Mindfulness- based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice

OBJECTIVE: This study compared changes in bodily pain,
health-related quality of life (HRQoL), and psychological symptoms during an
8-week mindfulness- based stress reduction (MBSR) program among groups of
participants with different chronic pain conditions. METHODS: From 1997-2003, a
longitudinal investigation of chronic pain patients (n=133) was nested within a
larger prospective cohort study of heterogeneous patients participating in MBSR
at a university-based Integrative Medicine center. Measures included the
Short-Form 36 Health Survey and Symptom Checklist-90- Revised. Paired t tests
were used to compare pre-post changes on outcome measures. Differences in
treatment effect sizes were compared as a function of chronic pain condition.
Correlations were examined between outcome parameters and home meditation
practice. RESULTS: Outcomes differed in significance and magnitude across
common chronic pain conditions. Diagnostic subgroups of patients with
arthritis, back/neck pain, or two or more comorbid pain conditions demonstrated
a significant change in pain intensity and functional limitations due to pain
following MBSR. Participants with arthritis showed the largest treatment
effects for HRQoL and psychological distress. Patients with chronic
headache/migraine experienced the smallest improvement in pain and HRQoL.
Patients with fibromyalgia had the smallest improvement in psychological
distress. Greater home meditation practice was associated with improvement on
several outcome measures, including overall psychological distress,
somatization symptoms, and self-rated health, but not pain and other quality of
life scales. CONCLUSION: MBSR treatment effects on pain, HRQoL and
psychological well-being vary as a function of chronic pain condition and
compliance with home meditation practice.