Mindfulness-based Interventions for Chronic Low Back Pain: A Systematic Review and Meta-analysis.
Myrella Paschali, Asimina Lazaridou, Jason Sadora, Lauren Papianou, Eric L Garland, Aleksandra Zgierska, Robert R Edwards
Clinical Journal of Pain February 1, 2024 DOI: 10.1097/AJP.0000000000001173 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review with meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 18 |
| Population | Adults with chronic low back pain |
| Interventions | mindfulness meditation mindfulness-based stress reduction mindfulness-based cognitive therapy mindfulness-oriented recovery enhancement acceptance and commitment therapy dialectical behavioral therapy meditation-cognitive behavioral therapy mindfulness-based care for chronic pain self-compassion course loving-kindness course |
| Topics | Meditation |
| Citations | 25 |
| Key findings | Mindfulness-based interventions have a large beneficial effect on reducing pain intensity in adults with chronic low back pain. |
Abstract
This systematic review aimed to compile existing evidence examining the effects of mindfulness-based interventions (MBIs) for chronic low back pain (CLBP). CLBP leads to millions of disabled individuals in the United States each year. Current pharmacologic treatments are only modestly effective and may present long-term safety issues. MBIs, which have an excellent safety profile, have been shown in prior studies to be effective in treating CLBP yet remained underutilized. Ovid/Medline, PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials (RCTs), pilot RCTs, and single-arm studies that explored the effectiveness of MBIs in CLBP. Separate searches were conducted to identify trials that evaluated MBIs in reducing pain intensity in individuals with CLBP. A meta-analysis was then performed using R v3.2.2, Metafor package v 1.9-7. Eighteen studies used validated patient-reported pain outcome measures and were therefore included in the meta-analysis. The MBIs included mindfulness meditation, mindfulness-based stress reduction, mindfulness-based cognitive therapy, mindfulness-oriented recovery enhancement, acceptance and commitment therapy, dialectical behavioral therapy, meditation-cognitive behavioral therapy, mindfulness-based care for chronic pain, self-compassion course, and loving-kindness course. Pain intensity scores were reported using a numerical rating scale (0 to 10) or an equivalent scale. The meta-analysis revealed that MBIs have a beneficial effect on pain intensity with a large-sized effect in adults with CLBP. MBIs seem to be beneficial in reducing pain intensity. Although these results were informative, findings should be carefully interpreted due to the limited data the high variability in study methodologies, small sample sizes, inclusion of studies with high risk of bias, and reliance on pre-post treatment differences with no attention to maintenance of effects. More large-scale RCTs are needed to provide reliable effect size estimates for MBIs in persons with CLBP.
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 10
- Mindfulness and meditation: Promoting emotional and cognitive health. Progress in Brain Research 2025
- How Do Mindfulness‐Based and Cognitive Behavioral Therapies Help Adults With Opioid‐Treated Chronic Low Back Pain? A Qualitative Study Pain Practice October 9, 2026
- How Practice Differences Shape Participant Experience in Second-Generation Mindfulness-Based Interventions: A Qualitative Study of Non-Buddhist University Students Mindfulness October 9, 2026
- Do Acceptance‐ and Mindfulness‐Based Interventions Improve Psychological Flexibility in People With Chronic Pain? A Systematic Review and Meta‐Analysis of Randomized Controlled Trials European Journal of Pain August 1, 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
and 5 more in the library
Cites 29
- Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology Science and Practice 2003
- Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study ☆ Pain June 4, 2007
- Mindfulness meditation–based pain relief: a mechanistic account Annals of the New York Academy of Sciences June 1, 2016
- Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial Pain Medicine March 10, 2016
- Brief Self-Compassion Training Alters Neural Responses to Evoked Pain for Chronic Low Back Pain: A Pilot Study. Pain Medicine October 1, 2020
and 24 more in the library