Efficacy of mindfulness-based intervention for the treatment of chronic headaches: A systematic review and meta-analysis.

Muhammad Aemaz Ur Rehman, Radeyah Waseem, Ume Habiba, Muhammad Fahad Wasim, Soha Alam Rehmani, Maha Alam Rehmani, Maryam Abdullah, Yumna Khabir, Mahnoor Rehan Hashmi, Talal Almas, Syed Shahan Ali, Syed Muhammad Huzaifa Shah, Kaneez Fatima

Journal: Annals of medicine and surgery (2012) 2022;78():103862

PMID: 35734718

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Plain Language Summary

The International Headache Society defines chronic daily headache (CDH) as headaches occurring on 15 or more days in a month for at least three months. Many pharmacological treatments are available to minimize the functional disability caused by headaches. However, meditation-based mindfulness techniques have gained popularity in recent years. The main aim of this study was to determine the efficacy of mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR) in improving headache frequency, duration, and intensity in patients suffering from chronic headaches. This study is an updated systematic review and meta-analysis which included 10 full-text articles (4 from previous meta-analysis and 6 recently published). Results provide limited evidence that MBSR/MBCT intervention may be effective in reducing the frequency, duration, and pain intensity of headaches, in patients with chronic headaches including tension-type and migraine compared with the usual care but it demonstrated a significant difference between groups in achieving mindfulness. Authors conclude that since their findings are inconclusive, MBSR/MBCT interventions for the treatment of migraine and/or tension-type headaches cannot be recommended.

Abstract

BACKGROUND

Mindfulness-based stress reduction/cognitive therapy has attained popularity as an adjunctive treatment for a plethora of medical and psychiatric conditions, however, its impact on chronic headaches is inconclusive. This review aims to assess the impact of MBSR/MBCT in alleviating the symptoms of chronic headaches.

DATA SOURCES AND DATA SELECTION

PubMed and Cochrane CENTRAL were searched from inception till 1st May 2021. Randomized Control Trials evaluating mindfulness-based stress reduction/cognitive therapy with either passive comparators (usual care) or active comparators (e.g., Health education or cognitive behavioral therapy) for chronic headaches (Migraine, Tension-type, or cluster headaches), which evaluated either headache frequency, pain intensity or headache duration as primary outcome were eligible for inclusion. The Risk of Bias was evaluated using the Cochrane Collaboration's Risk of Bias Tool.

RESULTS

A total of ten Randomized Controlled Trials (five on migraine; three on tension-type; two with mixed samples) were evaluated. In comparison to usual care, mindfulness-based stress reduction/cognitive therapy did not illustrate significant changes in headache frequency (MD = -0.14; 95% CI -1.26 to 0.97; P = 0.80; Moderate Certainty), headache duration (MD = -0.27; 95% CI -3.51 to 2.97, P = 0.87; Low Certainty) or pain intensity (MD = -0.19; 95% CI -0.46 to 0.07; P = 0.15; Moderate Certainty).

CONCLUSION

The results found are insignificant for the three primary outcomes, which may be due to the low number of participants and often a high or unclear risk of bias in the randomized control trials included. Perhaps more aggressive clinical trials with a larger sample size effectively demonstrate differences in outcomes before and after therapy for MBSR/MBCT could provide a more significant change.

Address: Department of Medicine, King Edward Medical University, Lahore, Pakistan.; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.; Department of Medicine, Baqai Medical University, Karachi, Pakistan.; Department of Medicine, Ziauddin University, Karachi, Pakistan.; Department of Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.; Department of Medicine, Liaquat College of Medicine and Dentistry, Karachi, Pakistan.

DOI: 10.1016/j.amsu.2022.103862