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 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and network meta-analysis Peer reviewed |
|---|---|
| Sample size | 5,339 |
| Population | Adults with chronic pain |
| Interventions | Mindfulness-based stress reduction Mindfulness-oriented recovery enhancement Mindfulness-based interventions |
| Duration | 8-week course, once per week, sessions lasting 90 to 120 minutes |
| Topics | Meditation |
| Keywords | Chronic pain Network meta-analysis |
| Citations | 13 |
| Key findings | 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.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |
Citations in the library
Cited by 5
- Trait mindfulness is associated with pain outcomes in patients with chronic back pain from a rural sample in the United States Journal of Neurosciences in Rural Practice February 19, 2026
- Mindfulness-based pain management for patients with chronic musculoskeletal pain: a randomized controlled trial Frontiers in Medicine September 28, 2026
- Effect of virtual reality-integrated mindfulness-based cognitive therapy on pain and psychological symptoms in chronic non-specific low back pain: protocol for a randomized controlled trial. Frontiers in Digital Health July 31, 2026
- Mindfulness on the brain: a review of structural and functional MRI findings in mindfulness-based stress reduction. European journal of radiology February 1, 2026
- Mindfulness-Based Stress Reduction Program to Improve Well-Being and Health in Healthcare Professionals. Journal of Clinical Medicine October 28, 2025
Cites 15
- Mindfulness-Based Stress Reduction for Health Care Professionals: Results From a Randomized Trial. International Journal of Stress Management May 1, 2005
- What defines mindfulness-based programs? The warp and the weft Psychological Medicine December 29, 2016
- Mindfulness-based interventions: an overall review British Medical Bulletin April 21, 2021
- Evaluation of the breathworks mindfulness‐based pain management programme: effects on well‐being and multiple measures of mindfulness Clinical Psychology & Psychotherapy November 13, 2009
- Evaluating the Implementation and Effectiveness of a Low-Dose Mindfulness-Based Intervention in a Student Sample: a Randomized Controlled Trial Mindfulness April 1, 2021
and 10 more in the library