Mindfulness Training and Yoga for the Management of Chronic Non-malignant Pain: A Review of Clinical Effectiveness and Cost-effectiveness

Details

Files
Project Status:
Completed
Project Line:
Health Technology Review
Project Sub Line:
Summary with Critical Appraisal
Project Number:
RC1185-000

Question

  1. What is the clinical effectiveness of mindfulness training for chronic non-malignant pain in adults?
  2. What is the clinical effectiveness of yoga for chronic non-malignant pain in adults?
  3. What is the cost-effectiveness of mindfulness training for chronic non-malignant pain in adults?
  4. What is the cost-effectiveness of yoga for chronic non-malignant pain in adults?

Key Message

Three systematic reviews and one non-randomized controlled study were identified that addressed the research questions, and the results were mixed. Evidence from a limited quality systematic review suggested that mindfulness training versus waitlist control significantly improved pain acceptance and depression scores for patients with chronic pain (low back pain, fibromyalgia, tension headache, general chronic pain), but did not significantly improve pain intensity, anxiety, and quality of life outcomes. More research is warranted for definitive conclusions. Results from two systematic reviews and one non-randomized study of low to moderate quality suggested that yoga was significantly more effective than no treatment for managing chronic non-malignant pain. The included systematic reviews suggested that yoga, compared to control, significantly reduced pain intensity and psychological distress and increased general activity (e.g., daily activities, socialization, absenteeism) for patients with primary dysmenorrhea. Compared to no treatment, the nonrandomized study reported that yoga significantly reduced back pain intensity and increased back flexibility and physiologic domains (e.g., serum serotonin) for patients with chronic low back pain. No evidence regarding the cost-effectiveness of mindfulness training or yoga for chronic non-malignant pain in adults was identified.