Introduction
Methods
Search Strategy
Eligibility Criteria
Procedures
Meta-analytic Techniques
Results
Description of Included Studies
Study | Sample size | Location | Source of pain | % male | Age (M (SD)) | Intervention | Comparators | Quality rating |
---|---|---|---|---|---|---|---|---|
Astin et al. [53] | 128 | USA | Fibromyalgia | 0.7 | 48 (10.6) | MBSR and Qigong for 8 weeks | Education support group | Poor |
Bakhshani et al. [61] | 40 | Middle East | Migraine, headache | 35.1 | Intervention, 30 (9.08); control, 31 (9.57) | MBSR for 8 weeks with TAU | TAU | Poor |
Banth and Ardebil [60] | 88 | Middle East | Back pain | 0 | 40.3(8.2) | MBSR for 8 weeks with TAU | TAU | Poor |
Brown and Jones [54] | 40 | Europe | Fibromyalgia, rheumatoid arthritis, other musculoskeletal | 26 | Intervention, 48 (10); control, 45 (12) | Mindfulness-based pain management program: breath awareness, body awareness, gentle movement, pain management, compassion training for 8 weeks | TAU | Poor |
Cash et al. [39] | 91 | USA | Fibromyalgia | 0 | Not reported | MBSR for 8 weeks | Waitlist control group | Fair |
Cathcart et al. [40] | 58 | Australia | Headache | 37 | Intervention, 46 (13.10); control, 45 (14.2) | Brief mindfulness-based therapy, based on MBSR and MBCT for 3 weeks | Waitlist control group | Fair |
Cherkin et al. [38] | 342 | USA | Back pain | 34.3 | 49 (12.3) | MBSR for 8 weeks with TAU | CBT with TAU or TAU alone | Good |
Davis and Zautra [42] | 79 | USA | Fibromyalgia | 2 | 46; range = 22–81 | Mindful social emotional regulation internet intervention in 12 modules for 6 weeks | Healthy lifestyle tips via internet | Fair |
Day et al. [41] | 36 | USA | Migraine, headache | 11 | 42 (12.0) | MBCT for 8 weeks adapted for headache pain with TAU | Waitlist control group | Fair |
Dowd et al. [43] | 124 | Europe | Headache, back pain, osteoarthritis, fibromyalgia, nerve pain, neuropathy | 10 | 45 (12.25) | MBCT computerized: included audio-recorded meditation, psychoeducation, mindfulness, and a cognitive and behavioral change for 6 weeks | Psychoeducation | Fair |
Esmer et al. [55] | 40 | USA | Back pain, leg pain | 56 | Intervention, 55 (11.2); control, 58 (9.5) | MBSR for 8 weeks with TAU | TAU | Poor |
Fjorback et al. [32] | 120 | Europe | Bodily distress syndrome | 20 | Intervention, 38 (9); control, 40 (8) | MBSR for 8 weeks with TAU | Enhanced TAU of 2-h specialist medical care and brief CBT | Good |
Fogarty et al. [30] | 51 | New Zealand | Rheumatoid arthritis | 12 | Intervention, 52 (12); control, 55 (13) | MBSR for 8 weeks and TAU | TAU | Good |
Garland et al. [44] | 115 | USA | Osteoarthritis, fibromyalgia | 32 | 48 (14) | MORE: multimodal intervention of mindfulness, CBT, positive psychology for 8 weeks with TAU | Support group with TAU | Fair |
Gaylord et al. [45] | 75 | USA | Irritable bowel syndrome | 0 | Intervention, 45 (12.55); control, 41 (14.68) | Mindfulness training tailored for IBS population for 8 weeks with TAU | TAU and support group | Fair |
Jay et al. [50] | 112 | Europe | Musculoskeletal pain | 0 | Intervention, 45.5 (9.0); control, 47.6 (8.2) | Mindfulness pain and stress workplace program for 10 weeks | TAU | Fair |
Johns et al. [37] | 71 | USA | Cancer | 9.9 | Intervention, 56 (9.9); control, 56 (12.7) | MBSR for 8 weeks | Psychoeducation support group | Good |
Kanter et al. [62] | 20 | USA | Interstitial cystitis, bladder pain syndrome | 0 | Intervention, 46 (15.2); control, 44 (13.9) | MBSR for 8 weeks with TAU | TAU | Poor |
Kearney et al. [51] | 55 | USA | Gulf War illness | 85.5 | Intervention,51 (6.8); control, 48 (7.4) | MBSR for 8 weeks with TAU | TAU | Fair |
la Cour and Petersen [46] | 109 | Europe | Varied, non-specific pain | 15 | Intervention, 47 (12.42); control, 49 (12.20) | MBSR: Standard program modified for chronic pain patients for 8 weeks with co-intervention TAU | Waitlist, TAU | Fair |
Lengacher et al. [52] | 322 | USA | Cancer | 0 | 56.6 (9.7) | MBSR modified for breast cancer patients for 6 weeks with TAU | TAU | Fair |
Ljotsson et al. [33] | 85 | Europe | Irritable bowel syndrome | 15 | 35 (9.4) | MBCT protocol via Internet for IBS group treatment for 10 weeks | Online discussion forum | Good |
Ljotsson et al. [34] | 195 | Europe | Irritable bowel syndrome | 21 | 39 (11.1) | MBCT protocol via internet for IBS group treatment for 10 weeks | Online stress management program | Good |
Meize-Grochowski et al. [56] | 31 | USA | Postherpetic neuralgia | 44 | Overall, 72 (9.6) | MBSR: 1 h instruction focusing breathing while seated comfortably, daily meditation using CD, phone call reminders, daily journal, for 6 weeks with TAU | TAU | Poor |
Morone et al. [47] | 37 | USA | Back pain | 43 | Intervention, 74 (6.1); controls, 76 (5.0) | Waitlist controls | Fair | |
Morone et al. [57] | 40 | USA | Back pain | 37 | Intervention, 78(7.1); control, 73(6.2) | Over the counter and prescribed medications | Poor | |
Morone et al. [36] | 282 | USA | Back pain | 33.7 | 74.5 (6.6) | MBSR for 8 weeks | Health education program | Good |
Omidi and Zargar [58] | 66 | Middle East | Headache | 20 | Intervention, 35 (2.41); control, 32 (3.2) | MBSR for 8 weeks | TAU | Poor |
Parra-Delgado and Latorre-Postigo [31] | 33 | Europe | Fibromyalgia | 0 | 53 (10.08) | MBCT for 12 weeks with TAU | TAU | Good |
Plews-Ogan et al. [59] | 30 | USA | Musculoskeletal pain | 23 | 47 (NR) | MBSR for 8 weeks | TAU (this group used in analysis) or massage | Poor |
Rahmani and Talepasand [63] | 24 | Middle East | Cancer | 0 | Intervention, 43 (3.07); control, 45 (3.28) | MBSR and group conscious yoga for 8 weeks | No treatment | Poor |
Schmidt et al. [48] | 177 | Europe | Fibromyalgia | 0 | 53 (9.6) | Modified MBSR: mindfulness, yoga, and social interaction topics for 8 weeks | Waitlist (this group used in analysis), relaxation and stretching support group | Fair |
Teixeira [64] | 22 | USA | Diabetic peripheral neuropathy | 25 | 75 (10.8) | Modified MBSR: mindfulness meditation instruction and compact disk 5 days/week over a 4-week period for 4 weeks | Nutritional information and food diary | Poor |
Wells et al. [49] | 19 | USA | Migraine | 11 | Intervention, 46 (17); control, 45 (12) | MBSR for 8 weeks | TAU | Fair |
Wong [65] | 100 | Asia | Unspecified | NR | NR | MBSR for 8 weeks | Multidisciplinary education program | Poor |
Wong [28] | 100 | Asia | Unspecified | NR | 48 (7.84) | MBSR for 8 weeks | Multidisciplinary pain intervention | Good |
Zautra et al. [29] | 144 | USA | Rheumatoid arthritis | 32 | Men, 62 (NR); women, 51 (NR) | Mindfulness meditation based on MBSR and emotion regulation therapy offered in sessions and home practice for 8 weeks | Education group (this group used in analysis), cognitive behavioral therapy | Good |
Zgierska et al. [35] | 35 | USA | Back pain | 20 | 51.8 (9.7) | MBCT-manualized program 6 days/week for 8 weeks with TAU | TAU and opioid therapy | Good |
Study | Outcome | Measure | % pain change Tx Grp | % pain change Ctrl Grp | SMD (95 % CI) | Follow-up (week) |
---|---|---|---|---|---|---|
Astin et al. [53] | Pain | SF-36 pain score | −31.58 % | −34.39 % | 0.02 (−0.47, 0.5) | 14 |
−28.79 % | −35.03 % | −0.04 (−0.52, 0.45) | 24 | |||
−23.22 % | −29.94 % | −0.05 (−0.54, 0.43) | 8 | |||
Depression | BDI | – | – | 0.15 (−0.35, 0.64) | 24 | |
Bakhshani et al. [61] | Pain | Significant improvement in pain, quality of life; sample size of groups at follow-up not reported | ||||
Quality of life | ||||||
Banth and Ardebil [60] | Pain | MPQ | −47.92 % | −11.62 % | 2.5 (1.94, 3.07) | 12 |
Quality of life | SF-12 mental health | – | – | 1.11 (0.65, 1.56) | 8 | |
– | – | 1.49 (1.01, 1.97) | 12 | |||
SF-12 physical health | – | – | 1.34 (0.88, 1.81) | 8 | ||
– | – | 1.86 (1.36, 2.37) | 12 | |||
Brown and Jones [54] | Pain | Laser pain unpleasantness | 9.26 % | 6.78 % | 0.24 (−0.51, 0.98) | 24 |
Quality of life, mental | SF-36 mental composite | – | – | 1.16 (0.36, 1.96) | 24 | |
Quality of life, physical | SF-36 physical composite | – | – | −0.42 (−1.17, 0.33) | 24 | |
Cash et al. [39] | Pain | VAS | −4.26 % | −5.92 % | 0 (−0.42, 0.41) | 16 |
−11.31 % | −1.01 % | 0.32 (−0.1, 0.74) | 8 | |||
Cathcart et al. [40] | Pain | Headache intensity | −4.42 % | −11.16 % | 0.08 (−0.52, 0.69) | 8 |
Cherkin et al. [38] | Pain | Significant reductions in pain and disability; Reported only adjusted data | ||||
Disability | ||||||
Davis and Zautra [42] | Pain | Pain | −0.93 % | −1.52 % | −0.24 (−0.69, 0.2) | 6 |
Day et al. [41] | Pain | BPI intensity | −11.98 % | −6.53 % | −0.01 (−0.66, 0.65) | 8 |
Dowd et al. [43] | Pain | Average pain | 1.26 % | −11.77 % | 0 (−0.36, 0.35) | 6 |
7.18 % | 1.71 % | −0.19 (−0.54, 0.17) | 30 | |||
Esmer et al. [55] | Pain | VAS | −29.74 % | −0.82 % | 0.3 (−0.5, 1.1) | 12 |
Disability | Roland-Morris disability | – | – | 0.90 ( 0.06 , 1.74 ) | 12 | |
Fjorback et al. [32] | Pain | SF-36 bodily pain | −31.25 % | −7.38 % | 0.15 (−0.23, 0.53) | 12 |
−44.12 % | −12.08 % | 0.23 (−0.18, 0.63) | 36 | |||
−34.93 % | −31.54 % | −0.1 (−0.51, 0.31) | 60 | |||
Quality of life, mental | SF-36 mental composite | – | – | −0.04 (−0.42, 0.34) | 60 | |
Quality of life, physical | SF-36 physical composite | – | – | 0.22 (−0.16, 0.61) | 60 | |
Fogarty et al. [30] | Pain | Significant reduction reported; no usable data as only reported change within group | ||||
Garland et al. [44] | Pain | BPI | −12.32 % | 11.11 % | 0.76 (0.38, 1.14) | 20 |
−10.66 % | 4.01 % | 0.57 (0.19, 0.94) | 8 | |||
Gaylord et al. [45] | Pain | Pain severity | −42.96 % | −14.73 % | 0.53 (0.06, 0.99) | 20 |
−35.83 % | −5.36 % | 0.54 (0.08, 1) | 8 | |||
Depression | BSI-18 depression | – | – | 0.03 (−0.42, 0.49) | 20 | |
Quality of life, general | IBS quality of life | – | – | 0.25 (−0.21, 0.7) | 20 | |
Jay et al. [50] | Pain | Significant reduction reported; no usable data as only reported differences | ||||
Johns et al. [37] | Pain | BPI | −35.19 % | −30.90 % | −0.07 (−0.54, 0.41) | 24 |
Kanter et al. [62] | Pain | VAS | −16.95 % | −19.30 % | −0.14 (−1.05, 0.77) | 8 |
Quality of life | SF-12 MCS | 0.7 (−0.24, 1.64) | 8 | |||
SF-12 PCS | −0.02 (−0.93, 0.89) | 8 | ||||
Kearney et al. [51] | Pain | MPQ | −23.87 % | −5.67 % | 0.41 (−0.13, 0.94) | 24 |
Depression | PHQ | – | – | 0.34 (−0.2, 0.87) | 8 | |
– | – | 0.47 (−0.07, 1) | 24 | |||
la Cour and Petersen [46] | Pain | BPI | −1.05 % | −6.77 % | −0.16 (−0.53, 0.22) | 8 |
Depression | HADS | – | – | 0.37 (−0.01, 0.75) | 8 | |
Quality of life, mental | SF-36 mental composite | – | – | 0.53 (0.15, 0.91) | 8 | |
Quality of life, physical | SF-36 physical composite | – | – | 0.00 (−0.38, 0.38) | 8 | |
Lengacher et al. [52] | Pain | BPI | −25.92 % | −10.63 % | 0.02 (−0.2, 0.25) | 12 |
Depression | CES-D score | – | – | 0.12 (−0.11, 0.35) | 6 | |
– | – | 0.04 (−0.18, 0.27) | 12 | |||
Quality of life | QoL MOS SF-36 | – | – | −0.05 (−0.28, 0.17) | 6 | |
– | – | 0.01 (−0.21, 0.24) | 12 | |||
Ljotsson et al. [33] | Pain | Total pain | −46.15 % | 0.00 % | 0.64 (0.19, 1.08) | 10 |
Depression | MADRS-S | – | – | 0.43 (−0.02, 0.87) | 10 | |
Quality of life, general | IBS quality of life | – | – | 0.95 (0.49, 1.41) | 10 | |
Disability | Sheehan disability scale | – | – | 0.47 ( 0.02, 0.91) | 10 | |
Ljotsson et al. [34] | Pain | Significant reduction IBS pain/discomfort; no usable data as did not report pain measure | 24 | |||
Depression | HADS | – | – | 0 (−0.28, 0.28) | 24 | |
Quality of life, general | IBS quality of life | – | – | 0.51 (0.22, 0.8) | 24 | |
Meize-Grochowski et al. [56] | Pain | SF MPQ—total pain | −8.57 % | −4.17 % | −0.48 (−1.25, 0.28) | 2 |
SF MPQ—total pain | −25.71 % | −12.50 % | −0.31 (−1.07, 0.45) | 8 | ||
Depression | CES-D | – | – | 0.32 (−1.08, 0.44) | 8 | |
Quality of life, mental | Emotional well being | – | – | 0.07 (−0.69, 0.82) | 8 | |
Quality of life, physical | Average physical subscales | – | – | −0.02 (−0.77, 0.74) | 8 | |
Morone et al. [47] | Pain | SF MPQ | −11.61 % | 3.29 % | 0.23 (−0.42, 0.88) | 8 |
Quality of life, mental | SF-36 mental composite | – | – | 0.22 (−0.43, 0.86) | 8 | |
Quality of life, physical | SF-36 physical composite | – | – | 0.11 (−0.53, 0.76) | 8 | |
Disability | Roland-Morris disability | – | – | 0.23 (−0.42, 0.87) | 8 | |
Morone et al. [57] | Pain | SF MPQ—total pain | −22.44 % | −26.71 % | −0.04 (−0.7, 0.63) | 24 |
SF MPQ—total pain | −26.28 % | −29.19 % | −0.01 (−0.68, 0.65) | 8 | ||
Morone et al. [36] | Pain | Numeric pain rating—average | −13.64 % | 0.95 % | 0.22 (−0.01, 0.46) | 24 |
Quality of life | SF-36 global health composite | – | – | 0.17 (−0.06, 0.41) | 8 | |
– | – | 0.03 (−0.2, 0.26) | 24 | |||
SF-36 physical health composite | – | – | 0.17 (−0.06, 0.4) | 8 | ||
– | – | 0 (−0.23, 0.23) | 24 | |||
Plews-Ogan et al. [59] | Pain | Pain unpleasantness vs. TAU | −7.46 % | −8.70 % | 0.02 (CI, −1.04, 1.07) | 12 |
Pain unpleasantness vs. massage | −7.46 % | −25.35 % | −0.16 (−1.19, 0.88) | 12 | ||
Pain unpleasantness vs. TAU | −16.42 % | −13.04 % | 0.07 (CI, −0.99, 1.13) | 4 | ||
Pain unpleasantness vs. massage | −16.42 % | −12.68 % | −0.11 (CI, −0.92, 1.14) | 4 | ||
Pain unpleasantness vs. TAU | −13.43 % | −1.45 % | 0.17 (CI, −0.89, 1.23) | 8 | ||
Pain unpleasantness vs. massage | −13.43 % | −39.44 % | −0.3 (CI, −1.34, 0.74) | 8 | ||
Quality of Life, mental | SF-12 mental composite | – | – | 0.67 (−0.42, 1.75) | 12 | |
Rahmani and Talepasand [63] | Pain | Global quality symptoms—pain | −26.52 % | 11.11 % | 1.85 (0.89, 2.8) | 16 |
−44.89 % | −1.85 % | 3.24 (2.02, 4.46) | 8 | |||
Quality of life, general | Global quality total score | – | – | 1.18 (0.32, 2.05) | 16 | |
Schmidt et al. [48] | Pain | Pain perception scale vs. waitlist | −13.19 % | −6.90 % | 0.17 (−0.2, 0.55) | 16 |
Pain perception scale vs. active | −13.19 % | −7.40 % | 0.15 (−0.22, 0.53) | 16 | ||
Pain Perception Scale vs. waitlist | −11.87 % | −8.00 % | 0.08 (−0.3, 0.45) | 8 | ||
Pain perception scale vs. active | −11.87 % | −4.86 % | 0.22 (−0.16, 0.6) | 8 | ||
Depression | CES-D | – | – | 0.1 (−0.27, 0.48) | 16 | |
Quality of Life, General | QoL profile for chronically ill | – | – | 0.26 (−0.12, 0.63) | 16 | |
Teixeira [64] | Pain | NeuroQoL pain | Missing baseline mean | 0.14 (−0.74, 1.01) | 4 | |
Quality of life, general | NeuroQoL overall | – | – | 0.79 (−0.12, 1.7) | 4 | |
Wells et al. [49] | Pain | Headache severity | −25.00 % | 0.00 % | 0.99 (0.04, 1.95) | 12 |
Headache severity | −27.27 % | 8.33 % | 1.5 (0.48, 2.51) | 8 | ||
Depression | PHQ | – | – | 0.59 (−0.33, 1.51) | 8 | |
Quality of life, general | Migraine-specific QoL | – | – | −0.43 (−1.34, 0.48) | 8 | |
Wong [65] | Pain | Significant pain decrease; no usable data | ||||
Wong [28] | Pain | No significant effect; no usable data | ||||
Zautra et al. [29] | Pain | Pain vs. education | −14.49 % | −17.70 % | 0.22 (−0.2, 0.63) | 8 |
Pain vs. cognitive behavior therapy | −14.49 % | −14.34 % | 0.56 (0.16, 0.96) | 8 | ||
Depression | Depressive symptoms | – | – | 0.28 (−0.13, 0.7) | 8 | |
Zgierska et al. [35] | Pain | Significant pain decrease; no follow-up data available |