Efficacy of Mindfulness-Based Therapies Challenged in Chronic Headache

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The investigators concluded that because of the low number, small scale, and often high or unclear risk for bias in the RCTs included in the analysis, the results of the study are imprecise.
The investigators concluded that because of the low number, small scale, and often high or unclear risk for bias in the RCTs included in the analysis, the results of the study are imprecise.

A systematic review and meta-analysis published in Cephalalgia found no evidence that mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) are effective in improving the frequency, duration, or intensity of headache in patients who experience chronic headaches.

Although MBSR and MBCT are often used for pain-related conditions, their effects on headache remain uncertain. The investigators sought to evaluate the efficacy and safety of MBSR and MBCT in the reduction of the symptoms associated with chronic headaches.

A total of 5 randomized controlled trials (RCTs) were selected for the analysis (2 on tension-type headache, 1 on migraine, and 2 with mixed samples). A total of 185 participants were included in the study. Compared with the use of usual care, MBSR therapy and MBCT did not improve the frequency of headaches (3 RCTs: standard mean difference, 0.00; 95% CI, 0.33-0.32) or the duration of headaches (3 RCTs: standardized mean difference, –0.08; 95% CI, –1.03 to 0.87).

In a similar fashion, there was no significant difference reported between the groups with respect to pain intensity (5 RCTs: standardized mean difference, –78; 95% CI, –1.72 to 0.16).

The investigators concluded that because of the low number, small scale, and often high or unclear risk for bias in the RCTs included in the analysis, the results of the study are imprecise. More rigorous trials with larger sample sizes and longer durations are warranted in order to help render a definitive conclusion on the benefits of MBSR and MBCT in improving the frequency, intensity, and duration of chronic headache.

Reference

Anheyer D, Leach MJ, Klose P, Dobos G, Cramer H. Mindfulness-based stress reduction for treating chronic headache: a systematic review and meta-analysis [published online January 1, 2018]. Cephalalgia. doi:10.1177/0333102418781795

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