Jeitler Michael, Brunnhuber Stefan, Meier Larissa, Lüdtke Rainer, Büssing Arndt, Kessler Christian, Michalsen Andreas
Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin, Berlin, Germany; Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany.
Department for Psychiatry and Psychotherapy, University Hospital Salzburg, Salzburg, Austria.
J Pain. 2015 Jan;16(1):77-86. doi: 10.1016/j.jpain.2014.10.009. Epub 2014 Nov 3.
Chronic neck pain is a common medical complaint partly mediated by psychosocial distress and having a high socioeconomic impact. There is preliminary evidence that stress reduction by meditation might be beneficial in chronic pain syndromes. We aimed to evaluate the effectiveness of an 8-week meditation program (jyoti meditation) in patients with chronic neck pain by means of a randomized clinical trial. Eighty-nine patients (aged 49.7 ± 10.5 years, 73 female) with chronic neck pain who scored >40 mm on a 100-mm visual analog scale and had concomitant increased perceived stress were randomized to an 8-week meditation program (jyoti meditation) with weekly 90-minute classes (n = 45) or to a home-based exercise program (n = 44) with a wait list offer for meditation. Both groups were instructed to practice at home. Outcomes were assessed at baseline and after 8 weeks. Primary outcome measure was change of mean pain at rest (visual analog scale score) from baseline to week 8. Secondary outcomes included pain at motion, functional disability, pain-related bothersomeness, perceived stress, quality of life, and psychological outcomes. Patients had neck pain for a mean of 11 years. Eighteen patients in the meditation group and 16 patients in the exercise group were lost to follow-up. Meditation training significantly reduced pain when compared to the exercise group after 8 weeks (reduction of 45.5 ± 23.3 mm to 21.6 ± 17.2 mm in the meditation group, and 43.8 ± 22.0 mm to 37.7 ± 21.5 mm in the exercise group; mean difference: 13.2 mm [95% confidence interval: 2.1, 24.4; P = .02]). Pain-related bothersomeness decreased more in the meditation group (group difference 11.0 mm [95% confidence interval: 1.0, 21.0; P = .03]). No significant treatment effects were found for pain at motion, psychological scores, and quality of life, although the meditation group showed nonsignificant greater improvements compared to the exercise group. In conclusion, meditation may support chronic pain patients in pain reduction and pain coping. Further well-designed studies including more active control comparisons and longer-term follow-up are warranted.
This article presents the results of a randomized controlled trial on the clinical effects of an 8-week meditation program or self-care exercise in patients with chronic neck pain. Meditation reduced pain at rest but not disability and might be a useful treatment option for pain management of chronic neck pain.
慢性颈痛是一种常见的医学主诉，部分由心理社会困扰介导，对社会经济有很大影响。有初步证据表明，通过冥想减轻压力可能对慢性疼痛综合征有益。我们旨在通过一项随机临床试验评估为期8周的冥想计划（jyoti冥想）对慢性颈痛患者的有效性。89例慢性颈痛患者（年龄49.7±10.5岁，73例女性），在100毫米视觉模拟量表上得分>40毫米，且感知压力增加，被随机分为为期8周的冥想计划（jyoti冥想）组，每周上课90分钟（n = 45），或家庭锻炼计划组（n = 44），并提供等待名单以参加冥想。两组均被指导在家中练习。在基线和8周后评估结果。主要结局指标是静息时平均疼痛（视觉模拟量表评分）从基线到第8周的变化。次要结局包括运动时疼痛、功能障碍、疼痛相关困扰、感知压力、生活质量和心理结局。患者颈痛平均持续11年。冥想组有18例患者和锻炼组有16例患者失访。8周后，与锻炼组相比，冥想训练显著减轻了疼痛（冥想组从45.5±23.3毫米降至21.6±17.2毫米，锻炼组从43.8±22.0毫米降至37.7±21.5毫米；平均差异：13.2毫米[95%置信区间：2.1,24.4；P = 0.02]）。冥想组疼痛相关困扰的减轻更多（组间差异11.0毫米[95%置信区间：1.0,21.0；P = 0.03]）。在运动时疼痛、心理评分和生活质量方面未发现显著治疗效果，尽管与锻炼组相比，冥想组显示出非显著的更大改善。总之，冥想可能有助于慢性疼痛患者减轻疼痛和应对疼痛。有必要进行进一步设计良好的研究，包括更多积极对照比较和长期随访。
本文介绍了一项关于为期8周的冥想计划或自我护理锻炼对慢性颈痛患者临床效果的随机对照试验结果。冥想减轻了静息时的疼痛，但未减轻残疾，可能是慢性颈痛疼痛管理的一种有用治疗选择。
