Dennis Anheyer, MA; Heidemarie Haller, MSc; Jürgen Barth, PhD; Romy Lauche, PhD; Gustav Dobos, MD; Holger Cramer, PhD
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1997.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Reproducible Research Statement:Study protocol, statistical code, and data set: Available from Mr. Anheyer (e-mail, firstname.lastname@example.org).
Requests for Single Reprints: Dennis Anheyer, MA, Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276 Essen, Germany; e-mail, email@example.com.
Current Author Addresses: Mr. Anheyer, Ms. Haller, and Drs. Dobos and Cramer: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276 Essen, Germany.
Dr. Barth: Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Sonneggstrasse 6, 8006 Zurich, Switzerland.
Dr. Lauche: Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, New South Wales 2007, Australia.
Author Contributions: Conception and design: D. Anheyer, H. Haller, R. Lauche, H. Cramer.
Analysis and interpretation of the data: D. Anheyer, J. Barth, H. Cramer.
Drafting of the article: D. Anheyer.
Critical revision of the article for important intellectual content: H. Haller, J. Barth, R. Lauche, G. Dobos, H. Cramer.
Final approval of the article: D. Anheyer, H. Haller, J. Barth, R. Lauche, G. Dobos, H. Cramer.
Statistical expertise: D. Anheyer, J. Barth, H. Cramer.
Administrative, technical, or logistic support: G. Dobos.
Collection and assembly of data: D. Anheyer, H. Haller, H. Cramer.
Mindfulness-based stress reduction (MBSR) is frequently used to treat pain-related conditions, but its effects on low back pain are uncertain.
To assess the efficacy and safety of MBSR in patients with low back pain.
Searches of MEDLINE/PubMed, Scopus, the Cochrane Library, and PsycINFO to 15 June 2016.
Randomized controlled trials (RCTs) that compared MBSR with usual care or an active comparator and assessed pain intensity or pain-related disability as a primary outcome in patients with low back pain.
Two reviewers independently extracted data on study characteristics, patients, interventions, outcome measures, and results at short- and long-term follow-up. Risk of bias was assessed using the Cochrane risk-of-bias tool.
Seven RCTs involving 864 patients with low back pain were eligible for review. Compared with usual care, MBSR was associated with short-term improvements in pain intensity (4 RCTs; mean difference [MD], −0.96 point on a numerical rating scale [95% CI, −1.64 to −0.34 point]; standardized mean difference [SMD], −0.48 point [CI, −0.82 to −0.14 point]) and physical functioning (2 RCTs; MD, 2.50 [CI, 0.90 to 4.10 point]; SMD, 0.25 [CI, 0.09 to 0.41 point]) that were not sustained in the long term. Between-group differences in disability, mental health, pain acceptance, and mindfulness were not significant at short- or long-term follow-up. Compared with an active comparator, MBSR was not associated with significant differences in short- or long-term outcomes. No serious adverse events were reported.
The number of eligible RCTs was limited; only 3 evaluated MBSR against an active comparator.
Mindfulness-based stress reduction may be associated with short-term effects on pain intensity and physical functioning. Long-term RCTs that compare MBSR versus active treatments are needed in order to best understand the role of MBSR in the management of low back pain.
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Anheyer D, Haller H, Barth J, Lauche R, Dobos G, Cramer H. Mindfulness-Based Stress Reduction for Treating Low Back Pain: A Systematic Review and Meta-analysis. Ann Intern Med. 2017;166:799–807. doi: 10.7326/M16-1997
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Published: Ann Intern Med. 2017;166(11):799-807.
Published at www.annals.org on 25 April 2017
Back Pain, Rheumatology.
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