Mindfulness-Oriented Recovery Enhancement Ameliorates the Impact of Pain on Self-Reported Psychological and Physical Function Among Opioid-Using Chronic Pain Patients

Abstract

Context Chronic pain impacts one-third of the U.S. population, and its effects are debilitating for individuals and costly to the medical system. Although opioids are commonly prescribed to address chronic pain, they confer risk for misuse and addiction, and may not fully restore life function – particularly with regard to psychosocial factors. Because of the multiplicity of impacts that chronic pain may have on daily functioning, broad-spectrum behavioral interventions are needed. Objectives The purpose of this study was to conduct follow-up analyses from a pilot randomized controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE) to assess specific effects of MORE on various biopsychosocial aspects of pain-related impairment. Methods Chronic pain patients (N=115; mean age 48±14 years; 68% female) were randomly assigned to either eight weeks of MORE or to a support group (SG). Domains of pain-related functional interference were measured with the Brief Pain Inventory at pre- and post-treatment, and at a three-month follow-up. Treatment effects were analyzed with multivariate intention-to-treat models. Results MORE participants reported significantly greater reductions in functional interference than SG participants at post-treatment across all domains, including: general activity, mood, walking ability, normal work, relationships, sleep, and enjoyment of life. These effects were largely maintained by the three-month follow-up; however, general activity level and walking ability were no longer significant, indicating differential long-term effects between physiological and psychological functioning. Conclusion Findings demonstrate preliminary efficacy of MORE as a treatment for pain-related functional impairments, and suggest that effects may be more pronounced and durable for aspects of psychological function.

Understanding Monitoring Technologies for Adults With Pain: Systematic Literature Review

“…therapy: participants were evaluated while doing some type of therapy (eg, leg curls, music, behavioral therapy) [ 30 - 35 , 44 , 46 , 49 , 52 , 58 , 93 , 104 ].…”

Happy Despite Pain

“…Examples are solution-focused therapy, 46 Loving Kindness Meditation, 10 and a mindfulness-based program complemented with principles from positive psychology (eg, savoring). 47 These interventions have also been found helpful, although for each of these interventions there is only preliminary evidence from small scale or pilot studies. Our study is the largest RCT so far on the usefulness of positive psychology techniques for chronic pain.…”

Mindfulness Meditation and Psychopathology

“…In particular, because pain-related syndromes are characterized by a variety of pathogenic alterations in neural pain processing (Bushnell et al 2013), it will be important to carry out mechanistic studies of MMBIs in specific clinical populations. Finally, for public health reasons, transdiagnostic applications of MMBIs to chronic pain in the context of long-term opioid use should be a high priority (see Garland et al 2014c for one such initiative).…”