With Americans becoming increasingly dependent on pain killers, a safer alternative may be just a deep breath away.

Published: April 14, 2016 | Updated: November 20, 2023

People of all ages experience low back pain. While our first impulse may be to reach for a pill, that’s not the only way to deal with pain. According to a new study, it may not be the most effective way either.

A program of mindfulness-based stress reduction (MBSR) and cognitive behavioral therapy (CBT) did a better job of managing low back pain than standard medical care among adults participating in a study recently published in JAMA, the Journal of the American Medical Association.

What are MBSR and CBT?

MBSR and CBT are types of integrative medicine. MBSR uses meditation and yoga to cultivate awareness and reduce stress. Participants learn to observe their reactions to life’s stressors and choose how to respond. Eventually they can apply those skills to connect more fully with themselves and their loved ones. CBT is a form of psychotherapy. It was originally designed to treat depression, but is now used for a number of conditions. It works to help patients solve current issues and change unhelpful thinking and behavior.

The study

The study randomly divided 342 adults into three groups. Some received MBSR, some received CBT (training to change pain-related thoughts and behaviors), and some received their usual care. The researchers tested for clinically meaningful improvement in functional limitations and pain. They found that after 26 weeks, the percentage of participants with improvement in function was higher for those who received MBSR (61 percent) and CBT (58 percent) than for those who received usual care (44 percent). The percentage of participants with improvement in pain after 26 weeks was 44 percent in the MBSR group and 45 percent in the CBT group, versus 27 percent in the usual care group.

“This highlights the important role the mind-body connection plays in addressing health issues,” said Rachel J. Busse, M.D., integrative and family medicine specialist, Norton Community Medical Associates – Highlands. “It is especially positive news in light of the increasingly serious opioid epidemic our nation is currently facing.”

A national epidemic

More people died from drug overdoses in 2014 than in any year on record, according to the Centers for Disease Control and Prevention. The majority of drug overdose deaths — more than 60 percent — involve opioid pain killers. Since 1999, the rate of overdose deaths involving opioids nearly quadrupled, with nearly half a million people dying from drug overdoses from 2000 to 2014.

Overdoses from prescription opioid pain relievers are a driving factor in the 15-year increase in opioid overdose deaths. Since 1999, the amount of prescription opioids sold in the U.S. nearly quadrupled, but the overall amount of pain that Americans report experiencing has not changed. In the same time frame, deaths from prescription opioids — oxycodone, hydrocodone and methadone — also quadrupled.

These statistics spurred the Food and Drug Administration to announce plans on March 22 to add a new warning label to immediate-release opioid painkillers regarding the drugs’ serious risks of misuse, abuse, addiction, overdose and death.

Unfortunately, insurance coverage has not yet caught up with the trend toward alternative methods of pain relief. Not all health insurance plans cover integrative medicine treatments.

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