sessions; just over half attended at least 6 of the 8 sessions.2 A similar dropout rate was seen in the German study. The researchers noted that patients who dropped out cited time constraints, lack of immediate results, and difficulty meditating as reasons.1 “Meditation is not for everyone,” says Dr Cherkin. “Not everyone can be comfortable being alone with themselves.”
Key Takeaways for Primary Care
Dr Morone’s next focus of research is on determining how to integrate meditation into primary care. “Meditation classes could be given in primary care settings. Many primary care physicians are interested in mindfulness. Treating chronic pain is frustrating for both patients and providers, and patients need another tool to help them cope. They are told to live with it but not told how to live with it,” says Dr Morone.
Meditation is safe and relatively inexpensive, and serves as a clinically significant addition to the management armamentarium for chronic low back pain. It is becoming increasingly available in pain management clinics. For resources to aid in learning more about MBSR, visit the University of Massachusetts Medical School Center for Mindfulness.
“The mind is an important part of pain. Pain beyond healing is complex. It is not all in your mind, but the mind-body connection plays an important role. Most people will have to live with chronic pain. Exercise for the body is important for pain management , but so is exercise for the mind,” says Dr Cherkin.
1. Michalsen A, Kunz N, Jeitler M, et al. Effectiveness of focused meditation for patients with chronic low back pain—a randomized controlled clinical trial. Complement Ther Med. 2016;26:78-84.
2. Morone NE, Greco CM, Moore CG, et al. A mind-body program for older adults with chronic low back pain. JAMA Intern Med. 2016;176(3):329-337.
3. Cherkin DC, Sherman KJ, Balderson B, et al. Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain. JAMA. 2016;315(12):1240-1249.