Methods: This study was a three-arm, randomized controlled trial conducted at a university-based orthopedic clinic during a preoperative information session for patients scheduled for surgery. Patients (N=261) were assigned to one of three, 15-minute psychosocial intervention conditions delivered by either a social worker or a psychologist: mindfulness (n=96), hypnotic suggestion (n=82), or psychoeducation based on cognitive-behavioral therapy (n=86). Patients completed a survey measuring pain, desire for pain medication, and anxiety pre- and post-intervention. Participants also completed the PROMIS Global Physical Health scale at their first post-surgical outpatient medical visit: x̅=29 (SD=25) days post-surgery.
Results: Repeated measures ANOVA with Tukey’s HSD post hoc analysis revealed a pattern of significantly reduced pain severity (F2,258=4.64, p=.010), desire for pain medication (F2,257=3.19, p= .043), and anxiety (F2,261=7.32, p=.001) for participants receiving one of the two MBIs (mindfulness or hypnosis) compared with psychoeducation. Results indicated the two MBIs did not significantly differ in their effectiveness. Additionally, participants receiving one of the two MBIs reported better physical health at their first post-surgical provider visit compared with participants receiving psychoeduction (F2,179=3.79, p= .025), after accounting for pre-surgical pain severity.
Conclusions and Implications: Findings from this study indicate that a brief MBI, conducted by a social worker, is likely to immediately alleviate pain severity by 23%, decrease medication desire by 31%, and relieve anxiety by 35% in patients preparing for elective, orthopedic surgery. Furthermore, involvement in a pre-surgical MBI resulted in better self-reported physical health nearly one-month post-surgery, suggesting durable effects from a single session intervention. As such, mind-body interventions may be useful adjuncts to medical pain management that a) can be easily disseminated in clinical settings via social workers, b) provide considerable pre-surgical pain and anxiety relief, c) potentially reduce patients’ reliance on opioid analgesics (and thereby reduce opioid misuse risk), and d) encourage better post-surgical outcomes.