BACKGROUND: Mindfulness-based stress reduction (MBSR) and massage may be useful adjunctive therapies for chronic musculoskeletal pain.
OBJECTIVE: To evaluate the feasibility of studying MBSR and massage for the management of chronic pain and estimate their effects on pain and mood.
DESIGN: Randomized trial comparing MBSR or massage with standard care.
PARTICIPANTS: Thirty patients with chronic musculoskeletal pain.
MEASUREMENTS: Pain was assessed with 0 to 10 numeric rating scales. Physical and mental health status was measured with the SF-12.
RESULTS: The study completion rate was 76.7%. At week 8, the massage group had average difference scores for pain unpleasantness of 2.9 and mental health status of 13.6 compared with 0.13 (P<.05) and 3.9 (P<.04), respectively, for the standard care group. These differences were no longer significant at week 12. There were no significant differences in the pain outcomes for the MBSR group. At week 12, the mean change in mental health status for the MBSR group was 10.2 compared with — 1.7 in the standard care group (P<.04).
CONCLUSIONS: It is feasible to study MBSR and massage in patients with chronic musculoskeletal pain. Mindfulness-based stress reduction may be more effective and longer-lasting for mood improvement while massage may be more effective for reducing pain.
mindfulness-based stress reduction massage chronic pain mental health integrative medicine
Berman BM, Swyers JP. Complementary and alternative therapies for chronic pain: establishing a research agenda for investigating alternative medial interventions for chronic pain. Primary Care: Clin Office Pract. 1997;24:743–58.CrossRefGoogle Scholar
Broderick JE. Mind-body medicine in rheumatologic disease. [review] [68 refs]. Rheum Dis Clin N Am. 2000;26:161–76.CrossRefGoogle Scholar
Wolsko PM, Eisenberg DM, Davis RB, Phillips RS. Use of mind-body medical therapies. J Gen Intern Med. 2004;19:43–50.PubMedCrossRefGoogle Scholar
Caudill M, Schnable R, Suttermeister P, et al. Decreased clinic utilization by chronic pain patients; response to behavioral medicine intervention. Clin J Pain. 1995;7:305–10.CrossRefGoogle Scholar
Kabat-Zinn J, Lipworth L, Burney R. The clinical use of mindfulness meditation for the self-regulation of chronic pain. J Behav Med. 1985;8:163–90.PubMedCrossRefGoogle Scholar
Kabat-Zinn J, Lipworth L, Burney R, Sellers W. Four year follow-up of a meditation-based program for the self-regulation of chronic pain: treatment outcomes and compliance. Clin J Pain. 1986;2:159–73.CrossRefGoogle Scholar
Kaplan KH, Goldenberg DL, Galvin-Nadeau M. The impact of a meditation-based stress reduction program on fibromyalgia. Gen Hosp Psychiatr. 1993;15:284–9.CrossRefGoogle Scholar
Bishop SR. What do we really know about mindfulness-based stress reduction? Psychosom Med. 2002;64:71–83.PubMedGoogle Scholar
Cherkin D, Sherman K, Deyo R, Shekelle P. A review of the evidence for the effectiveness, safety and cost of acupuncture, massage therapy and spinal manipulation for back pain. Ann Intern Med. 2003;138:898–906.PubMedGoogle Scholar
Cherkin DC, Eisenberg D, Sherman K, Barlow W, Kaptchuk T, Street J, et al. Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Arch Intern Med. 2001;161:1081–8.PubMedCrossRefGoogle Scholar
Preyde M. Effectiveness of massage therapy for subacute low back pain: a randomized controlled trial. CMAJ. 2000;162:1815–20.PubMedGoogle Scholar
Hernandez-Reir M, Field T, Krasnegor J, Theakston H. Lower back pain is reduced and range of motion increased after massage therapy. I J Nurs. 2001;1061:131–45.Google Scholar
Downie WW, Leatham PA, Rhind VM, Wright V, Branco JA, Anderson JA. Studies with pain rating scales. Ann Rheum Dis. 1978;37:378–81.PubMedCrossRefGoogle Scholar
Kremer E, Atkinson JH, Ignelzi RJ. Measurement of pain: patient preference does not confound pain measurement. Pain. 1981;10:241–8.PubMedCrossRefGoogle Scholar
Seymour RA. The use of pain scales in assessing the efficacy of analgesics in post-operative dental pain. Eur J Clin Pharmacol. 1982;23:441–4.PubMedCrossRefGoogle Scholar
Wallenstein SL, Heidrich GI, Kaiko R, RWH. Clinical evaluation of mild analgesics: the measurement of clinical pain. Br J Clin Pharmacol. 1980;10:319S-27S.PubMedGoogle Scholar
Ware JE, Kosinski M, Keller SD. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–33.PubMedCrossRefGoogle Scholar
Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatr. 1982;4:33–47.CrossRefGoogle Scholar