A single 20-minute online mindfulness session did not reduce chronic pain intensity or unpleasantness more than sham mindfulness or a general sham condition in 169 adults with chronic or recurrent pain. All three active conditions reduced pain unpleasantness compared to an audiobook control, and this effect was most strongly linked to participants' expectations (placebo). No evidence was found that mindfulness engages its theorized specific processes. The findings suggest that short-term pain relief from a single mindfulness session may be driven by placebo effects rather than mindfulness-specific mechanisms.
For people with rheumatoid arthritis, online mindfulness-based stress reduction (MBSR) and cognitive behaviour therapy (CBT) both reduced pain interference more than a waitlist control, with comparable improvements in depression. MBSR was better than CBT for fear of progression after treatment and for functional ability at 6-month follow-up, while CBT alone reduced pain severity at 6-month follow-up. A history of recurrent depression did not affect how well either treatment worked. The effect sizes matched those of face-to-face interventions, confirming both online treatments are effective for rheumatoid arthritis.