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bibliography * The PainScience Bibliography contains plain language summaries of thousands of scientific papers and others sources, like a specialized blog. This page is about a single scientific paper in the bibliography, Mehling 2005.

Meditation for back pain as good as physical therapy

updated
Mehling WE, Hamel KA, Acree M, Byl N, Hecht FM. Randomized, controlled trial of breath therapy for patients with chronic low-back pain. Altern Ther Health Med. 2005 Jul-Aug;11(4):44–52. PubMed #16053121.
Tags: back pain, yoga, pain problems, spine, exercise, self-treatment, treatment

PainSci summary of Mehling 2005?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★☆☆?3-star ratings are for typical studies with no more (or less) than the usual common problems. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.

A study of thirty-six patients with chronic low back pain, comparing physical therapy to meditation (they call it “breathing therapy,” and describe it as “body awareness, breathing, meditation, and movement”), with a follow-up at six months. The benefits of meditation were roughly as good as physical therapy, but modest across the board. The researchers concluded that patients who meditated “improved significantly” and got benefits “comparable to high-quality, extended physical therapy.”

Sounds good, doesn’t it? Unfortunately, there are important caveats: beating physical therapy at treating low back pain is no great accomplishment, because it doesn’t work particularly well, and the benefits of both treatments were statistically signicant but minor (see Statistical Significance Abuse), and roughly consistent with the slow but steady improvement that always occurs, regardless of treatment.

original abstractAbstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

CONTEXT: Patients suffering from chronic low back pain (cLBP) are often unsatisfied with conventional medical care and seek alternative therapies. Many mind-body techniques are said to help patients with low back pain by enhancing body awareness, which includes proprioception deficit in cLBP, but have not been rigorously studied in cLBP. Breath therapy is a western mind-body therapy integrating body awareness, breathing, meditation, and movement. Preliminary data suggest benefits from breath therapy for proprioception and low back pain.

OBJECTIVE: To assess the effect of breath therapy on cLBP.

DESIGN: Randomized, controlled trial.

SETTING: Academic medical center.

PARTICIPANTS: Thirty-six patients with cLBP.

INTERVENTIONS: Six to eight weeks (12 sessions) of breath therapy versus physical therapy.

MAIN OUTCOME MEASURES: Pain by visual analog scale (VAS), function by Roland Scale, overall health by Short Form 36 (SF-36) at baseline, six to eight weeks, and six months. Balance as a potential surrogate for proprioception and body-awareness measured at the beginning and end of treatment.

RESULTS: Pre- to post-intervention, patients in both groups improved in pain (VAS: -2.7 with breath therapy, -2.4 with physical therapy; SF-36: +14.9 with breath therapy and +21.0 with physical therapy). Breath therapy recipients improved in function (Roland: -4.8) and in the physical and emotional role (SF-36: +15.5 and 14.3). Physical therapy recipients improved in vitality (SF-36: +15.0). Average improvements were not different between groups. At six to eight weeks, results showed a trend favoring breath therapy; at six-months, a trend favoring physical therapy. Balance measures showed no improvements and no correlations with other outcomes.

CONCLUSIONS: Patients suffering from cLBP improved significantly with breath therapy. Changes in standard low back pain measures of pain and disability were comparable to those resulting from high-quality, extended physical therapy. Breath therapy was safe. Qualitative data suggested improved coping skills and new insight into the effect of stress on the body as a result of breath therapy. Balance measures did not seem to be valid measures of clinical change in patients’ cLBP.

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