Low back pain\u00a0affects over 600 million people and is the single leading cause of disability worldwide.\u00a0New research from\u00a0Boston Medical Center (BMC), the largest essential hospital in New England,\u00a0suggests that\u00a0the Optimizing Pain Treatment\u00a0In\u00a0Medical\u00a0settings\u00a0Using Mindfulness (OPTIMUM) trial, where\u00a0an adapted\u00a0group\u00a0mindfulness\u00a0program\u00a0is\u00a0delivered\u00a0through\u00a0primary care\u00a0telehealth\u00a0for patients with chronic low back pain,\u00a0produced\u00a0sustained reductions in pain\u00a0and\u00a0improvements in\u00a0patients’\u00a0daily lives.\u00a0The findings,\u00a0published in\u00a0JAMA Internal Medicine,\u00a0highlight a scalable, non-pharmacological approach for treating chronic pain.\u00a0<\/p>\n
Not only can chronic low back pain limit the ability of a person to walk, work, sleep, and socialize, but it can also negatively\u00a0impact\u00a0a person’s mental health and overall wellbeing.\u00a0Low back pain is\u00a0also\u00a0one of the most common reasons people visit their primary care physician,\u00a0yet the treatment options routinely available\u00a0are\u00a0limited. Medications carry\u00a0risks,\u00a0surgery helps only a narrow subset of patients, and effective non-pharmacological therapies\u00a0can be\u00a0difficult to access.\u00a0<\/p>\n
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What our program\u00a0does is give people real, repeatable skills for how to respond to pain differently. Once patients have those skills, they also seem to carry them forward and we see improvements lasting beyond the program.”<\/p>\n
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Natalia Morone, MD, MS, study’s lead author and primary care and internal medicine clinician at BMC\u00a0<\/p>\n
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The researchers tested a version of\u00a0Mindfulness-Based Stress Reduction (MBSR)\u00a0adapted specifically to treat pain as a stressor. 451 participants across three states attended\u00a0120-minute group sessions over a period of eight weeks. The sessions were led by a trained mindfulness instructor and a primary care physician. Rather than referring\u00a0patients out\u00a0to a separate program, the OPTIMUM trial brought the clinician into the room and gave every participant direct access to a physician as an integrated part of the experience. Through gentle stretching exercises and mindfulness activities, participants learned to work with their pain rather than against it, adapting their activities and building awareness of how pain shapes their lives.\u00a0<\/p>\n
The team found that participants showed significant improvements to pain and pain interference, or how much pain limited their physical activity and their enjoyment of life measured on a 0-to-10 scale, with those gains sustained at a 12-month follow-up.\u00a0<\/p>\n
The trial was designed to reach as many patients as possible. Entry criteria were intentionally broad to reflect the diversity of real patients, and the telehealth approach removed transportation and scheduling barriers that often keep people from accessing structured programs. The program model is also billable as a\u00a0group\u00a0medical visit, meaning it can be reimbursed through existing payment structures in a scalable way.\u00a0<\/p>\n
“We have evidence-based guidelines, but the challenge has been getting those approaches to more people,” said Dr. Morone. “If we can bring evidence-based treatment into primary care and build a model the healthcare system can sustain, we have a real opportunity to help far more people. That’s what drives this research – getting effective care\u00a0to\u00a0the people who need it most.”\u00a0<\/p>\n
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