Research in Mindfulness Interventions for Patients With Fibromyalgia: A Critical Review

Abstract

Fibromyalgia is one of the most common causes of widespread chronic pain. It has a huge impact on the quality of life, namely because it appears earlier in life than most of the chronic pain conditions. Furthermore, emotional-cognitive distress factors, such as depression and anxiety, are a common feature in patients with fibromyalgia. The neurobiological mechanisms underlying fibromyalgia remain mostly unknown. Among non-pharmacological treatments, cognitive-behavioral therapy has been used during the last decade, namely with the enrolment of patients in programs of mindfulness-based stress reduction (MBSR) and in mindfulness-based interventions (MBI). We critically analyzed the literature to search for scientific evidence for the use of MBI in fibromyalgia. The studies were evaluated as to several outcomes of fibromyalgia improvement along with aspects of the study design which are currently considered relevant for research in mindfulness. We conclude that despite the sparsity of well-structured longitudinal studies, there are some promising results showing that the MBI are effective in reducing the negative aspects of the disease. Future design of studies using MBI in fibromyalgia management should be critically discussed. The importance of active controls, evaluation of sustained effects along with investigation of the subserving neurobiological mechanisms and detailed reports of possible adverse effects should be considered.

Mindfulness for people with chronic pain: Factors affecting engagement and suggestions for programme optimisation

“…10 Adapted mindfulness approaches for chronic pain are in the early stages and high drop‐out rates remain an issue. 22 We therefore consider that our work remains topical and relevant today.…”

“…However, research on mindfulness for people with chronic pain remains inconclusive and further research is recommended in the current NICE guidelines 10 . Adapted mindfulness approaches for chronic pain are in the early stages and high drop‐out rates remain an issue 22 . We therefore consider that our work remains topical and relevant today.…”

“…21 The majority of published randomised controlled trials (RCTs) of mindfulness for people with chronic pain continue to use the standard MBSR programme rather than a programme tailored to the pain population. [22][23][24] To our knowledge, no studies have systematically looked at the barriers and facilitators to engagement with established mindfulness programmes based on MBSR to better understand the changes needed to improve acceptability for people with chronic pain. Systematic reviews of mindfulness for people with chronic pain have shown high attrition rates from mindfulness programmes of up to 50% (median 20%).…”

The Western origins of mindfulness therapy in ancient Rome

“…A growing body of research suggests that mindfulness may improve neuropsychiatric symptoms that commonly occur in a range of neurological disorders [11]. Specifically, there is evidence for the effectiveness of mindfulness-based interventions in patients with movement disorders associated with behavioural symptoms, such as Parkinson disease [12], multiple sclerosis [13][14][15][16], epilepsy [17,18], sleep disorders [19][20][21][22], headache [23][24][25][26], and chronic pain symptoms [27][28][29]. Patients with acquired brain pathologies such as mild traumatic brain injury [30,31], cerebrovascular accidents [32,33] and dementia [34][35][36] have also been shown to potentially benefit from mindfulness-based interventions, as well as their carers [37][38][39].…”

Beyond the Pain: A Systematic Narrative Review of the Latest Advancements in Fibromyalgia Treatment

“…Mind-body interventions: Mind-body interventions, such as mindfulness-based stress reduction (MBSR), have demonstrated efficacy in improving symptoms of fibromyalgia by targeting stress, anxiety, and depression [ 45 ]. A recent study published in 2022 investigated the effectiveness of MBSR in fibromyalgia patients and reported positive outcomes, including reductions in pain and fatigue, as well as improvements in quality of life [ 46 ]. Similarly, a study published in 2012 examined the effectiveness of CBT in fibromyalgia patients and found that it effectively reduced pain, anxiety, and depression, while enhancing physical function [ 47 ].…”