Which type and dosage of mindfulness-based interventions are most effective for chronic pain? A systematic review and network meta-analysis.
Mengting Zhu, Samuel Yeung-Shan Wong, Claire Chenwen Zhong, Yu Zeng, Luyao Xie, Eric Kam-Pui Lee, Vincent Chi-Ho Chung, Regina Wing-Shan Sit
Journal of psychosomatic research April 1, 2025 DOI: 10.1016/j.jpsychores.2025.112061 via PubMed
Summary
A network meta-analysis of 68 studies with 5,339 participants compared different mindfulness-based interventions for chronic pain. Mindfulness-based stress reduction showed the strongest evidence for reducing pain intensity and depression, with moderate to high certainty. Mindfulness-oriented recovery enhancement was most effective for improving physical function, though the evidence was low certainty. An 8-week course with weekly 90- to 120-minute sessions appeared optimal for addressing pain, physical function, and depression. These findings support the use of mindfulness-based interventions in chronic pain management and help inform evidence-based guidelines.
Study at a glance
| Characteristics | Systematic review and network meta-analysis Peer reviewed |
|---|---|
| Sample size | 5,339 |
| Population | Adults with chronic pain |
| Topics | Meditation |
| Keywords | Chronic pain Network meta-analysis |
| Citations | 13 |
| Key finding | Mindfulness-based stress reduction was most effective for pain intensity and depression, while mindfulness-oriented recovery enhancement was most effective for physical function, with an 8-week, once-weekly, 90-120 minute session being the optimal dosage. |
Abstract
Chronic pain exerts an enormous personal and economic burden worldwide. While clinical trials have confirmed the benefits of mindfulness-based interventions (MBIs) in chronic pain management, knowledge on the best type and dosage remains unknown. This study aims to compare the clinical effectiveness of different MBIs on chronic pain and to identify the optimal dosage of MBIs. The primary outcome was pain intensity and secondary outcomes were physical function and depression. We applied a random-effect pairwise meta-analysis to synthesize data, and network meta-analysis to compare effectiveness among different types and dosages of MBIs. The findings were further categorized according to the partially contextualized framework. A total of 68 studies with 5,339 participants were included. Mindfulness-based stress reduction demonstrated the most promising results for improving pain intensity (SMD -0.76, 95 % CI -1.06 to -0.46, Surface Under the Cumulative Ranking Area (SUCRA) 0.75) and depression (SMD -0.77, 95 % CI -0.98 to -0.56, SUCRA 0.86), supported by moderate and high certainty of evidence, respectively. On the other hand, mindfulness-oriented recovery enhancement emerged as the most effective for enhancing physical function (SMD -1.42, 95 % CI -2.28 to -0.57, SUCRA 0.96), albeit with low certainty of evidence. An 8-week course, conducted once per week, with sessions lasting between 90 and 120 min, appeared to be the optimal dosage for addressing pain intensity, physical function, and depression. Our findings contribute to the evidence supporting the use of MBIs in chronic pain management and informing the development of evidence-based guidelines and standardizing the course structures of MBIs. Systematic review registration: PROSPERO CRD42021293938.