Do patients with low back pain have lower pain intensity and better physical function after mindfulness-based stress reduction?

Mindfulness-based stress reduction, including sitting and/or walking meditation, hatha yoga, body scanning, and sustained mindfulness practice (in which attention is sequentially focused on different parts of the body) produced little immediate benefit and no sustained benefit for patients with low back pain. (LOE = 1a)

Anheyer D, Haller H, Barth J, Lauche R, Dobos G, Cramer H. Mindfulness-based stress reduction for treating low back pain. a systematic review and meta-analysis. Ann Intern Med 2017;166(11):799-807.  [PMID:28437793]

Meta-analysis (randomized controlled trials)

Self-funded or unfunded

Various (meta-analysis)

The researchers of this meta-analysis searched 4 databases, including Cochrane CENTRAL, to identify randomized controlled trials that compared mindfulness-based stress reduction with usual care or another treatment. They followed PRISMA guidelines for selecting and evaluating the research articles. They identified 7 studies of 864 patients (40% from a single study). Three studies compared mindfulness-based stress reduction with an active comparator (cognitive behavioral therapy or face-to-face health education sessions). All studies used the mindfulness-based stress reduction curriculum originally developed at the University of Massachusetts to treat chronic pain (Gen Hosp Psychiatry 1982;4:33-47). Compared with usual care, mindfulness treatment provided a small but not likely clinically important benefit (0.96-point benefit on a 11-point scale) as compared with usual care on short-term measures of pain and physical functioning. This difference was not sustained over time. Mindfulness was not better than either active comparator. There was no effect, short term or long term, on disability, mental health, pain acceptance, or mindfulness. The risk of bias was moderate in the studies. Heterogeneity was low to moderate across the studies, depending on the outcome being measured. Publication bias was not assessed.