Effectiveness of mindfulness meditation on the quality of life, pain intensity, mobility and physical function in adults with chronic low back pain: a systematic review and meta-analysis

A systematic review and meta-analysis of seven randomized controlled trials found that mindfulness meditation is associated with significant improvements in pain reduction and quality of life for patients with chronic lower-back pain, compared to standard care. The pooled effect size for pain was large (standardized mean difference −1.01), and for quality of life it was moderate (standardized mean difference −0.57). However, there was no evidence that mindfulness meditation improves physical function, with a negligible effect size (standardized mean difference 0.03). Substantial heterogeneity among studies suggests variations in design and protocols. The authors conclude that mindfulness meditation is more effective than conventional treatments for pain and quality of life but not for physical function.

Study at a glance

Abstract

To evaluate recent randomized controlled trials (RCTs) on mindfulness meditation in clinical settings to assess effects on pain reduction, mobility, quality of life, and physical function in patients with chronic lower-back pain (CLBP). In this systematic review and meta-analysis, a literature search was conducted using the Population, Intervention, Comparison, and Outcomes (PICO) framework. Mindfulness meditation was compared to control or usual care. Data from RCTs published between January 2010 and January 2025 were extracted from Google Scholar, PubMed, Scopus, and Cochrane Library. Studies were selected following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines; risk of bias was assessed using the Cochrane Risk of Bias (RoB 2) tool. Meta-analysis was performed using Review Manager (RevMan). Mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated for outcomes such as pain intensity, physical function, and quality of life. Heterogeneity was assessed using the I² statistic. Forest plots summarized effect sizes, and funnel plots assessed publication bias. Of 204 identified citations, seven RCTs met eligibility criteria. The pooled standardized mean difference (SMD) for pain outcomes was − 1.01 (95% CI: − 1.77 to − 0.25; p < 0.00001), while quality of life showed an SMD of − 0.57 (95% CI: 0.15 to 0.99; p < 0.001). These results suggest that mindfulness meditation techniques are associated with significant improvements in pain reduction and enhanced quality of life compared to standard treatment. In contrast, the pooled SMD for physical function between mindfulness meditation and conventional therapy was 0.03 (95% CI: − 0.98 to 1.04), indicating no strong evidence that mindfulness meditation improves physical function over standard interventions. Notably, there was substantial heterogeneity among studies (χ² = 369.89, df = 5, p < 0.001; I² = 98.76%), likely due to variations in study design, sample populations, and intervention protocols in the mobility domain. Mindfulness meditation is more effective than conventional treatments for reducing pain intensity and improving quality of life in CLBP, though it may not enhance physical function or mobility. Further studies should assess long-term outcomes and optimal delivery methods.