Lower back pain is a constant issue for many people. While it may seem like a minor inconvenience to some, it can severely impact their quality of life. For people who are suffering from ongoing back pain, finding relief can be incredibly challenging. While there are medications available, there are side-effects one must consider. However, new research suggests that two types of therapy might offer a promising solution, especially for those who have been relying on opioid medications. Therapies Show Promise for Opioid Users A study published April 7 in JAMA Network Open found that mindfulness-based therapy (MBT) and cognitive behavioral therapy (CBT) significantly improved the quality of life for people managing chronic low back pain with opioids. Participants reported less pain and were able to reduce their opioid dosages in the months following the start of these therapies. Researchers noted that the participants had lived with moderate to severe back pain for a long time, most for over five years, and had tried many other treatments without success. The improvements seen were therefore even more significant. Addressing a Common and Stubborn Problem Chronic low back pain affects a large number of people; data suggests that as many as 28% of Americans experience it. Despite its prevalence, effective treatments are often hard to come by. One study in March found that only 10% of non-surgical treatments for lower back pain actually work. This led researchers to explore whether CBT and MBT could offer a better approach. Cognitive Behavioral Therapy (CBT) helps patients identify negative thoughts and behaviors, then uses problem-solving and self-reflection to change those patterns. Mindfulness-Based Therapy (MBT) teaches people to observe their bodily sensations, feelings, and thoughts without reacting to them, often through meditation to focus on the present moment. Promising Results from the Study The study involved 770 adults who were using opioids for their chronic low back pain. On average, participants were about 58 years old and experienced moderate-to-severe pain, limitations in their daily activities, and a reduced quality of life.Half of the participants received CBT, and the other half received MBT. They attended weekly two-hour group sessions for eight weeks. After this, they were encouraged to practice what they learned for 30 minutes daily, six days a week, for the remainder of the 12-month study. Although about 30% of participants dropped out by the six-month mark, those who continued reported: Less pain.Reduced daily opioid use.Better daily function.Improved quality of life.These benefits lasted throughout the year, with over 65% of participants still reporting progress at the 12-month mark. Dr. Zgierska highlighted that chronic back pain usually doesn't get better on its own, often worsening over time, which makes these lasting improvements particularly striking. Since both therapies showed similar positive results, people can confidently choose the approach that best suits them, whether it's the structured nature of CBT or the mindfulness focus of MBT. Both in-person and online formats were found to be effective. Supporting Evidence and Future Needs While this JAMA Network Open study didn't include a control group or have much racial and ethnic diversity among its participants, its findings align with other research suggesting that behavioral therapies can help adults using opioids for chronic pain. It's important to note that this area still needs more research. Only 17 studies have looked at MBT for chronic low back pain, and only three have directly compared it to CBT. However, previous studies have shown that both MBT and CBT are generally effective for pain relief, even if they haven't always included people on opioids for chronic back pain. The fact that this new research shows they help in more severe cases (with opioid use) further strengthens these findings.