• Aleksandra E Zgierska, Cindy A Burzinski, Jennifer Cox, John Kloke, Aaron Stegner, Dane B Cook, Janice Singles, Shilagh Mirgain, Christopher L Coe, and Miroslav Bačkonja.
• Department of *Family Medicine and Community Health, aleksandra.zgierska@fammed.wisc.edu.
• Pain Med. 2016 Oct 1; 17 (10): 1865-1881.

ObjectiveTo assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP).Design26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone).SettingOutpatient.SubjectsAdults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months.MethodsThe intervention comprised eight weekly group sessions (meditation and CLBP-specific CBT components) and 30 minutes/day, 6 days/week of at-home practice. Outcome measures were collected at baseline, 8, and 26 weeks: primary-pain severity (Brief Pain Inventory) and function/disability (Oswestry Disability Index); secondary-pain acceptance, opioid dose, pain sensitivity to thermal stimuli, and serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein).ResultsThirty-five (21 experimental, 14 control) participants were enrolled and completed the study. They were 51.8 ± 9.7 years old, 80% female, with severe CLBP-related disability (66.7 ± 11.4), moderate pain severity (5.8 ± 1.4), and taking 148.3 ± 129.2 mg/day of MED. Results of the intention-to-treat analysis showed that, compared with controls, the meditation-CBT group reduced pain severity ratings during the study (P = 0.045), with between-group difference in score change reaching 1 point at 26 weeks (95% Confidence Interval: 0.2,1.9; Cohen's d = 0.86), and decreased pain sensitivity to thermal stimuli (P < 0.05), without adverse events. Exploratory analyses suggested a relationship between the extent of meditation practice and the magnitude of intervention benefits.ConclusionsMeditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP.© 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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