Chronic back pain can be debilitating and its treatments painful in themselves. Could mindfulness meditation help?

If you found working from home a pain in the back, you are not alone.

Working at kitchen tables, in bedrooms — or even in the bathroom, as we heard some people had to do — won’t have done anything to lower the number of people su­ffering from chronic back pain and issues with movement.

For many people, chronic back pain can lead to anxiety and depression, with the pain itself causing people to become fearful of movement — only making the problem worse.

The fact that exercise is often recommended to help resolve it can also be seen as unhelpful or unrealistic; especially when exercise will inevitably hurt and over-the-counter medication seems to o­ffer quicker, easier relief instead.

Yet pharmaceuticals come with their own set of risk factors.

In 2005, for instance, a study by the American Gastroenterological Association reported that chronic users of non-steroidal anti-inflammatory drugs (NSAIDs), which include medications such as ibuprofen, naproxen, aspirin and ketoprofen, have an increased risk of bleeding and visible damage to their small intestine.

NSAIDs can also negatively interact with other medications or exacerbate existing health issues.

Physio for lower back pain

This leaves many su­fferers struggling for options.

According to a recent study from researchers in Australia and Canada, however, a combination of physiotherapy and psychological therapies could be one possible solution.

The team reviewed 97 randomised controlled trials to determine what type of psychological interventions — such as pain management, behavioural therapy, cognitive behavioural therapy, and pain education — combined with physiotherapy, might be more sustainable.

According to their findings, for chronic, non-specific lower back pain, psychological interventions appear to work best when delivered in conjunction with physiotherapy — mainly structured exercise.

Whilst pain education programmes and behavioural therapy resulted in the most sustainable e­ffects of treatment, however, they said that there remained uncertainty as to such treatments’ long-term e­ffectiveness.

Yet according to one US-based spinal surgeon, chronic back pain may be helped by meditation.

Dr Ken Hansraj, who has been meditating for years to manage his own chronic pain, created LIFT: Meditations to Boost Back Health, a set of guided meditations specifically designed to improve back health and reduce back pain.

Meditation for pain

An ancient practice that goes back thousands of years, meditation can be used to calm the mind, help to support mental health and lower stress.

Some studies have also looked at its potential to help with pain relief; and in some cases its benefits may even be immediate, according to a 2017 study from Leeds Beckett University.

For the study, researchers asked participants to hold their hands in ice water for as long as they could, then to do 10 minutes of meditation, and to repeat the process.

After meditating, participants could endure the pain for longer; researchers also observed that volunteers were less anxious about the pain, and their pain threshold and tolerance significantly increased.

Other studies have highlighted the potency of several-week meditation programmes to help those already experiencing chronic pain.

Studies in 2015 and 2016 delivered mindfulness meditation sessions for eight and 26 weeks, respectively, to patients with neck and back pain.

Compared to those who continued with their usual treatment, patients who underwent the meditation programme were more likely to report clinically significant improvements in their symptoms.

Both pain and pain-related “bothersomeness” decreased with meditation.

Living with pain

Furthermore, several years of regular practice can predispose people to cope better with pain.

A 2010 study from the University of Manchester concluded that people who meditate regularly, and have done so for some time, experience pain as less unpleasant than those who do not.

Dr Christopher Brown, who led the research, concluded that this was because: “Meditation trains the brain to be more present-focused and therefore to spend less time anticipating future negative events.”

In other words, those who anticipated the pain less, experienced it less.

Meditation — specifically the type that trains the brain to be more mindful — can therefore have considerable benefits for people dealing with pain, both in the short and long term.

It can target both the sensation of pain and emotions that exacerbate it.

Indeed, Dr Fadel Zeidan from the Wake Forest Baptist Medical Center, USA, has tested the efficacy of meditation multiple times over several years, including against placebo or ‘sham’ meditation.

He concluded that meditation interacts with distinct regions of the brain, activating a region associated with self-control, and deactivating the thalamus, which passes sensory information to higher centres in the brain.

In this way, mindfulness meditation may help people both self-regulate their reactions to pain and physically feel it less.

Despite such potential benefits, however, anyone su­ffering from chronic back pain should seek medical advice.

The NHS advises: “Very rarely, back pain can be a sign of a serious problem such as a broken bone, cancer or an infection.”

Consulting a physiotherapist will also help identify appropriate types of exercise.

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