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Mindfulness for chronic low back pain

Musculoskeletal
        1. Mindfulness for chronic low back pain

First published: 5 May 2021

The RACGP gratefully acknowledge the following contributor:

  • Zoe Michaleff, Institute for Evidence-Based Healthcare, Bond University

Related GP HANDI entry Mindfulness and CBT for chronic low back pain


 

Your doctor has recommended that you stay active to help you recover from your low back pain.

Key points

  • Mindfulness programs (also known as mindfulness-based stress reduction therapy) may help to improve back pain and your ability to do everyday activities in the short term.
  • They can also improve your mental health.

How can mindfulness help with low back pain?

  • Your mood, thoughts, and feelings can affect your pain. The opposite is also true: your pain can affect your mood, thoughts and feelings.
  • Mindfulness is a type of mind-body treatment based on meditation. It focuses on the moment and being aware of your thoughts, sensations and feelings.
  • Mindfulness may help you manage your thoughts and feelings, and reduce stress.
  • It can be used on its own or with a type of talk therapy (cognitive behaviour therapy).

How do I get started?

  • Your doctor may refer you to a psychologist or mindfulness program provider. Before starting, ask about the cost of treatment sessions or training programs and if there are any Medicare rebates available. If you have private health insurance, ask if they cover mind-body therapies.
  • Mindfulness training is usually done as a group by a trained instructor over 8 weeks. For example, you may have a weekly session of between 30 minutes and 2 hours, and a one-day session in the last week but this can vary.
  • The mindfulness program usually includes mental and physical exercises, such as:
    • Body scan meditation – For example, lie on your back with your eyes closed, legs extended and arms at your sides, palms facing up. Focus on each part of your body, from toe to head or head to toe. Be aware of any sensations, feelings or thoughts.
    • Yoga
    • Focusing your attention on your breathing – For example, sit comfortably with your back straight, feet flat on the floor and hands in your lap. Breathe through your nose and focus on your breath moving in and out. If noises, sensations or thoughts disturb you, note the experience and then return your focus to your breath.
    • Increasing your awareness during everyday activities. Focus on the experience of sitting, eating or walking including being aware of any sensations such as taste, smells, textures and movements.

What to look out for

  • Mindfulness programs are usually safe for back pain. However, any exercise such as yoga may increase your back pain or stiffness at first. So it is best to start any exercise slowly and increase the difficulty over time.
  • Mindfulness programs have been shown to help reduce low back pain. However, it is not known if only practising some parts, such as body scan meditation, will be effective although it may help to reduce anxiety and depression.
  • Ask about the costs and qualifications of the mindfulness program provider. The original mindful-based stress reduction program was developed at the University of Massachusetts Medical School, USA. However, many places now offer online or face-to-face mindfulness training but there is no organisation to make sure any standards are followed. Ask your doctor if you need help with finding a provider.
  • There are also many apps, books and online information on mindfulness. Ask your doctor if a specific resource can be trusted and can help you.

On mindfulness:

On back pain:

Australian Psychological Society: Find a psychologist who can help you manage your back pain through the use of mind-body treatments at Find a Psychologist.
Speak with a nurse on Musculoskeletal Australia’s free help line 1800 263 265 (weekdays 9 am – 5 pm).
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