Takeaway
- The use of mind-body therapies (MBTs) was associated with a moderate decrease in pain and a slight decrease in opioid use, and may help with opioid craving and misuse.
- The largest effect was found with meditation, hypnosis, suggestion, and cognitive behavioral therapy (CBT).
Why this matters
- This meta-analysis is the largest study to date of the use of MBTs to treat pain and their effect on opioid use.
Study design
- Systematic review/meta-analysis of 60 randomized clinical trials (opioid-treated pain; n=6404).
- Interventions: meditation (5 studies), hypnosis (25 studies), relaxation (14 studies), guided imagery (7 studies), therapeutic suggestion (6 studies), and CBT (7 studies).
- Funding: None disclosed.
Key results
- Overall, MBTs were associated with a reduction in:
- pain (moderate association; Cohen's d, −0.51; P<.001) and
- opioid dose (small association; Cohen's d, −0.26; P=.01).
- Significant improvements in pain outcomes were noted for:
- meditation (strong association; Cohen's d, −0.70; P<.001),
- hypnosis (moderate association; Cohen's d, −0.54; P<.001), and
- suggestion (moderate association; Cohen's d, −0.68; P=.008).
- Improved opioid-related outcomes were reported with meditation (4 studies), CBT (4 studies), and hypnosis (12 studies).
Limitations
- The study may have been underpowered.
- High levels of heterogeneity.
Coauthored with Chitra Ravi, MPharm
References
References