Can mindfulness meditation reduce chronic pain?

If you have suffered from chronic pain, you have likely tried several strategies to relieve the pain. One strategy that has recently become popular for pain relief is mindfulness meditation. Mindfulness meditation refers to a process of developing the skill of bringing one’s attention to whatever is happening in the present moment.

In a recently published meta-analysis, Hilton and colleagues (2017) examined the effectiveness and safety of mindfulness meditation interventions for the treatment of chronic pain in adults. A meta-analysis is a research methodology in which the findings from several studies on the same topic are combined and analyzed together. It is considered the gold standard of evidence for understanding the robustness of an effect. In addition, this meta-analysis is particularly valuable because researchers only included randomized controlled trials, which means that participants were randomly assigned to a mindfulness meditation condition or a control condition. Because this meta-analysis included only randomized controlled trials, findings from this meta-analysis shed light on the extent to which mindfulness meditation treatments lead to decreases in chronic pain.

There were 38 studies included in the meta-analysis that had patients reporting chronic pain for at least 3 months. The patients were then randomized to either a formal mindfulness meditation treatment or a control treatment. Control treatments included no intervention, an education support group, or treatment as usual. Researchers coded for the effect of each intervention. In addition, researchers rated quality of evidence for each study as high, medium, low or very low. A study was rated lower quality if, for example, it did not report important pieces of the study methodology or did not include participants who dropped out of the study in analyses.

The results indicated that mindfulness meditation was more effective than control treatments in reducing chronic pain. However, the effect size was small and the quality of evidence was considered low due to publication bias (a bias where findings with significant results are more likely to get published) and inconsistency of results among the studies. In addition, 13 out of the 38 studies were rated as poor quality. Mindfulness meditation was also associated with improvement in depression, physical health-related quality of life (e.g., ability to engage in physically demanding activities), and mental-health related quality of life (e.g., having emotional problems that interfere with daily functioning).

Overall, findings suggest that mindfulness meditation results in improvements in chronic pain, depression, and quality of life. However, the weaknesses in the body of evidence (e.g., publication bias, inconsistencies among studies, large number of poor quality studies) prevent strong conclusions. Future researchers should conduct more rigorous randomized controlled trials examining the effect of mindfulness meditation on chronic pain. The trials should report all important pieces of study methodology, have longer follow-up, and include all participants who were randomized into the study when analyzing the results.

Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., … Maglione, M. A. (2017). Mindfulness meditation for chronic Pain: Systematic review and meta-analysis. Annals of Behavioral Medicine, 51(2), 199–213. http://doi.org/10.1007/s12160-016-9844-2