Boston Medical Center announced on June 29 that its Optimizing Pain Treatment In Medical settings Using Mindfulness (OPTIMUM) trial delivered through primary care telehealth led to sustained reductions in pain and improvements in daily life for patients with chronic low back pain. The research, published in JAMA Internal Medicine, highlights a scalable, non-pharmacological approach to treating chronic pain.
Low back pain affects over 600 million people and is the single leading cause of disability worldwide. It often limits a person's ability to walk, work, sleep, and socialize while also impacting mental health and overall wellbeing. Although it is one of the most common reasons for visiting a primary care physician, treatment options are limited; medications carry risks, surgery helps only some patients, and non-pharmacological therapies can be difficult to access.
The OPTIMUM trial tested an adapted version of Mindfulness-Based Stress Reduction specifically designed to treat pain as a stressor. A total of 451 participants across three states attended 120-minute group sessions over eight weeks led by both a trained mindfulness instructor and a primary care physician. Unlike traditional referrals to outside programs, this model integrated the clinician directly into each session so every participant had direct access to medical expertise as part of their experience. Participants engaged in gentle stretching exercises and mindfulness activities aimed at helping them adapt their activities and build awareness around how pain shapes their lives.
Researchers found significant improvements in both reported pain levels and "pain interference"—the extent that pain limited physical activity or enjoyment—measured on a 0-to-10 scale. These gains were sustained at follow-up after twelve months.
The trial was intentionally designed with broad entry criteria reflecting real-world patient diversity. The telehealth format removed transportation or scheduling barriers that can prevent access to structured programs. Additionally, because the program is billable as a group medical visit, it can be reimbursed through existing payment structures.
"We have evidence-based guidelines, but the challenge has been getting those approaches to more people," said Dr. Morone. "If we can bring evidence-based treatment into primary care and build a model the healthcare system can sustain, we have a real opportunity to help far more people. That's what drives this research—getting effective care to the people who need it most."
