WEDNESDAY, April 9, 2025 (HealthDay News) -- Folks with low back pain can use their minds to effectively cope with their suffering, a new clinical trial says.

Mindfulness meditation and cognitive-behavioral therapy (CBT) both significantly reduced pain among people with chronic back pain, according to findings published Monday in JAMA Network Open.

The therapies worked so well that patients reduced the amount of opioid painkillers they take in search of relief, researchers reported.

“These therapies aren’t a total cure, but they teach people how to develop the inner resources they need to cope with chronic pain and to live a better life,” senior researcher Eric Garland, a professor of health sciences and psychology at the University of California-San Diego, said in a news release.

This is the largest trial to date comparing mindfulness and CBT as potential therapies for chronic pain so bad it’s being quelled by opioids, researchers said.

For the clinical trial, researchers recruited 770 adults being treated for low back pain in Madison, Wisc.; Boston; and Salt Lake City.

“The people in this study had quite severe back pain that interfered with their life and was bad enough to need opioid medication. Usually, in that condition, people don’t really get better over time on their own,” co-lead researcher Dr. Bruce Barrett, professor of family medicine and community health at the University of Wisconsin-Madison, said in a news release.

The patients were randomly assigned to receive either mindfulness therapy or CBT, which were delivered in therapist-led two-hour group sessions for eight weeks.

The mindfulness group learned to notice the sensations they experience, giving them more control over how they relate and respond to pain and other symptoms, researchers said.

Meanwhile, the CBT group learned skills and strategies for changing negative thought patterns and behaviors that contribute to their back pain.

“Mindfulness is a self-regulated tool that comes from within, unlike surgery or medication where something is being done to you from the outside,” Garland said. “By learning these techniques, patients continue to experience lasting benefit.”

Participants were told to practice these techniques a half-hour a day, six days a week during the 12-month study. By design, they were not told to reduce their opioid dosage, but to continue with their regular routine along with either mindfulness or CBT.

By the end, both groups reported significant and long-lasting benefits from both therapies. Both had less pain, improved function, and better health-related quality of life, results show.

The therapies also helped patients reduce their reliance on opioid painkillers, results show.

“Both mindfulness and cognitive behavioral therapy were shown to be safe, effective treatments, providing lasting benefits for people with opioid-treated chronic back pain,” lead researcher Dr. Aleksandra Zgierska, vice chair for research of family and community medicine at the Penn State College of Medicine, said in a news release.

These improvements were the byproduct of people implementing the skills they learned, she said.

For example, people were taught to take a mindful breath before taking medication, rather than simply popping a pill in response to pain, Zgierska said.

As a result, people decreased their opioid use on their own after learning how to better cope with pain, researchers said.

“The study’s interventions likely helped reduce the participants’ sense of suffering, which probably allowed them to function a whole lot better,” researcher Penney Cowan, founder of the American Chronic Pain Association, said in a news release.

“People can live with pain, but they need to know how to do it,” she added. “This study provides a sense of hope. It says you can do this and help yourself to a better quality of life.”

These results indicate that both mindfulness and CBT might help people manage other types of chronic pain, researchers said.

“Mindfulness and CBT are other tools that you can add to your toolbox to increase your capacity to cope and live a meaningful life,” researcher Christin Veasley, founder of the Chronic Pain Research Alliance, said in a news release. “What's important about the types of therapies, like the ones evaluated in this study, is that they can be used broadly across all pain conditions and all pain severities.”

More information

The National Institutes of Health has more on chronic pain.

SOURCE: Penn State, news release, April 7, 2025