Can mindfulness-based stress reduction alleviate chronic pain?
Date of publication of the randomized controlled trial: April 2015
Design
Randomized controlled trial (RCT).
Participants
109 patients (mean age: 52.5 years, male %: 16.2%) diagnosed with chronic pain.
Intervention
A weekly mindfulness-based stress reduction (MBSR) program for 9 weeks.
Comparator
Comparison: MBSR versus wait-list.
Major Outcomes
Outcome 1: Vitality measured by SF36 vitality scale. Higher scores indicated higher level of vitality;
Outcome 2: Pain measured by Brief Pain Inventory (BPI). Higher scores indicated higher level of pain;
Outcome 3: Pain measured by SF36 pain scale. High scores indicated lower level of pain;
Outcome 4: Physical function measured by SF36 physical function scale. Higher scores indicated lower level of physical limitation.
Settings
This trial was performed in an outpatient setting.
Comparison    MBSR versus wait-list.
Main Results
Chronic pain patients in MBSR group had a significantly higher vitality level (p=0.04) than patients in wait-list control. The effect of MBSR on pain measured by BPI (p=0.17), pain measured by SF36 pain scale (p=0.26) and physical function (p=0.78) is not significant.
Comparison: MBSR versus wait-list among chronic pain patients.
Outcomes No. of studies (Total number of participants) Mean score (SD)/ No. of participants Heterogeneity test (I2) MD (95% CI) p value Overall quality of evidence*
Intervention Comparator
1 1 (109) 36.8 (22.4)/ 54 27.8 (20.2)/ 55 Not applicable as there is only 1 study. Not reported 0.04 Moderate
2 1 (109) 18.8 (5.9)/ 54 17.9 (5.6)/ 55 Not applicable as there is only 1 study. Not reported 0.17 Low
3 1 (109) 28.5 (18.1)/ 54 25.1 (15.5)/ 55 Not applicable as there is only 1 study. Not reported 0.26 Low
4 1 (109) 48.3 (25.8)/ 54 48.6 (21.3)/ 55 Not applicable as there is only 1 study. Not reported 0.78 Low
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval.
Comparison    MBSR versus wait-list.
Main Results
Chronic pain patients in MBSR group had a significantly higher vitality level (p=0.04) than patients in wait-list control. The effect of MBSR on pain measured by BPI (p=0.17), pain measured by SF36 pain scale (p=0.26) and physical function (p=0.78) is not significant.
Comparison: MBSR versus wait-list among chronic pain patients.
Outcomes 1 2 3 4
No. of studies (Total number of participants) 1 (109) 1 (109) 1 (109) 1 (109)
Mean score (SD)/ No. of participants Intervention 36.8 (22.4)/ 54 18.8 (5.9)/ 54 28.5 (18.1)/ 54 48.3 (25.8)/ 54
Comparator 27.8 (20.2)/ 55 17.9 (5.6)/ 55 25.1 (15.5)/ 55 48.6 (21.3)/ 55
MD (95% CI) Not reported Not reported Not reported Not reported
p value 0.04 0.17 0.26 0.78
Overall quality of evidence* Moderate Low Low Low
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval.
Conclusion
Benefits
Compared to wait-list control, MBSR significantly increases vitality level among patients with chronic pain. For Outcome 1, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect. For Outcome 2-4, the overall quality of evidence is low. Further research is likely to have an important impact on our confidence in this estimate of effect.
Harms
2 participants had experienced temporary stronger feeling of anger towards pain condition and 2 participants experienced increased level of anxiety.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/25376753
The synopsis is based on the following article:
la Cour P, Petersen M. Effects of mindfulness meditation on chronic pain: a randomized controlled trial. Pain Medicine. 2015 Apr 1;16(4):641-52.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.