What it is the Evidence that Mindfulness Based Stress Reduction Is Helpful for Patients with Chronic Pain?
Speaker: John Schorling; Matthew Goodman; Blake Garmon
Format: Audio & Slides

Chronic pain is a complex experience that is made worse by stress, negative thinking, depressed affect, muscle tension, restricted movement, and inflammation. Meditation and the mindful regulation of attention can reduce stress through down-regulation of the limbic system and hypothalamic pituitary axis, and reductions in stress may improve the affective as well as the sensory components of pain.

Despite this potential, two recent reviews of the efficacy of mindfulness-based interventions (MBIs) for chronic pain reached differing conclusions. Chiessa and Serrenti conducted a systematic review of MBIs for chronic pain that included 10 studies with control groups, 6 of which were randomized trials. They concluded that MBIs could have nonspecific effects for the reduction of pain but found limited evidence of specific benefits compared to active controls. A review by Reiner, Tibi and Lipsitz included 16 studies that used MBSR, MBSR variants, or Acceptance and Commitment Therapy, but only 2 randomized trials. They concluded that MBIs decrease pain intensity for patients with chronic pain.

In this session, we will present an updated systematic review that incorporates additional controlled studies including 7 new randomized clinical trials, focusing on MBSR and closely related interventions. We will address four questions: 1) How strong is the clinical science on which we base recommendations for MBSR for chronic pain? 2) Does MBSR reduce pain severity in case series and cohort studies? 3) Does MBSR reduce pain severity compared to active or passive control conditions? 4) Does MBSR make it easier for patients to live with chronic pain? Following this overview, there will be a discussion focused on the clinical implications of these findings and the most appropriate direction for future research.