Mindfulness modestly improves chronic back pain

Telehealth mindfulness group visits modestly reduced chronic low back pain but did not reach the prespecified clinically important average benefit.
*Pragmatic randomized clinical trial; Level 2 (OCEBM).

Citation

Morone NE, Faurot KR, Weinberg J, et al. Mindfulness-Based Group Medical Visits for Persons With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Internal Medicine. 2026;186(9):1090-1099. doi:10.1001/jamainternmed.2026.2186

Background

Chronic low back pain is common, disabling, and often incompletely relieved by usual treatments. Mindfulness programs are guideline-supported but rarely built into routine primary care.

Patients

451 adults from primary care clinics in Massachusetts, Pennsylvania, and North Carolina with low back pain lasting at least 3 months and a Pain, Enjoyment of Life and General Activity score of 3 or higher. Exclusions included unexplained fever or weight loss, pregnancy, metastatic cancer, or living with another study participant.

Intervention

Eight weekly 120-minute telehealth mindfulness group medical visits, led by a mindfulness instructor and including a primary care clinician.

Control

Usual primary care for chronic low back pain.

Outcome

Change in Pain, Enjoyment of Life and General Activity score (0 to 10; higher is worse). A 1-point between-group difference was prespecified as clinically important.

Follow-up Period

8 weeks, 6 months, and 12 months.

Results

Outcome Time Between-group difference
Pain and activity score 8 weeks Mean difference −0.89 (95% CI −1.27 to −0.51)
Pain and activity score (primary) 6 months Mean difference −0.62 (95% CI −1.02 to −0.23)
Pain and activity score 12 months Mean difference −0.74 (95% CI −1.14 to −0.34)

Pain, Enjoyment of Life and General Activity score combines pain intensity and pain interference.

Results were intention-to-treat. Usual care was the available current primary care treatment. The mean benefit never reached the prespecified clinically important 1-point difference. For at least a 1-point improvement, the number needed to treat was about 8 at 6 months and 6 at 12 months; confidence intervals were not reported.

Limitations

Participants knew their treatment assignment, and there was no attention-matched control, so group support and clinician attention may explain some benefit. Only 45% met the prespecified session-attendance target. Technology problems sometimes hindered participation. Results came from 3 health systems and may not apply to all settings. Statistically significant average improvements were small and may not feel meaningful to many patients.

Funding

U.S. National Institutes of Health; no funder role.

Clinical Application

Offer telehealth mindfulness group visits as an optional adjunct, not a replacement, for usual chronic low back pain care.