Report Endorses Insurance Coverage for Yoga/Mindfulness for Chronic Back Pain

Will the future of back pain treatment involve practices like yoga and meditation? While this may seem like a pipe dream, a recent comprehensive report reviewing the current research and its impact brings us one step closer to this reality. The report, sponsored by the Institute for Clinical and Economic Review (ICER) found that not only are yoga and meditation beneficial for relieving chronic low back pain, but that these practices are more cost effective than surgery or medication.

Low back pain is among the leading causes of disability worldwide, with the cost of treatment rapidly rising during the past 20 years. To curb the epidemic of opioid addiction, many physicians and patients are turning to mind-body therapies.

So far, however, many insurance companies refuse to cover treatment. To address this issue, the Institute for Clinical and Economic Review (ICER) convened a group of researchers to examine whether mind-body therapies might serve as an alternate approach to low back pain management, and warrant insurance reimbursement.

ICER is an independent, non-profit organization that evaluates medical research in collaboration with clinical experts, patients and stakeholders with the goal of informing patient care, improving outcomes, and controlling costs. The ICER report was reviewed in a public meeting, and approved by the California Technical Assessment Forum (CTAF) prior to its release.

Yoga and Mindfulness Offer Low-cost Alternative Back Pain Treatment

The report summarized a review of the evidence of the effectiveness of yoga and mindfulness-based approaches for treating chronic back pain for adults 18 years of age and older whose pain was not due to trauma, fracture, pregnancy, cancer, or progressive neurological problems. Effectiveness was defined by the treatment’s ability to improve function, reduce pain, depression and disability, and enhance quality of life.

The report noted that yoga and mindfulness-based therapies hold promise as alternative treatments for chronic low back pain. Perhaps their greatest benefits are derived from their cost- effectiveness compared to standard forms of treatment. This may allow those with little access to traditional forms of care, such as physical therapy, to seek and find pain relief.

The report also included several caveats. First, we have yet to understand whether a particular form of yoga, or mind-body therapy is most effective in remediating chronic low back pain. Given the significant inconsistency in approaches among the different schools of yoga, and the limited number and quality of studies, additional research using highly skilled yoga therapists is needed to better understand best practices for yoga and mindfulness interventions for back pain.

Similarly, there is a great deal of variability in the causes of chronic low back pain. Some mind-body therapies may be particularly impactful for some subtypes of pain, whereas others may not. This has yet to be determined.

Importantly, the ICER report concluded that “the mind-body interventions evaluated in this assessment have no important harms.” This is great news for those seeking low-cost, non-pharmaceutical options for treating low back pain, and hopefully a stimulus for additional, high quality studies of yoga and mindfulness-based approaches for chronic pain, and for insurance providers to more extensively cover these services.

B Grace Bullock, PhD, E-RYT 500 is a psychologist, research scientist, educator, yoga and mindfulness expert and author of the acclaimed book, Mindful Relationships: Seven Skills for Success– Integrating the Science of Mind, Body and Brain. She specializes in working with large and small organizations to improve health and wellbeing, job satisfaction, engagement and business performance by using evidence-based approaches grounded in applied neuroscience, interpersonal neurobiology, psychophysiology, psychology and the science of mindfulness to reduce stress and increase health, wellbeing and resilience, and to improve the quality of relationships. She offers mindfulness-informed coaching, training, education and leadership enhancement programs to professionals interested in reducing stress and cultivating skillful, successful personal and professional relationships. Dr. Bullock is an Associate Scientist at the Oregon Research Institute, Adjunct Professor at Endicott College, Faculty at the Oregon Mind Body Institute, and the Founding Director and CEO of the International Science & Education Alliance, an organization devoted to the design, development, training and evaluation of mindfulness-based programs to support health and wellbeing, and to promote effective leadership, decision-making and social change. She excels in the development, testing and validation of innovative programs, and quantitative, qualitative and mixed-methods assessments for clinical, organizational leadership, education, systems evaluation and mindfulness-oriented research. She is a frequent contributor to Mindful and Yoga International, and the former editor in chief of the International Journal of Yoga Therapy. For more information see www.bgracebullock.com. 

Sources

Tice JA, Kumar V, Otuonye I, Webb M, Sneider M et al. (2017). Cognitive and mind-body therapies for chronic low back and neck pain: Effectiveness and value. Institute for Clinical and Economic Review.