Telehealth mindfulness group visits ease chronic low back pain, trial finds

Boston Medical Center’s OPTIMUM trial found that telehealth mindfulness group visits eased chronic low back pain, with improvements in pain intensity and pain interference that lasted 12 months. The gains were real, but they stayed modest, which puts the story squarely in the realm of access and delivery rather than a breakthrough cure.

The pragmatic randomized clinical trial, called OPTIMUM, short for Optimizing Pain Treatment in Medical settings Using Mindfulness, ran from May 7, 2021, to November 6, 2024. It enrolled adults with chronic low back pain in primary care clinics in Massachusetts, Pennsylvania and North Carolina, with the implementation phase involving about 450 patients. Led by Natalia E. Morone of the Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, the program adapted mindfulness-based stress reduction for primary-care telehealth instead of sending patients to a separate in-person course.

Each participant in the mindfulness arm took part in eight-week group sessions that lasted 120 minutes apiece. A trained mindfulness instructor and a primary care physician led the sessions together, folding medical oversight into the practice. That structure matters for people who struggle with travel, scheduling or finding a nearby program, and it helps explain why the trial was designed around group medical visits rather than a standalone meditation class.

The trial found significant improvements in pain intensity and pain interference compared with usual care, meaning pain became less disruptive to daily activity and enjoyment of life. Those benefits held at 12 months, a notable result in a chronic condition that can grind on for years. Even so, the between-group change did not meet the prespecified mean 1-point minimal clinically important difference, so the study supports mindfulness as a useful adjunct, not a dramatic reset.

That balance fits the broader back-pain landscape. The World Health Organization says low back pain affected 619 million people globally in 2020 and could reach 843 million by 2050. Mindfulness-based stress reduction already appears in American College of Physicians guidance for chronic low back pain, alongside other noninvasive, nonpharmacological approaches. For people who can commit to an eight-week, 120-minute telehealth group and want another tool in the pain toolkit, the trial points to a practical option that is easier to reach than a clinic across town, but still not a promise of large relief.