A synthesis of meta-analyses of mindfulness-based interventions in pain.
Louise Sharpe, Bethany Richmond, Rachel E. Menzies, Daniel Forrest, Geert Crombez, Ben Colagiuri
Pain August 14, 2023 DOI: 10.1097/j.pain.0000000000002997 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Umbrella review Peer reviewed |
|---|---|
| Intervention | Mindfulness-based interventions (MBIs) |
| Topics | Anxiety Meditation |
| Keywords | Humans Anxiety disorders Somatoform disorders Meta-analysis as topic Pain management |
| Key findings | Across 21 meta-analyses including 127 unique studies, mindfulness-based interventions showed effects on pain severity, anxiety, and depression but not pain interference or disability. Only fibromyalgia and headache benefited significantly when conditions were analyzed separately, and effects on pain severity appeared only against passive, not active, controls. The authors argue that individual meta-analyses may have overestimated MBI efficacy and that MBIs should not be considered a panacea. |
Abstract
Abstract: Mindfulness interventions have become popular in recent decades, with many trials, systematic reviews, and meta-analyses of the impact of mindfulness-based interventions (MBIs) on pain. Although many meta-analyses provide support for MBIs, the results are more mixed than they at first appear. The aim of this umbrella review was to determine the strength of evidence for MBIs by synthesizing available meta-analyses in pain. We conducted a systematic search in 5 databases and extracted data from published meta-analyses as the unit of analysis. For each outcome, we reported the range of effect sizes observed across studies and identified the largest meta-analysis as the "representative" study. We separately analysed effect sizes for different pain conditions, different types of MBIs, different control groups, and different outcomes. We identified 21 meta-analyses that included 127 unique studies. According to Assessment of Multiple Systematic Review ratings, the meta-analyses ranged from very strong to weak. Overall, there was an impact of MBIs on pain severity, anxiety, and depression but not pain interference or disability. When conditions were considered in isolation, only fibromyalgia and headache benefited significantly from MBIs. Mindfulness-based interventions were more efficacious for pain severity than passive control conditions but not active control conditions. Only pain severity and anxiety were affected by MBIs at follow-up. Overall, our results suggest that individual meta-analyses of MBIs may have overestimated the efficacy of MBIs in a range of conditions. Mindfulness-based interventions likely have a role in pain management but should not be considered a panacea.
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 6
- A Tale of Two Treatments: A Randomised Controlled Trial of Mindfulness or Cognitive Behaviour Therapy Delivered Online for People with Rheumatoid Arthritis. Psychotherapy and Psychosomatics 2025
- Recalibrating Pain–Mood Coupling in Fibromyalgia: A Hypothesis-Generating Multisystem Neurobehavioral Framework for Mindfulness-Based Interventions Anesthesia Research September 13, 2026
- Mindfulness-based interventions for pain, anxiety, depression, and quality of life in patients receiving palliative care: a meta-analysis. Journal of Research in Nursing February 26, 2026
- Mindfulness Based Pain Management (MBPM) for Chronic Pain: Long-Term Effects Journal of Contemporary Psychotherapy December 1, 2025
- Adding Anodal Transcranial Direct Current Stimulation to Mindfulness Meditation Abolishes Mindfulness-Induced Improvements in Emotion Regulation in Fibromyalgia: A Responder Analysis. Clinical Journal of Pain November 1, 2025
and 1 more in the library
Cites 21
- Mindfulness: A proposed operational definition. Clinical Psychology Science and Practice 2004
- Meditation Programs for Psychological Stress and Well-being JAMA Internal Medicine January 6, 2014
- Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation Perspectives on Psychological Science October 10, 2017
- Mindfulness‐based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta‐analysis of randomized controlled trials Psycho-Oncology September 11, 2019
- Mindfulness-based stress reduction for treating chronic headache: A systematic review and meta-analysis Cephalalgia June 4, 2018
and 16 more in the library