Effect of Mindfulness-Based Stress Reduction on Pain Severity and Mindful Awareness in Patients With Tension Headache: A Randomized Controlled Clinical Trial

Abstract

Background: Programs to improve the pain and health status in illnesses with pain such as headache are still in their infancy. Mindfulness-based stress reduction (MBSR) is a new psychotherapy that appears to be effective in treating chronic pain. Objectives: This study evaluated efficacy of MBSR in improving pain severity and mindful awareness in patients with tension headache. Patients and Methods: This study was a randomized controlled clinical trial that was conducted in 2012 in Shahid Beheshti Hospital of Kashan City. Sixty patients who were diagnosed with tension-type headache according to the International Headache Classification Subcommittee were randomly assigned to treatment as usual (TAU) or MBSR groups. The MBSR group received eight weekly treatments. Any session lasted 120 minutes. The sessions were based on MBSR protocol. Diary scale for measuring headache and Mindful Attention Awareness Scale (MAAS) were administered at pretreatment, and posttreatment, and three-month follow-up in both groups. The data was analyzed using repeated measures analysis of variance. Results: The mean of pain severity was 7.36 ± 1.25 before intervention that was significantly reduced to 5.62 ± 1.74 and 6.07 ± 1.08 after the intervention and follow-up (P < 0.001). In addition, the MBSR group showed higher scores in mindful awareness in comparison with the control group at posttest session. The mean of mindful awareness before intervention was 34.9 ± 10.5 and changed to 53.8 ± 15.5 and 40.7 ± 10.9 after the intervention and follow-up sessions (P < 0.001). Conclusions: MBSR could reduce pain and improve mindfulness skills in patients with tension headache. It appears that MBSR is an effective psychotherapy for treatment of patients with tension headache.

Mindfulness Meditation for Chronic Pain: A Systematic Review

“…The median short-term follow-up time was eight weeks (range 4-12 weeks). Figure 3.3 shows a positive effect of meditation on pain from 0-12 weeks in 17 studies (Brown and Jones, 2013;Cash et al, 2015;Cathcart et al, 2014;Esmer et al, 2010;Morone, Greco, and Weiner, 2008;Omidi and Zargar, 2014;Plews-Ogan et al, 2005;Teixeira, 2010;Wells et al, 2014;Zautra et al, 2008;Parra-Delgado and LatorrePostigo, 2013;Rahmani and Talepasand, 2015;Gaylord et al, 2011;Ljotsson, Falk, et al, 2010), which was statistically significant in five studies Omidi and Zargar, 2014;Wells et al, 2014;Rahmani and Talepasand, 2015;Gaylord et al, 2011). The pooled analysis of all 24 RCTs showed a significant positive effect (SMD 0.27; CI 0.04, 0.50; 24 RCTs; I 2 64.6%).…”

“…Ten studies were judged to be of fair quality, primarily due to being unclear in some aspects of the methods (Cash et al, 2015;Davis and Zautra, 2013;Day et al, 2014;Dowd et al, 2015;Gaylord et al, 2011;la Cour and Petersen, 2015;Morone, Greco, and Weiner, 2008;Wells et al, 2014). Eleven studies were judged to be poor; eight of these were primarily due to issues with completeness of reporting outcome data, such as inadequate or missing ITT analysis or less than 80-percent follow-up Brown and Jones, 2013;Cathcart et al, 2014;Esmer et al, 2010;Meize-Grochowski et al, 2015;Morone et al, 2009;Omidi and Zargar, 2014;PlewsOgan et al, 2005). Three studies were judged poor primarily due to unclear methods (Rahmani and Talepasand, 2015;Teixeira, 2010;Wong, 2009).…”

“…Pain scales and comparators varied from study to study (Astin et al, 2000;Brown and Jones, 2013;Cash et al, 2015;Cathcart et al, 2014;Davis and Zautra, 2013;Day et al, 2014;Dowd et al, 2015;Esmer et al, 2010;la Cour and Petersen, 2015;Meize-Grochowski et al, 2015;Morone, Greco, and Weiner, 2008;Morone et al, 2009;Omidi and Zargar, 2014;Plews-Ogan et al, 2005;Teixeira, 2010;Wells et al, 2014;Zautra et al, 2008;Parra-Delgado and Latorre-Postigo, 2013;Rahmani and Talepasand, 2015;Gaylord et al, 2011;Ljotsson, Falk, et al, 2010). The median follow-up time was 12 weeks, with a range of four to 60 weeks.…”

“…Eleven RCTs followed study participants more than 12 weeks (median: 20 weeks; range: 16-60 weeks) Cash et al, 2015;Dowd et al, 2015;Morone et al, 2009;Omidi and Zargar, 2014;Parra-Delgado and Latorre-Postigo, 2013;Rahmani and Talepasand, 2015;Gaylord et al, 2011). Figure 3.4 shows that there is an effect of meditation on pain for participants in six of these studies but not overall (SMD 0.37; C −0.01, 0.74; 11 RCTs, I 2 74.7%) Omidi and Zargar, 2014;Parra-Delgado and Latorre-Postigo, 2013;Rahmani and Talepasand, 2015;Gaylord et al, 2011). Substantial heterogeneity was detected.…”

“…Seven RCTs compared the effect of mindfulness meditation to TAU (Brown and Jones, 2013;Esmer et al, 2010;Omidi and Zargar, 2014;Plews-Ogan et al, 2005;Wells et al, 2014;Parra-Delgado and Latorre-Postigo, 2013;) (see Figure 3.5). Two of the seven studies reported significant effects and the pooled effect was significant overall (SMD 0.45; CI 0.02, 0.88; 7 RCTs; I 2 51.5%) (Omidi and Zargar, 2014;Wells et al, 2014). Heterogeneity among studies was moderate.…”