Mindfulness and Chronic Low Back Pain

Chronic pain affects over 100 million Americans and costs the United States approximately
$635 billion dollars a year. The widespread use of opioids to treat chronic pain has led to
the so-called "opioid epidemic", a phenomenon marked by the exponential growth in opioid
misuse and addiction. These staggering statistics highlight the importance of developing,
testing and validating fast-acting, non-pharmacological approaches to treat pain. Mindfulness
meditation has been found to significantly reduce pain in experimental and clinical settings.
However, lack of mechanistic data and the assumption that extensive meditation training is
required to experience analgesia has limited the clinical deployment of this cost-effective
and narcotic-free treatment. The central aim of the proposed study is to determine the
specific neural mechanisms that are engaged during mindfulness-based analgesia. This study
will examine if longer bouts of meditation training will increase meditation-induced brain
activation (i.e., OFC, sgACC) during chronic low back pain evocation. The knowledge gained
from this study will provide novel mechanistic insight to better develop and tailor cognitive
therapeutic interventions to target multiple chronic pain conditions.

Inclusion criteria are:

- Participants must have a medical evaluation that shows the source of low-back pain is
associated with at least one degenerated, torn or herniated lumbar disc with a minimum
Grade III disc degeneration. Study physicians will confirm diagnosis.

- Participants must be between the ages of 18-65 years.

- Participants must rate their daily chronic pain intensity at a 3 or greater on 0-10
visual analog scale.

- Participants must have experienced their radicular pain for at least 6 months
duration.

- They must not be participating in any other pain management procedures during the
study period.

- Participants must not have had back surgery within the last year before their
enrollment into the study.

- Participants must not have had any other sensory or motor deficits that precludes
participation in this study.

- Participants must be right-handed.

- Participants must have no prior meditative experience/

Exclusion criteria:

- Participants will be excluded from the study if they have known anomalies of the
central nervous system including: stroke, dementia, aneurysm, a personal history of
psychosis.

- Participants will be excluded from the study if they test positive for opiates before
each MRI testing session.

- Participants that have metal implants including ferrous arterial stints or coils,
spinal stimulators, pacemakers, or defibrillators, permanently implanted hearing
aides, bullets, BBs, or pellets, retinal eye implants, infusion pump for insulin or
other medicines, ferrous surgical clips, staples, metal sutures, orthopedic hardware
above or including the shoulders, body piercings that cannot be removed.

- Participants will be excluded from the study if they are claustrophobic.

- Participants that do not produce positive straight leg test (i.e. a test is considered
positive when the person reports reproducible pain at 40 degrees of hip flexion or
less).