Mindfulness meditation reduces pain more effectively than slow-breathing meditation: the mediating role of respiration.
Anita B Amorim, Morgan Gianola, Daniel Barrows, Fadel Zeidan
Pain March 1, 2026 DOI: 10.1097/j.pain.0000000000003832 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 245 |
| Population | Healthy, pain-free, meditation-naïve individuals |
| Interventions | Mindfulness meditation Slow-breathing sham-mindfulness meditation |
| Topics | Anxiety Meditation |
| Keywords | Pain Respiration Slow-paced breathing |
| Key findings | Mindfulness meditation produced significantly greater analgesia compared with sham-mindfulness meditation and controls, and slower respiration rate partially mediated analgesia for both meditation techniques. |
Abstract
Mindfulness meditation, a slow breathing practice that is predicated on cultivating nonreactive awareness, also reduces pain. The existing literature has been mixed in demonstrating whether mindfulness meditation is more effective than slow breathing alone (ie, sham-mindfulness meditation) at reducing pain. Furthermore, smaller sample sizes in prior work have hindered a clear understanding of how respiration rate and state anxiety contribute to analgesia during meditation. This study pooled data from 5 randomized controlled trials using paralleling interventions and methodologies in 245 healthy, pain-free, meditation-naïve individuals. Noxious heat (49°C; right calf) was used to test whether changes in respiration and state anxiety mediate the effects of (1) mindfulness meditation (n = 113), (2) a slow-breathing sham-mindfulness meditation technique (n = 73), and (3) a book-listening control (n = 60) on pain intensity ratings ("0" no pain; "10" worst pain imaginable). Three separate 3 (group) × 2 (pre- vs postmanipulation) repeated-measures analysis of variances assessed whether mindfulness and sham-mindfulness meditation significantly reduced pain, anxiety, and respiration, respectively. Mediation analyses examined whether changes in state anxiety and respiration, respectively, mediated analgesia during meditation. Mindfulness meditation produced significantly greater analgesia when compared with sham-mindfulness meditation and controls. Slower respiration rate partially mediated analgesia for mindfulness and sham-mindfulness meditation as compared with controls. Both meditation techniques significantly lowered anxiety, but these improvements did not mediate pain relief. The present findings demonstrate that mindfulness meditation is more effective than slow-breathing (sham-mindfulness) meditation at reducing pain and highlight the role of slower breathing in the direct modulation of acutely evoked pain by meditation.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 25
- Short-term meditation training improves attention and self-regulation Proceedings of the National Academy of Sciences October 11, 2007
- Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity Frontiers in Human Neuroscience October 9, 2018
- Effects of Brief and Sham Mindfulness Meditation on Mood and Cardiovascular Variables The Journal of Alternative and Complementary Medicine July 28, 2010
- Mindfulness meditation–based pain relief: a mechanistic account Annals of the New York Academy of Sciences June 1, 2016
- Pain Attenuation through Mindfulness is Associated with Decreased Cognitive Control and Increased Sensory Processing in the Brain Cerebral Cortex December 15, 2011
and 20 more in the library