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Role of Mindfulness Meditation on Pain Sensation, Stress Reduction, Anxiety, and Sleep Quality of Young Adult Female Patients with Non-specific Chronic Low Back Pain
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Received: ,
Accepted: ,
How to cite this article: Ghosh D, Ghosh S, Chakraborty S. Role of Mindfulness Meditation on Pain Sensation, Stress Reduction, Anxiety, and Sleep Quality of Young Adult Female Patients with Non-specific Chronic Low Back Pain. Bengal J Psychiatry. 2026;31:5-10. doi: 10.25259/ BJPSY_7_2026
Abstract
Introduction:
Mindfulness refers to bring attention to the current moment.
Objectives:
Mindfulness or meditation–based interventions help to improve pain symptomology across a wide range of pain-connected disorders.
Material and Methods:
A total of 60 female participants, aged 19-40 years (mean age 32.33), who were diagnosed with non-specific chronic low back pain by physicians, were selected for the present study. Participants were randomly assigned to two groups: 1. the study group (involved in mindfulness meditation practice, i.e., body scan & thought observation, and usual medical care, i.e., pharmacotherapy & physiotherapy); and 2. the control group (not involved in any meditation practice, only received usual medical care, i.e., pharmacotherapy & physiotherapy). The participants were assessed by the mcgill pain questionnaire, sleep quality scale (SQS), state-trait anxiety inventory (STAI), and perceived stress scales (PSS) at pre- and post-intervention levels. Data were examined using the Wilcoxon Signed Rank Test, Mann- Whitney U Test, and Spearman’s Rank Correlation.
Results:
Results revealed that mindfulness meditation practice helped the study group perceive a significantly lesser amount of pain (p< 0.01). Their perceived stress (p< 0.01) and anxiety (p< 0.01) levels decreased; sleeping quality (p < 0.01) improved.
Conclusion:
Mindfulness meditation (body scan, thought observation) practice was effective in reducing pain sensation, stress level, and anxiety levels. It helped to improve the sleep quality of young adult female patients with Non-Specific Chronic Low Back Pain.
Keywords
Anxiety
Mindfulness meditation
Non-specific chronic low back pain
Sleep
Stress
INTRODUCTION
Mindfulness is a practice of meditation that purposely brings one's attention to the present moment.1 Mindfulness meditation focuses on cultivating inner calmness for outer strength, thereby restraining mental time travel, focusing nonjudgmentally on the present moment, and accepting it as it is.2,3 It has been revealed that mindfulness practice helped older adults reduce chronic back pain4 and improve their quality of life, attention skills, mood, and sleep quality.5
A therapeutic alliance was observed to be significantly connected with improvements in pain intensity perception.6 Another study conducted among older adults suffering from chronic lower back pain revealed that mindfulness meditation helped them.7 From a sociocultural perspective, it can be said that factors like religion, socio-familial environment, and educational status come into play while discussing mechanisms to perceive, express, and manage pain.8
The problem of low back pain is a common issue among employees stuck mostly in the office.9 In India, a study10 in Tamil Nadu about the 1-year prevalence of low back pain revealed that among women, the highest prevalence rate was 50% for the age group of 41-50 years, while that among women in general was 52.9%. In West Bengal, a study was conducted on the impact of perceived stress on chronic nonspecific low back pain in Urban females of the reproductive age group. It revealed that Mckenize Exercise was effective in reducing perceived stress.11 Other than this no other related study was reported, so it can be said that ikan West Bengal, it has been found that there is a paucity of research considering the role of mindfulness meditation on low back pain in young adults. To establish this research gap, the current study aims to analyze the role of mindfulness practices on pain perception, stress reduction, anxiety, and sleep quality in young adult patients with nonspecific chronic low back pain.
MATERIAL AND METHODS
Objectives
This study aims to find out whether there is any difference in physical components, stress, pain sensation, sleep, and anxiety between the study group pre-measure and post-measure (who don’t receive any Mindfulness Meditation Intervention), as well as to find out whether there is any difference in these same variables between baseline measures and measures after practicing mindfulness meditation in the study group participants. Additionally, it seeks to find out whether there is any difference in physical components, stress, pain sensation, sleep, and anxiety between the study group post-measure and the control group post-measure, and finally, to find out whether there is any significant correlation in physical components, stress, pain sensation, sleep, and anxiety among the study group post-measure and the control group post-measure.
Design
In the present study, a pretest-posttest design was used to assess the role of mindfulness meditation (body scan & thought observation) in patients with Non-specific chronic lower back pain. Participants were assessed with the McGill pain questionnaire, sleep quality scale, state-trait anxiety inventory (STAI), and the perceived stress scale at baseline level before receiving mindfulness meditation treatment. Then they were assessed using the same testing tools after receiving treatment for four consecutive weeks. All participants practiced mindfulness meditation (body scan & thought observation) each day (40 minutes) for the consecutive 4 weeks from February 2022 to May 2022. Meditation was administered following Siegel’s (2010) guidelines, as mentioned in 'The Mindfulness Solution Book’’. All participants had given their verbal feedback after practicing meditation each day. All 30 study group participants were divided into 5 groups, each consisting of 6 members. Each day, all groups were constantly monitored. The control group participants were not given any sort of intervention. They were only under the treatment of physiotherapy and pharmacotherapy.
Sample size
A total of 60 female participants, aged between 19 and 40 years (mean age = 32.33), were diagnosed with chronic non specific lower back pain (NSLBP) by a physician at least 6 months before. 60 participants met the inclusion criteria and consented to participation in the research program. Selected 60 Participants were assigned randomly to two groups: 1. the study group (involved in mindfulness meditation practice, i.e., body scan & thought observation, and usual medical care, i.e., pharmacotherapy & physiotherapy), consisting of 30 participants, and 2. The control group (not involved in any meditation practice, only received usual medical care, i.e., pharmacotherapy & physiotherapy) consisted of 30 participants. Initially, 100 female participants were approached. Out of that, 15 participants dropped out due to unavailability of time, and 25 participants did not match the inclusion criteria. Finally, 60 female participants were chosen based on the inclusion criteria. Sessions were conducted 7 days a week and for 4 consecutive weeks. 30 participants attended all intervention sessions. The rest of the 30 participants were in the waiting group. All 30 participants attended 42 sessions.
Participants
Participants were female adults aged between 19 and 40 years who had given their consent and were included in the study. Those who have been on medical treatment (physiotherapy and pharmacotherapy) for the last 6 months and who have a medical history of non-specific chronic low back pain for the last 6 months were included. Participants were not meditation practitioners. Participants who had a history of spine surgery and had other comorbid chronic diseases were excluded. Hospitalized or ambulatory clinic patients and patients with psychiatric illnesses were not included in the study. Meditation practitioners were excluded. Those who would not practice mindfulness meditation for the four weeks were excluded.
Assessments
Blood pressure, oxygen consumption rate, pulse rate, and weight were measured by those participants who gave consent to participate in the study at the baseline level and after receiving the mindfulness meditation intervention.
Furthermore, the participants were tested on the general health questionnaire (GHQ28), perceived stress scale (PSS), McGill pain questionnaire (which includes sensory, affective, evaluative, miscellaneous pain, pain rating index, present pain intensity), sleeping quality, state-trait anxiety inventory STAI, before the intervention at baseline level, and 4 weeks after receiving the interventions. In addition, all the participants were interviewed. The following testing tools were used:
The short-form McGill pain questionnaire
The McGill Pain Questionnaire consists of pain descriptors categorized into 3 dimensions: sensory, affective, and evaluative, in a 4-point intensity scale for patients to report subjective pain experiences. It has 2 subscales, i.e., Sensory and affective subscales.12
Sleep quality scale (SQS)
The Sleep Quality Scale consists of 28 items and analyzes six domains of sleep quality satisfaction.13
State-trait anxiety inventory (STAI)
State-Trait Anxiety Inventory (STAI) is an inventory that consists of forty self-report items on a 4-point scale. The STAI measures state anxiety and trait anxiety.14
Perceived stress scale
The Perceived Stress Scale measures the extent to which situations in one’s life are considered stressful. The form consists of positive and negative phrased items.15
Data analysis
The statistical package for the social sciences (SPSS), version 20, IBM, New York, United States of America, was used to analyze data. Descriptive statistics, including mean and standard deviation (SD), were used to present the demographic characteristics of the participants. Wilcoxon signed rank test, Mann-Whitney U Test, and Spearman’s rank correlation were used to assess the changes within the group further, as the two groups to be compared were not normally distributed.
RESULTS
The mean age of the female participants was 32.33, SD = 4.46; all of them were working, married, and from middle-income families. Among them, 28% had two children, 65% had one child, and 6% of them did not have any children 64% of them reported very poor quality of sleep on the Sleep Quality Scale. On the baseline measure, it has been revealed that 76% of patients have very high levels of stress on PSS.
According to Table 1, there is a significant difference between the study groups pre- and post-measure in pulse rate, GHQ at the 0.01 level. The mean and SD are lower in the post-measure study group than in the pre-measure study group, with significance on the Wilcoxon signed rank test.
| Variables | Study group | Control group | Z value | Significance level | ||
|---|---|---|---|---|---|---|
| Post test | Post test | |||||
| Mean | SD | Mean | SD | |||
| Blood pressure rate systolic | 102.47 | 9.20 | 99.13 | 4.92 | -1.556 | 0.120 |
| Blood pressure rate diastolic | 73.03 | 7.23 | 70.73 | 5.66 | -1.220 | 0.222 |
| Oxygen consumption rate | 98.03 | 1.03 | 98.1 | 1.03 | -.192 | 0.848 |
| Pulse rate | 87.03 | 9.48 | 81.9 | 8.75 | -2.244 | 0.025** |
| Weight | 68.33 | 9.57 | 68.07 | 9.66 | -1.633 | 0.102 |
| GHQ | 24.03 | 7.79 | 21.7 | 8.41 | -4.024 | 0.001** |
According to Table 2, there is a significant difference between the Study group post-measure and the control group post-measure in Pulse rate and weight at the 0.01 level of significance on the Mann-Whitney U Test. The mean and SD in the Study group post-measure group.
| Variables | Study group | Control group | Z value | Significance level | ||
|---|---|---|---|---|---|---|
| Post test | Post test | |||||
| Mean | SD | Mean | SD | |||
| Blood pressure rate systolic | 99.13 | 4.92 | 1.02 | 17.94 | -0.307 | 0.758 |
| Blood pressure rate diastolic | 70.73 | 5.66 | 70.93 | 6.77 | -0.289 | 0.772 |
| Oxygen consumption rate | 98.1 | 1.03 | 98.27 | .944 | -0.620 | 0.535 |
| Pulse rate | 81.9 | 8.75 | 63.43 | 7.049 | - 6.133 | 0.001** |
| Weight | 68.33 | 9.57 | 79.73 | 10.56 | - 3.781 | 0.001** |
| GHQ | 24.03 | 7.79 | 24.60 | 8.81 | - 1.510 | 0.131 |
The results from Table 3 indicated that there is a significant difference between baseline measures and post-intervention measures of the study group in Affective pain sensation (p< 0.01); Miscellaneous pain sensation (p< 0.01); Pain rating index (p< 0.01); Evaluative pain sensation (p< 0.01, State anxiety (p<0.01), Trait anxiety perceived stress (p< 0.01), sleep (p< 0.01) on Wilcoxon Signed Rank Test.
| Variables | Study group | Z value | Significance level | |||
|---|---|---|---|---|---|---|
| Baseline measure | Post-intervention | |||||
| Mean | SD | Mean | SD | |||
| McGill pain sensory | 27.43 | 7.83 | 26.5 | 6.52 | -1.188 | 0.235 |
| McGill pain affective | 9.07 | 2.96 | 7.23 | 2.86 | -3.316 | 0.001** |
| McGill pain evaluative | 3.43 | 1.33 | 2.93 | 1.08 | -2.139 | 0.032* |
| McGill pain miscellaneous | 10.8 | 3.86 | 8.7 | 2.81 | -3.012 | 0.003* |
| PRI | 50.73 | 14.81 | 45.47 | 10.76 | -4.806 | 0.001** |
| PPI | 2.13 | 0.89 | 2.47 | 0.78 | -1.714 | 0.086 |
| Sleep | 46.53 | 12.77 | 42.7 | 13.30 | -4.482 | 0.001** |
| STAI X1 | 49.2 | 8.91 | 45.03 | 9.43 | -3.176 | 0.001** |
| STAI X2 | 48.33 | 12.15 | 44.87 | 8.38 | -1.938 | 0.053* |
| PSS | 31.27 | 9.00 | 27.07 | 5.67 | -4.009 | 0.001** |
From Table 4, Spearman’s coefficient of correlation revealed that there is a positive correlation between sensory and affective pain sensation; Sensory and pain rating index; affective and evaluative pain sensation; affective and miscellaneous, affective and pain rating index; evaluative and miscellaneous; evaluative and pain rating index; evaluative and perceived stress; miscellaneous and perceived stress (p< 0.01).
| Variables | Sensory | Affective | Evaluative | Miscellaneous | PRI | PPI | Sleep | STAI X1 | STAI X2 | PSS |
|---|---|---|---|---|---|---|---|---|---|---|
| Sensory | -- | 0.591** | 0.440* | 0.392* | 0.888** | -0.075 | -0.066 | 0.209 | 0.224 | 0.141 |
| Affective | 0.591** | -- | 0.503** | 0.558** | 0.827** | -0.094 | -0.070 | 0.103 | 0.058 | 0.127 |
| Evaluative | 0.440* | 0.503** | -- | 0.599** | 0.641** | 0.285 | -0.146 | 0.057 | -0.093 | 0.365* |
| Miscellaneous | 0.392* | 0.558** | 0.599** | -- | 0.244 | 0.244 | -0.179 | -0.153 | 0.177 | 0.527** |
| PRI | 0.888** | 0.827** | 0.641** | 0.660** | -- | 0.026 | -0.130 | 0.110 | 0.059 | 0.286 |
| PPI | -0.075 | -0.094 | 0.285 | 0.244 | 0.026 | -- | -0.153 | -0.276 | -0.263 | 0.247 |
| Sleep | -0.066 | -0.070 | -0.146 | -0.179 | -0.130 | -0.153 | -- | 0.253 | 0.117 | -0.287 |
| STAI X1 | 0.209 | 0.103 | 0.057 | -0.153 | 0.110 | -0.276 | 0.253 | -- | 0.684** | -0.485** |
| STAI X2 | 0.224 | 0.058 | -0.093 | 0.177 | 0.059 | -0.263 | 0.117 | 0.684** | -- | -0.321 |
| PSS | 0.141 | 0.127 | 0.365* | 0.527** | 0.286 | 0.247 | -0.287 | -0.485** | -0.321 | -- |
DISCUSSION
The results revealed that the study group that received Mindfulness Meditation (Body Scanning and thought observation) demonstrated significant improvement in their overall pain sensation, sleep quality, stress level, and anxiety level scores as a result of the training compared to the control group, receiving only standard medical care. It reduced pain perception, stress levels, and anxiety levels and enhanced sleep quality.
According to the results, those who participated in mindfulness meditation practice experienced less affective pain. The affective component of pain refers to the quality of the pain that makes the pain unpleasant or aversive. It has also been found that participants practicing mindfulness meditation experienced less evaluative pain. The evaluative domain of the McGill Pain Questionnaire refers to how severe the pain is.16 The Pain Rating Index (PRI) constitutes the sum of the rank values from 20 sets of pain descriptions in the McGill pain questionnaire15 which has also been reduced after the intervention was given.
Previous studies have shown that mindfulness is effective in the treatment of anxiety and insomnia.17-19 In the present study, it has also been revealed that those participants practicing mindfulness meditation experienced less sleep disturbance as it prepares the mind for sleep, and can also improve sleep quality and reduce anxiety as mindfulness promotes experiencing the present moments openly and non-judgmentally.20
Results of this study also suggest that participants practicing mindfulness meditation are effective in perceiving lower levels of stress. Practicing mindfulness reduces activity in the amygdala, a part of the brain. The amygdala is responsible for turning on the response to stress, so effectively that background stress levels are reduced.21
According to the results, if sensory pain experience increases, then affective pain experience also increases. Affective pain refers to the discomfort inherent in pain and emotions, while sensory pain refers to the experience of pain involving the perception of the location, intensity, and quality of pain.22
Results revealed that if evaluative pain increases, then stress, sensory pain, and affective pain also increase. Stress causes muscles to spasm, which increases pain. At times of stress, levels of cortisol, a hormone, rise, which can cause pain as well as inflammation over time.23
In addition, meditation practitioners perceived positive changes in their lives. Once they acquired the skill to objectively see continuous pain and observe other sensations in their bodies, they applied a similar mechanism through mindfulness techniques to their daily lives. As a result, they learned to get along with their health and started to devote themselves to their daily work consciously.
Strengths
The strengths of the present study is-
The current study reflects the effectiveness of mindfulness meditation in the reduction of pain sensation and improvement of physical and mental components of the Non- Specific Chronic Low Back Pain in female patients.
Limitations
All study group participants did not receive the same physiotherapy treatment and the same medicine for pain management, and the whole meditation session was monitored online and feedback was collected in online mode, while only female participants were available for this present study as male participants were not available.
Scope for further study
Further research can be conducted on physiological variables such as MRI, NMR, and neurologic signals to test the efficacy of mindfulness meditation (body scanning and thought observation) to decrease pain in sufferers.
CONCLUSION
From the present study, it can be concluded that mindfulness meditation practice was effective in reducing pain sensation, stress level, and anxiety level, and improving sleep quality of female young adult patients with non-specific chronic low back pain.
Ethical approval:
The research/study was approved by the Institutional Review Board at West Bengal State University, number WBSU/ IHEC/07/2024/23, dated 28th Aug 2024.
Declaration of patient consent:
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given consent for clinical information to be reported in the journal. The patient understand that the patient’s names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Conflicts of interest:
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation:
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
Financial support and sponsorship: Nil.
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