Ask the Doctors

Dear Doctor: I've had back pain since my 20s and have gotten to the point where I can't use aspirin or other pain relievers because they tear up my stomach. My sister-in-law wants me to try meditation, which sounds a little nutty. Do you think it can help?

Dear Reader: The power of the mind over the body is a concept that has been explored, questioned, promoted and ridiculed for centuries, if not millennia. However, the latest studies on the subject offer intriguing insights. Researchers are uncovering evidence that techniques such as meditation and mindfulness can be an effective means of dealing with pain. This is good news for the estimated 11 percent of Americans who live with chronic pain.

Several recent studies have focused on meditation and mindfulness techniques to alleviate lower back pain, with some surprising results. Not only did researchers add to the growing body of evidence that mind-based techniques can be effective, but they also discovered that the relief from pain comes via unexpected pathways.

One study involved 342 adults between the ages of 20 and 70 who had lower back pain for three or more months, a length of time for it to be considered chronic. None of the individuals could attribute the onset of their pain to a particular cause, such as injury, overuse or disease.

The participants were divided into three treatment groups -- one that followed the traditional medical approach of rest, activity modification, heat or ice, and over-the-counter pain relievers. A second group learned a technique called cognitive behavioral therapy, or CBT, which addresses thought and behavior. The third group was taught something the researchers called "mindfulness-based stress reduction," which included several types of meditation as well as gentle yoga practice.

Six months later, 61 percent of each mind-based treatment group reported improved physical function. About 45 percent of them said they had less back pain. That was measurably better than the group assigned to traditional medical practices. In that group, 44 percent reported improved function, and 27 percent said they had less pain.

While the results may not be extraordinary, they are significant. And as acceptance of this novel pain relief pathway grows, the hope is that continued research will lead to greater understanding and to new techniques that are even more effective.

Speaking of understanding, the results of a study published in the Journal of Neuroscience last year also offered a few surprises.

When you hurt yourself -- stub your toe or scrape your knee -- your body responds with a flood of natural opioid compounds that make the resulting pain more bearable. But for the participants in this study, researchers blocked that pain relief pathway. Yet patients involved in meditation still reported feeling less pain in response to unpleasant stimuli than those who did not meditate. This led researchers to conclude the pain relief mechanism of meditation occurs independent of the opioid receptors in the brain.

Bottom line: Your sister-in-law has a point regarding meditation. With a bit of research, you can find a class or program in your area. And if you do follow through, please let us know how it goes.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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