Table 2 Open in new tab Characteristics...

Table 2

Characteristics of mind–body therapy studies

Citation	Total Participants, Condition	Interventions	# Assigned (Dropout %)	Dosage (Total Hours/Time Period)	Relevant Pain Outcomes	Conclusions	Quality
Meditation/Mindfulness (N = 11)
Hsu et al. [40]	45, Fibromyalgia	ASA	24 (13%)	7.5 hours/3 weeks	BPI (pain severity): P = 0.03 at PT; P < 0.01 at FU; ES: d = 1.14 at PT, d = 1.46 at FU	ASA is more effective than WLC for reducing pain and number of painful body regions post intervention and at 6 months follow-up.	+
Hsu et al. [40]	45, Fibromyalgia	WLC	21 (0%)	ND	BPI (number of painful body regions): P < 0.001 at PT; P = 0.001 at FU		+
Wong [39]	100, Chronic pain	MBSR	51 (20%)	19 hours/8 weeks	NRS (pain): p < 0.05** (both groups); P = NS	Both MBSR and MIP programs are equally effective in reducing chronic pain intensity.	+
Wong [39]	100, Chronic pain	MIP	49 (8%)	12 hours/ND	NRS (pain): p < 0.05** (both groups); P = NS		+
Morone [30]	40, Chronic low back pain	Meditation	20 (20%)	12 hours/8 weeks	SF-MPQ (pain): P = Sig** (both groups) over time; P = NS	Both the meditation and the education program are equally effective in improving chronic low back pain.	+
Morone [30]	40, Chronic low back pain	Education	20 (5%)	12 hours/8 weeks	SF-36 Pain Subscale (pain intensity): P = Sig** (meditation) over time; P = NS at FU		+
Schmidt [34]	177, Fibromyalgia	MBSR	59 (10%)	19 hours/8 wks	PPS (sensory and affective pain): P = NS**	None of the groups (MBSR, active control, WLC) were effective in treating fibromyalgia pain.	+
Schmidt [34]	177, Fibromyalgia	WLC	59 (0%)	ND	PPS (sensory and affective pain): P = NS**		+
Active control	59 (5%)	12 hours/8 weeks
Morone [31]	37, Chronic low back pain	Meditation	19 (32%)	12 hours/8 weeks	SF-MPQ (pain intensity): P = NS; ES: d = 0.32	Neither meditation nor WLC was effective in improving chronic low back pain.	+
Morone [31]	37, Chronic low back pain	WLC	18 (5%)	ND	SF-36 Pain Subscale (pain): P = NS; ES: d = 0.16		+
Esmer [35]	40, Failed back surgery syndrome	MBSR	19 (21%)	12 hours/8 weeks	VAS (pain): P < 0.021 at wk 12; P = Sig at FU; ES: d = 1.02	MBSR is more effective than WLC in reducing pain associated with failed back surgery syndrome.	−
Esmer [35]	40, Failed back surgery syndrome	WLC	21 (24%)	ND			−
Ehrlich [32]^*	579, Chronic low back pain	Alexander technique (6 tx)	579 (20%)	ND	Von Korff Scale (pain): P = Sig (Alexander technique 24, exercise/control) at month 12	Both 6 lessons and 24 lessons with Alexander Technique, followed by exercise, are equally effective in treating chronic back pain.	−
		Alexander technique (24 tx)		ND
		Massage		ND
		Exercise		ND
Normal care	ND
Wong [36]	100, Chronic pain	MBSR	100 (ND)	ND	NRS (pain intensity): P = Sig** (both groups) at mo 6; P = NS	Both MBSR and the education program are equally effective in improving chronic pain intensity.	−
Wong [36]	100, Chronic pain	Education	100 (ND)	ND			−
Carson [33]	43, Chronic low back pain	Loving-kindness meditation	43 (ND)	12 hours/8 weeks	MPQ (pain intensity): P = Sig (meditation); P = NS (UC); ES: d = 0.42	A meditation program is effective in lowering chronic low back pain scores.	−
Carson [33]	43, Chronic low back pain	UC	43 (ND)	ND/8 weeks			−
BPI (usual pain, worst pain): P < 0.01** (meditation, usual pain); P = 0.05** (meditation, worst pain); P = ND; ES: d = 0.42		UC		ND/8 weeks
Plews-Ogan [37]	30, Musculoskeletal pain	MBSR	10 (30%)	12 hours/8 weeks	NRS (pain sensation and unpleasantness): P = Sig (massage, unpleasantness) at FU; P = NS** (MBSR, SC); P = NS	MBSR is not effective for reducing musculoskeletal pain; however, massage is more effective than SC for reducing musculoskeletal pain.	−
Plews-Ogan [37]	30, Musculoskeletal pain	Massage	10 (10%)	8 hours/8 weeks			−
SC	10 (20%)	ND
Teixeira [38]	22, Diabetic neuropathy	Meditation	11 (9%)	1 hour/1 day	NPS (pain intensity): P = NS** at PT ES: d = 0.16	Neither mindfulness meditation nor attention-placebo effectively reduced pain associated with diabetic neuropathy.	−
Teixeira [38]	22, Diabetic neuropathy	Attention-placebo	11 (9%)	1 hour/1 day	NPS (pain intensity): P = NS** at PT ES: d = 0.16		−
Relaxation (N = 22)
Stenstrom [54]	54, Inflammatory rheumatic disease	PMR	27 (0%)	ND/12 months	Nottingham Health Profile Pain Subscale (pain): P = NS at PT	PMR shows minor improvements in the reduction of pain; no differences between groups noted.	+
Stenstrom [54]	54, Inflammatory rheumatic disease	DMT	27 (0%)	ND/12 months			+
AIMS2 Pain Impact Subscale (pain): P < 0.05** (relaxation), P = NS at PT		DMT	27 (0%)	ND/12 months
Mehling [52]	36, Chronic low back pain	Breathing	18 (11%)	9 hours/6 weeks	VAS (pain intensity): P < 0.005 (both groups) at PT; P < 0.005 (both groups), P = NS at FU	Both breath therapy and physical therapy were equally effective in reducing pain and disability associated with low back pain.	+
Mehling [52]	36, Chronic low back pain	PT	18 (33%)	9 hours/6 weeks			+
SF-36 (bodily pain): P < 0.005 (both groups) at PT; P < 0.005 (both groups), P = NS at FU		PT	18 (33%)	9 hours/6 weeks
Larsson [55]	41, Chronic headaches	TAR	14 (14%)	8.25 hours/ND	Headache Activity (headache activity): P < 0.05e (TAR/SM), P < 0.05e (SHR/SM) at PT and post-booster; P < 0.01d (SHR) over time; P < 0.01d (TAR) at FU; P = NSe (TAR/SHR)	Both therapist and self-help relaxation are equally more effective than no treatment for reducing chronic headache pain.	+
Larsson [55]	41, Chronic headaches	SHR	16 (13%)	ND/ND			+
Self-monitoring (SM)	11 (9%)	ND
Poole [51]	234, Chronic low back pain	Relaxation	82 (30%)	6 hours/6 weeks	SF-36 Pain Subscale (pain): P < .0005** (all groups) over time; P = NS	Relaxation, usual care, and reflexology are all equally effective in reducing chronic low back pain.	+
		UC	75 (43%)	ND
		Reflexology	77 (16%)	6 hours/6 weeks
VAS (pain): P = NS**		Reflexology	77 (16%)	6 hours/6 weeks
Anderson [57]	59, Cancer pain	Relaxation	16 (63%)	3.3 hours/2 weeks	BPI (pain): P < 0.05 (WLC/all groups, worst pain) at wk 7; P < 0.05** (PMD, WLC, pain severity) at PT; P < 0.05** (positive mood, WLC, average pain) at PT	Distraction and WLC were equally effective in improving pain severity, while positive mood and WLC were equally effective in improving average pain scores. Furthermore, both relaxation and distraction groups reported immediate posttreatment pain reduction.	+
		PMD	16 (44%)	3.3 hours/2 weeks
		Distraction	13 (46%)	3.3 hours/2 weeks
		WLC	14 (43%)	ND
Pain Intensity Rating (pain): P < 0.03** (relaxation, PMD) at PT		WLC	14 (43%)	ND
Boyce [56]	105, Irritable bowel syndrome	Relaxation	36 (64%)	4 hours/8 weeks	SF-36 (bodily pain): P < 0.01** (all groups) over time; P < 0.05 (UC) over time	All groups were equally effective in treating pain associated with irritable bowel syndrome.	+
Boyce [56]	105, Irritable bowel syndrome	CBT	35 (49%)	8 hours/8 weeks			+
UC	34 (38%)	0.75 hours + 190.4 g psyllium hus/ND
Trautmann [49]	65, Migraine, tension headache or combined migraine/tension headache	Applied relaxation	22 (14%)	ND/6 weeks	Headache Diary (headache intensity): P = NS**; ES: d = 0.0 (CBT), d = −0.27 (AR), d = −0.11 (EDU)	None of the groups (applied relaxation, education, cognitive behavioral therapy) are effective for reducing intensity of recurrent headache pain.	+
Trautmann [49]		Education	19 (47%)	ND/6 weeks			+
CBT	24 (54%)	ND/6 weeks
Hammond [50]	183, Fibromyalgia	Relaxation	86 (28%)	10 hours/10 weeks	FIQ (pain): P = NS**	Neither the relaxation nor the patient education are effective in reducing fibromyalgia pain.	+
Hammond [50]	183, Fibromyalgia	Education	97 (27%)	20 hours/10 weeks	FIQ (pain): P = NS**		+
Gustavsson [53]	37, Long-lasting neck pain	Applied relaxation	18 (11%)	10.5 hours/7 weeks	Ordinal Scale of Pain (pain intensity): P = NS**	Neither the relaxation group nor treatment as usual group effectively reduced neck pain.	+
Gustavsson [53]	37, Long-lasting neck pain	UC	19 (11%)	ND	Ordinal Scale of Pain (pain intensity): P = NS**		+
Wahlund [60]	122, Temporo-mandibular disorders	Relaxation	41 (17%)	ND/ND	VAS (pain): P < 0.01 (occlusal appliance/ brief information); P = NS (relaxation/occlusal appliance); P = ND** (relaxation/brief information)	Occlusal appliance is more effective than brief information training in the reduction of pain intensity associated with temporomandibular disorders; no significant differences between the occlusal appliance and the relaxation training group or relaxation and brief information groups.	−
Wahlund [60]	122, Temporo-mandibular disorders	Occlusal appliance	42 (12%)	ND			−
Brief information	39 (0%)	0.5 hours/1 day
Larsson [65]	48, Tension headache	Relaxation	31 (0%)	ND/5 weeks	Headache Index (headache parameters): P < 0.05(peak intensity, headache frequency, headache free days), P = NS (headache duration) at PT	Relaxation training program is more effective than WLC in reducing tension headache pain.	−
Larsson [65]	48, Tension headache	WLC	17 (0%)	ND			−
Loew [64]	54, Tension headache	EFR	27 (11%)	0.75 hours/1 day	Standardized Pain Diary (pain intensity): P = 0.003(intense pain), P = 0.03(medium pain) at PT	EFR is more effective than an unspecified intervention in reducing tension headache pain intensity.	−
Loew [64]	54, Tension headache	Unspecified intervention	27 (56%)	0.75 hours/1 day			−
Larsson [67]	26, Chronic tension-type headache	Relaxation	13 (0%)	4.2 hours/5 weeks	Headache Activity (headache): P < 0.05	School-based, nurse-administered relaxation training program is more effective than no treatment in reducing chronic tension-type headaches in school children.	−
Larsson [67]	26, Chronic tension-type headache	NT	13 (0%)	ND	Headache Activity (headache): P < 0.05		−
Larsson [66]	32, Chronic headaches	Relaxation training	12 (9%)	4.2 hours/5 weeks	Headache Activity (headache parameters): P = NS (all groups, headache intensity); P = Sig (relaxation/information contact, headache sum); P = Sig (relaxation/NT, headache sum) at PT; P = NS (headache sum score) at FU	Relaxation is more effective than information contact and no treatment in reducing weekly headache intensity at end of treatment; however, no differences were noted at follow up.	−
Larsson [66]	32, Chronic headaches	Information contact	13 (0%)	ND/ND			−
NT	7 (0%)	ND
Thorsell [61]	115, Chronic pain	Applied relaxation	61 (46%)	3 hours/2 days	OMPQ (pain intensity): P = NS (applied relaxation) at PT, months 6, 12; P < 0.05 (ACT) at PT, month 6; P = ND; ES: d = −0.37 (ACT at PT), d = −0.47 (ACT at month 12)	Applied relaxation is not as effective as ACT in treating chronic pain symptoms.	−
Thorsell [61]	115, Chronic pain	ACT	54 (43%)	3 hours/2 days			−
McGrath [62]	99, Migraine	Relaxation training	32 (38%)	6 hours/6 weeks	Headache Diary (headache): P < 0.05** (all groups) over time; P = NS	Both relaxation and placebo treatments are equally effective in reducing migraine pain.	−
McGrath [62]	99, Migraine	Placebo	37 (43%)	6 hours/6 weeks			−
Own best efforts	30 (30%)	ND
Blanchard [69]	39, Tension headache	PMR + home practice (PMR+)	39 (15%)	ND/8 weeks	Headache Diary (headache): P = 0.005 (PMR+), P = 0.04 (PMR), P = Sig (PMR+, PMR/WLC), P = NS (PMR+/PMR) at PT	Both PMR + home practice and PMR are equally more effective than WLC in reducing headache intensity.	−
Blanchard [69]	39, Tension headache	PMR	39 (15%)	ND/8 weeks			−
WLC	ND
Barsky [59]	168, Rheumatoid arthritis	Relaxation response	44 (27%)	6.7 hours/ND	Rheumatoid Arthritis Symptom Questionnaire (pain): P < 0.001 (all groups) over time, month 6; P = Sig (education), P = NS** (CBT, relaxation), P = NS (all groups) at month 12 ES: d = 0.26–0.35 (at PT)	Relaxation, arthritis education, and CBT are all equally effective in reducing pain.	−
Barsky [59]	168, Rheumatoid arthritis	Arthritis education	56 (21%)	6.7 hours/ND			−
CBT	68 (16%)	12 hours/ND
Linton [58]	15, Chronic pain	Applied relaxation	15 (0%)	6 hours/4 weeks	5-Point Likert Scale (pain intensity): P = Sig (applied relaxation/WLC) at PT; P = Sig** (all groups) over time	Although all groups were effective in reducing pain, applied relaxation seems to be more effective than applied relaxation + operant conditioning and WLC.	−
Linton [58]	15, Chronic pain	Applied relaxation + operant conditioning	15 (0%)	ND/4 weeks			−
WLC	ND
Funch [68]	57, Chronic temporomandibular joint pain	Relaxation	30 (0%)	1 hour/ND	6-Point Likert Scale (pain rating): P = NS**	Neither relaxation nor biofeedback is effective in reducing chronic temporomandibular joint pain.	−
Funch [68]	57, Chronic temporomandibular joint pain	Biofeedback	27 (0%)	0.2 hours/1 day	6-Point Likert Scale (pain rating): P = NS**		−
Lundgren [63]	68, Rheumatoid arthritis	Relaxation training	37 (11%)	10 hours/10 weeks	VAS (pain): P = NS**	Neither muscle relaxation training nor a no-treatment control group are effective in reducing pain associated with rheumatoid arthritis.	−
Lundgren [63]	68, Rheumatoid arthritis	NT	31 (13%)	ND	VAS (pain): P = NS**		−
Gay [24]	41, Osteoarthritis pain	Relaxation	14 (7%)	4 hours/8 weeks	VAS (pain): P < 0.0004 (hypnosis/relaxation, hypnosis/WLC), P = NS (relaxation/WLC) at week 4; P < 0.003 (hypnosis/WLC, relaxation/WLC), P = NS (hypnosis/relaxation) at PT; P < 0.004 (hypnosis/WLC), P = NS (hypnosis/relaxation, relaxation/WLC) at month 3, P = NS (all groups) at month 6	Hypnosis is more effective than both relaxation and WLC in reducing osteoarthritis pain at 4 weeks; however, both hypnosis and relaxation are equally more effective than WLC at 8 weeks. None of the groups were effective at 6 months.	−
Gay [24]	41, Osteoarthritis pain	Hypnosis	14 (7%)	4 hours/8 weeks			−
WLC	13 (23%)	ND
Biofeedback (N = 13)
Kapitza [76]	42, Chronic low back pain	Respiratory feedback	21 (0%)	7.5 hours/15 days	Pain Diary (pain): P < 0.02** (respiratory biofeedback, pain at rest/during activity), P = 0.014** (placebo biofeedback, pain during activity) at month 3; P = NS** (placebo biofeedback, pain at rest), P = NS	Respiratory biofeedback is more effective than placebo biofeedback in reducing pain 3 months post intervention.	+
Kapitza [76]	42, Chronic low back pain	Placebo biofeedback	21 (0%)	7.5 hours/15 days			+
Scharff [80]	36, Migraine in children	Handwarming biofeedback	13 (0%)	4.5 hours/6 weeks	Headache Index (headache intensity): P = Sig** (all groups), P = NS (all groups) at month 12	Both handwarming biofeedback and handcooling biofeedback seem to be equally effective in reducing headache intensity over time.	+
Scharff [80]	36, Migraine in children	Handcooling biofeedback	11 (9%)	4.5 hours/6 weeks			+
WLC	12 (8%)	ND
Bruhn [82]	28, Chronic muscle contraction headache	EMG biofeedback	14 (7%)	5.3 hours/8 weeks	Headache Diary (headache intensity): P < 0.01 (biofeedback) at last 2 weeks of therapy; P = ND (UC); P = ND	EMG biofeedback therapy is effective in reducing severe muscle contraction headaches at posttest; no between group differences were reported.	−
Bruhn [82]	28, Chronic muscle contraction headache	UC	14 (29%)	ND			−
Kayiran [83]	40, Fibromyalgia	Neurofeedback sensory motor training	20 (10%)	10 hours/4 weeks	VAS (pain intensity): P < 0.05 at every PT visit	Neurofeedback Sensory Motor Training is more effective than escitalopram in reducing pain associated with fibromyalgia.	−
Kayiran [83]	40, Fibromyalgia	Escitalopram	20 (10%)	560 mg/8 weeks	VAS (pain intensity): P < 0.05 at every PT visit		−
Babu [84]	30, Fibromyalgia	EMG biofeedback	15 (0%)	4.5 hours/6 days	VAS (pain): P = 0.000	EMG biofeedback is more effective than sham biofeedback in reducing fibromyalgia pain.	−
Babu [84]	30, Fibromyalgia	Sham biofeedback	15 (0%)	4.5 hours/6 days	VAS (pain): P = 0.000		−
Nelson [85]	42, Fibromyalgia	LENS	21 (24%)	ND/ND	NRS (pain intensity): P < 0.001** (LENS, pain intensity of past 24 h); P = NS** (placebo, pain intensity of past 24 h); P = ND** (both groups, current pain intensity); P = ND	LENS treatment is more effective than placebo biofeedback at alleviating fibromyalgia pain.	−
Nelson [85]	42, Fibromyalgia	Placebo biofeedback	21 (24%)	ND/ND			−
Ma [86]	60, Neck and/or shoulder pain	Biofeedback	15 (33%)	24 hours/6 weeks	VAS (pain): P < 0.04 (biofeedback, active exercise, PassTx), P = NS (education), P = Sig (education/other groups), P = NS (active exercise/ PassTx) at PT; P = 0.00 (biofeedback/other groups) at PT, month 6;	Biofeedback was more effective than active exercise, passive treatment, and an education group in reducing neck and shoulder pain.	−
		Biofeedback	15 (33%)	24 hours/6 weeks	P < 0.02 (active exercise/ PassTx, education), P = NS (PassTx /education) at month 6
		Active exercise	ND	57.3 hours/6 weeks
		PassTx	ND	7 hours/6 weeks
Education book	15 (40%)	ND/6 weeks
Simon [87]	30, Chronic constipation	EMG biofeedback	15 (0%)	6 hours/1 month	10-Point Likert Scale (pain): P < 0.01 (biofeedback) at FU; P = NS (counseling); P = Sig	EMG biofeedback is more effective than counseling for reducing pain associated with chronic constipation in elderly patients.	−
Simon [87]	30, Chronic constipation	Counseling	15 (0%)	6 hours/1 month			−
Newton-John [78]	44, Chronic low back pain	EMG biofeedback	16 (38%)	8 hours/4 wks	Pain Diary (pain severity): P < 0.007 (biofeedback/WLC, CBT/WLC); P = NS (biofeedback/CBT)	Both CBT and EMG biofeedback were equally more effective than WLC in reducing self-monitored chronic low back pain.	−
Newton-John [78]	44, Chronic low back pain	CBT	16 (19%)	8 hours/4 weeks			−
WLC	12 (ND)	ND
Bohm-Starke [88]	35, Provoked vestibulodynia	Surface EMG biofeedback	17 (0%)	40 hours/4 months	VAS (pain intensity): P = NS**	Both surface EMG biofeedback and topical lidocaine were equally effective in decreasing gastrointestinal tract, shoulder, joint, and back pain symptoms at 6 months post intervention.	−
		Surface EMG biofeedback	17 (0%)	40 hours/4 months	SF-36 Pain Subscale (bodily pain): P = NS**
		Topical lidocaine	18 (0%)	ND/4 months	SF-36 Pain Subscale (bodily pain): P = NS**
Subjective Outcome and Bodily Pain (pain): P < 0.01**(gastrointestinal tract, joint, shoulder, back pain), P = NS at FU		Topical lidocaine	18 (0%)	ND/4 months
Holroyd [81]	43, Tension headache	Decrease/High	43 (12%)	5 hours/12 weeks	Headache Recordings (headache intensity): P < 0.05** (Decrease/High, Increase/High, Increase/Moderate); P = NS	All EMG biofeedback groups were equally more effective than the decrease/moderate group in improving tension headache pain scores.	−
		Decrease/Moderate		5 hours/12 weeks
		Increase/High		5 hours/12 weeks
Increase/Moderate	5 hours/12 weeks
Nouwen [77]	20, Chronic low back pain	EMG biofeedback	10 (0%)	10 hours/3 weeks	Back Pain Log (pain): P = NS**	Neither EMG biofeedback nor WLC are effective in alleviating low back pain.	−
Nouwen [77]	20, Chronic low back pain	WLC	10 (0%)	MD	Back Pain Log (pain): P = NS**		−
Bush [79]	72, Chronic low back pain	Biofeedback	23 (9%)	4 hours/ND	Daily Low Back Pain Record (pain severity): P = NS (all groups)	Neither EMG biofeedback nor placebo is effective in treating chronic low back pain in a nonhospitalized population.	−
		Placebo	24 (4%)	4 hours/ND
		WLC	25 (0%)	ND
MPQ—PPI (present pain severity): P = NS (all groups) at PT		WLC	25 (0%)	ND
Guided Imagery/Self-Hypnosis (N = 6)
Menzies [95]	48, Fibromyalgia	GI	24 (0%)	ND/10 weeks	SF-MPQ PPI Subscale (present pain intensity): P = NS**	Neither guided imagery nor usual care were effective in reducing fibromyalgia pain.	+
Menzies [95]	48, Fibromyalgia	UC	24 (0%)	ND/10 weeks	SF-MPQ PPI Subscale (present pain intensity): P = NS**		+
SF- MPQ VAS Subscale (pain): P = NS**		UC	24 (0%)	ND/10 weeks
Fors [96]	58, Fibromyalgia	GI	17 (0%)	0.5 hours/1 day	VAS (pain): P < 0.001 (GI and patient education) at PT; P < 0.05 (GI/pain-related talk, patient education/pain-related talk); P = NS (GI/patient education); P = NS (pain-related talk)	Both guided imagery and patient education are equally more effective than a pain-related talk group in reducing short-term fibromyalgia pain.	−
Fors [96]	58, Fibromyalgia	Pain-related talk	19 (0%)	0.5 hours/1 day			−
Patient education	22 (0%)	0.5 hours/1 day
van Tilburg [97]	34, Abdominal pain	GI + SMC	19 (16%)	ND/8 weeks	Abdominal Pain Index (parent report of pain intensity and pain severity): P < 0.05** (GI + SMC), P = ND at PT, FU	Guided imagery plus standard medical care is effective in reducing pain associated with the abdomen.	−
van Tilburg [97]	34, Abdominal pain	SMC	15 (0%)	ND			−
Patterson [98]	21, Physical trauma injuries	VRH	21 (22%)	8 hours/1 day	GRS (pain): P < 0.05** (VRH, NT, pain intensity, pain unpleasantness), P < 0.05** (VRH, least pain intensity in past 8h), P < 0.05** (NT, least pain intensity in past 8h), P = NS at PT	VRH is effective in reducing pain intensity and unpleasantness associated with physical trauma injuries, whereas the control group reported increases in these areas; no significant between group differences were noted.	−
Patterson [98]	21, Physical trauma injuries	Virtual reality/NT	21 (22%)	ND			−
Carrico [99]	30, Insterstitial cystitis	GI	15 (27%)	46.7 hours/8 weeks	VAS (pain): P = 0.027 (GI), P = NS (WLC), P = NS at PT	Guided imagery is effective in reducing insterstitial cystitis pain, whereas the control group indicated no changes; no significant difference between groups were noted.	−
Carrico [99]	30, Insterstitial cystitis	WLC	15 (7%)	46.7 hours/8 weeks			−
Lewandowski [100]	44, Chronic pain	GI	22 (5%)	21 minutes/3 days	VAS (pain intensity): P < 0.05 at day 4, 5; P = NS at day 2, 3	Guided imagery is effective in reducing chronic pain.	−
Lewandowski [100]	44, Chronic pain	WLC	22 (5%)	ND		Guided imagery is effective in reducing chronic pain.	−
Autogenic Training (N = 2)
Asbury [23]	53, Cardiac syndrome x	AT	27 (15%)	12 hours/8 weeks	Symptom Monitoring Diary (symptom severity): P < 0.001** (AT), P = NS at PT	Autogenic training is effective in reducing cardiac symptom pain symptom severity; no between group differences noted.	−
Asbury [23]	53, Cardiac syndrome x	Symptom monitoring	26 (4%)	ND			−
VanDyck [107]	71, Chronic tension headaches	AT	71 (23%)	10 hours/7 weeks	Headache Index (pain intensity): P < 0.05** (AT, hypnotic imagery) over time; ES: d = 0.45	Both autogenic training and future-oriented hypnotic imagery were equally effective in reducing chronic pain.	−
VanDyck [107]	71, Chronic tension headaches	Future-oriented hypnotic imagery	71 (23%)	10 hours/7 weeks			−

Citation	Total Participants, Condition	Interventions	# Assigned (Dropout %)	Dosage (Total Hours/Time Period)	Relevant Pain Outcomes	Conclusions	Quality
Meditation/Mindfulness (N = 11)
Hsu et al. [40]	45, Fibromyalgia	ASA	24 (13%)	7.5 hours/3 weeks	BPI (pain severity): P = 0.03 at PT; P < 0.01 at FU; ES: d = 1.14 at PT, d = 1.46 at FU	ASA is more effective than WLC for reducing pain and number of painful body regions post intervention and at 6 months follow-up.	+
Hsu et al. [40]	45, Fibromyalgia	WLC	21 (0%)	ND	BPI (number of painful body regions): P < 0.001 at PT; P = 0.001 at FU		+
Wong [39]	100, Chronic pain	MBSR	51 (20%)	19 hours/8 weeks	NRS (pain): p < 0.05** (both groups); P = NS	Both MBSR and MIP programs are equally effective in reducing chronic pain intensity.	+
Wong [39]	100, Chronic pain	MIP	49 (8%)	12 hours/ND	NRS (pain): p < 0.05** (both groups); P = NS		+
Morone [30]	40, Chronic low back pain	Meditation	20 (20%)	12 hours/8 weeks	SF-MPQ (pain): P = Sig** (both groups) over time; P = NS	Both the meditation and the education program are equally effective in improving chronic low back pain.	+
Morone [30]	40, Chronic low back pain	Education	20 (5%)	12 hours/8 weeks	SF-36 Pain Subscale (pain intensity): P = Sig** (meditation) over time; P = NS at FU		+
Schmidt [34]	177, Fibromyalgia	MBSR	59 (10%)	19 hours/8 wks	PPS (sensory and affective pain): P = NS**	None of the groups (MBSR, active control, WLC) were effective in treating fibromyalgia pain.	+
Schmidt [34]	177, Fibromyalgia	WLC	59 (0%)	ND	PPS (sensory and affective pain): P = NS**		+
Active control	59 (5%)	12 hours/8 weeks
Morone [31]	37, Chronic low back pain	Meditation	19 (32%)	12 hours/8 weeks	SF-MPQ (pain intensity): P = NS; ES: d = 0.32	Neither meditation nor WLC was effective in improving chronic low back pain.	+
Morone [31]	37, Chronic low back pain	WLC	18 (5%)	ND	SF-36 Pain Subscale (pain): P = NS; ES: d = 0.16		+
Esmer [35]	40, Failed back surgery syndrome	MBSR	19 (21%)	12 hours/8 weeks	VAS (pain): P < 0.021 at wk 12; P = Sig at FU; ES: d = 1.02	MBSR is more effective than WLC in reducing pain associated with failed back surgery syndrome.	−
Esmer [35]	40, Failed back surgery syndrome	WLC	21 (24%)	ND			−
Ehrlich [32]^*	579, Chronic low back pain	Alexander technique (6 tx)	579 (20%)	ND	Von Korff Scale (pain): P = Sig (Alexander technique 24, exercise/control) at month 12	Both 6 lessons and 24 lessons with Alexander Technique, followed by exercise, are equally effective in treating chronic back pain.	−
		Alexander technique (24 tx)		ND
		Massage		ND
		Exercise		ND
Normal care	ND
Wong [36]	100, Chronic pain	MBSR	100 (ND)	ND	NRS (pain intensity): P = Sig** (both groups) at mo 6; P = NS	Both MBSR and the education program are equally effective in improving chronic pain intensity.	−
Wong [36]	100, Chronic pain	Education	100 (ND)	ND			−
Carson [33]	43, Chronic low back pain	Loving-kindness meditation	43 (ND)	12 hours/8 weeks	MPQ (pain intensity): P = Sig (meditation); P = NS (UC); ES: d = 0.42	A meditation program is effective in lowering chronic low back pain scores.	−
Carson [33]	43, Chronic low back pain	UC	43 (ND)	ND/8 weeks			−
BPI (usual pain, worst pain): P < 0.01** (meditation, usual pain); P = 0.05** (meditation, worst pain); P = ND; ES: d = 0.42		UC		ND/8 weeks
Plews-Ogan [37]	30, Musculoskeletal pain	MBSR	10 (30%)	12 hours/8 weeks	NRS (pain sensation and unpleasantness): P = Sig (massage, unpleasantness) at FU; P = NS** (MBSR, SC); P = NS	MBSR is not effective for reducing musculoskeletal pain; however, massage is more effective than SC for reducing musculoskeletal pain.	−
Plews-Ogan [37]	30, Musculoskeletal pain	Massage	10 (10%)	8 hours/8 weeks			−
SC	10 (20%)	ND
Teixeira [38]	22, Diabetic neuropathy	Meditation	11 (9%)	1 hour/1 day	NPS (pain intensity): P = NS** at PT ES: d = 0.16	Neither mindfulness meditation nor attention-placebo effectively reduced pain associated with diabetic neuropathy.	−
Teixeira [38]	22, Diabetic neuropathy	Attention-placebo	11 (9%)	1 hour/1 day	NPS (pain intensity): P = NS** at PT ES: d = 0.16		−
Relaxation (N = 22)
Stenstrom [54]	54, Inflammatory rheumatic disease	PMR	27 (0%)	ND/12 months	Nottingham Health Profile Pain Subscale (pain): P = NS at PT	PMR shows minor improvements in the reduction of pain; no differences between groups noted.	+
Stenstrom [54]	54, Inflammatory rheumatic disease	DMT	27 (0%)	ND/12 months			+
AIMS2 Pain Impact Subscale (pain): P < 0.05** (relaxation), P = NS at PT		DMT	27 (0%)	ND/12 months
Mehling [52]	36, Chronic low back pain	Breathing	18 (11%)	9 hours/6 weeks	VAS (pain intensity): P < 0.005 (both groups) at PT; P < 0.005 (both groups), P = NS at FU	Both breath therapy and physical therapy were equally effective in reducing pain and disability associated with low back pain.	+
Mehling [52]	36, Chronic low back pain	PT	18 (33%)	9 hours/6 weeks			+
SF-36 (bodily pain): P < 0.005 (both groups) at PT; P < 0.005 (both groups), P = NS at FU		PT	18 (33%)	9 hours/6 weeks
Larsson [55]	41, Chronic headaches	TAR	14 (14%)	8.25 hours/ND	Headache Activity (headache activity): P < 0.05e (TAR/SM), P < 0.05e (SHR/SM) at PT and post-booster; P < 0.01d (SHR) over time; P < 0.01d (TAR) at FU; P = NSe (TAR/SHR)	Both therapist and self-help relaxation are equally more effective than no treatment for reducing chronic headache pain.	+
Larsson [55]	41, Chronic headaches	SHR	16 (13%)	ND/ND			+
Self-monitoring (SM)	11 (9%)	ND
Poole [51]	234, Chronic low back pain	Relaxation	82 (30%)	6 hours/6 weeks	SF-36 Pain Subscale (pain): P < .0005** (all groups) over time; P = NS	Relaxation, usual care, and reflexology are all equally effective in reducing chronic low back pain.	+
		UC	75 (43%)	ND
		Reflexology	77 (16%)	6 hours/6 weeks
VAS (pain): P = NS**		Reflexology	77 (16%)	6 hours/6 weeks
Anderson [57]	59, Cancer pain	Relaxation	16 (63%)	3.3 hours/2 weeks	BPI (pain): P < 0.05 (WLC/all groups, worst pain) at wk 7; P < 0.05** (PMD, WLC, pain severity) at PT; P < 0.05** (positive mood, WLC, average pain) at PT	Distraction and WLC were equally effective in improving pain severity, while positive mood and WLC were equally effective in improving average pain scores. Furthermore, both relaxation and distraction groups reported immediate posttreatment pain reduction.	+
		PMD	16 (44%)	3.3 hours/2 weeks
		Distraction	13 (46%)	3.3 hours/2 weeks
		WLC	14 (43%)	ND
Pain Intensity Rating (pain): P < 0.03** (relaxation, PMD) at PT		WLC	14 (43%)	ND
Boyce [56]	105, Irritable bowel syndrome	Relaxation	36 (64%)	4 hours/8 weeks	SF-36 (bodily pain): P < 0.01** (all groups) over time; P < 0.05 (UC) over time	All groups were equally effective in treating pain associated with irritable bowel syndrome.	+
Boyce [56]	105, Irritable bowel syndrome	CBT	35 (49%)	8 hours/8 weeks			+
UC	34 (38%)	0.75 hours + 190.4 g psyllium hus/ND
Trautmann [49]	65, Migraine, tension headache or combined migraine/tension headache	Applied relaxation	22 (14%)	ND/6 weeks	Headache Diary (headache intensity): P = NS**; ES: d = 0.0 (CBT), d = −0.27 (AR), d = −0.11 (EDU)	None of the groups (applied relaxation, education, cognitive behavioral therapy) are effective for reducing intensity of recurrent headache pain.	+
Trautmann [49]		Education	19 (47%)	ND/6 weeks			+
CBT	24 (54%)	ND/6 weeks
Hammond [50]	183, Fibromyalgia	Relaxation	86 (28%)	10 hours/10 weeks	FIQ (pain): P = NS**	Neither the relaxation nor the patient education are effective in reducing fibromyalgia pain.	+
Hammond [50]	183, Fibromyalgia	Education	97 (27%)	20 hours/10 weeks	FIQ (pain): P = NS**		+
Gustavsson [53]	37, Long-lasting neck pain	Applied relaxation	18 (11%)	10.5 hours/7 weeks	Ordinal Scale of Pain (pain intensity): P = NS**	Neither the relaxation group nor treatment as usual group effectively reduced neck pain.	+
Gustavsson [53]	37, Long-lasting neck pain	UC	19 (11%)	ND	Ordinal Scale of Pain (pain intensity): P = NS**		+
Wahlund [60]	122, Temporo-mandibular disorders	Relaxation	41 (17%)	ND/ND	VAS (pain): P < 0.01 (occlusal appliance/ brief information); P = NS (relaxation/occlusal appliance); P = ND** (relaxation/brief information)	Occlusal appliance is more effective than brief information training in the reduction of pain intensity associated with temporomandibular disorders; no significant differences between the occlusal appliance and the relaxation training group or relaxation and brief information groups.	−
Wahlund [60]	122, Temporo-mandibular disorders	Occlusal appliance	42 (12%)	ND			−
Brief information	39 (0%)	0.5 hours/1 day
Larsson [65]	48, Tension headache	Relaxation	31 (0%)	ND/5 weeks	Headache Index (headache parameters): P < 0.05(peak intensity, headache frequency, headache free days), P = NS (headache duration) at PT	Relaxation training program is more effective than WLC in reducing tension headache pain.	−
Larsson [65]	48, Tension headache	WLC	17 (0%)	ND			−
Loew [64]	54, Tension headache	EFR	27 (11%)	0.75 hours/1 day	Standardized Pain Diary (pain intensity): P = 0.003(intense pain), P = 0.03(medium pain) at PT	EFR is more effective than an unspecified intervention in reducing tension headache pain intensity.	−
Loew [64]	54, Tension headache	Unspecified intervention	27 (56%)	0.75 hours/1 day			−
Larsson [67]	26, Chronic tension-type headache	Relaxation	13 (0%)	4.2 hours/5 weeks	Headache Activity (headache): P < 0.05	School-based, nurse-administered relaxation training program is more effective than no treatment in reducing chronic tension-type headaches in school children.	−
Larsson [67]	26, Chronic tension-type headache	NT	13 (0%)	ND	Headache Activity (headache): P < 0.05		−
Larsson [66]	32, Chronic headaches	Relaxation training	12 (9%)	4.2 hours/5 weeks	Headache Activity (headache parameters): P = NS (all groups, headache intensity); P = Sig (relaxation/information contact, headache sum); P = Sig (relaxation/NT, headache sum) at PT; P = NS (headache sum score) at FU	Relaxation is more effective than information contact and no treatment in reducing weekly headache intensity at end of treatment; however, no differences were noted at follow up.	−
Larsson [66]	32, Chronic headaches	Information contact	13 (0%)	ND/ND			−
NT	7 (0%)	ND
Thorsell [61]	115, Chronic pain	Applied relaxation	61 (46%)	3 hours/2 days	OMPQ (pain intensity): P = NS (applied relaxation) at PT, months 6, 12; P < 0.05 (ACT) at PT, month 6; P = ND; ES: d = −0.37 (ACT at PT), d = −0.47 (ACT at month 12)	Applied relaxation is not as effective as ACT in treating chronic pain symptoms.	−
Thorsell [61]	115, Chronic pain	ACT	54 (43%)	3 hours/2 days			−
McGrath [62]	99, Migraine	Relaxation training	32 (38%)	6 hours/6 weeks	Headache Diary (headache): P < 0.05** (all groups) over time; P = NS	Both relaxation and placebo treatments are equally effective in reducing migraine pain.	−
McGrath [62]	99, Migraine	Placebo	37 (43%)	6 hours/6 weeks			−
Own best efforts	30 (30%)	ND
Blanchard [69]	39, Tension headache	PMR + home practice (PMR+)	39 (15%)	ND/8 weeks	Headache Diary (headache): P = 0.005 (PMR+), P = 0.04 (PMR), P = Sig (PMR+, PMR/WLC), P = NS (PMR+/PMR) at PT	Both PMR + home practice and PMR are equally more effective than WLC in reducing headache intensity.	−
Blanchard [69]	39, Tension headache	PMR	39 (15%)	ND/8 weeks			−
WLC	ND
Barsky [59]	168, Rheumatoid arthritis	Relaxation response	44 (27%)	6.7 hours/ND	Rheumatoid Arthritis Symptom Questionnaire (pain): P < 0.001 (all groups) over time, month 6; P = Sig (education), P = NS** (CBT, relaxation), P = NS (all groups) at month 12 ES: d = 0.26–0.35 (at PT)	Relaxation, arthritis education, and CBT are all equally effective in reducing pain.	−
Barsky [59]	168, Rheumatoid arthritis	Arthritis education	56 (21%)	6.7 hours/ND			−
CBT	68 (16%)	12 hours/ND
Linton [58]	15, Chronic pain	Applied relaxation	15 (0%)	6 hours/4 weeks	5-Point Likert Scale (pain intensity): P = Sig (applied relaxation/WLC) at PT; P = Sig** (all groups) over time	Although all groups were effective in reducing pain, applied relaxation seems to be more effective than applied relaxation + operant conditioning and WLC.	−
Linton [58]	15, Chronic pain	Applied relaxation + operant conditioning	15 (0%)	ND/4 weeks			−
WLC	ND
Funch [68]	57, Chronic temporomandibular joint pain	Relaxation	30 (0%)	1 hour/ND	6-Point Likert Scale (pain rating): P = NS**	Neither relaxation nor biofeedback is effective in reducing chronic temporomandibular joint pain.	−
Funch [68]	57, Chronic temporomandibular joint pain	Biofeedback	27 (0%)	0.2 hours/1 day	6-Point Likert Scale (pain rating): P = NS**		−
Lundgren [63]	68, Rheumatoid arthritis	Relaxation training	37 (11%)	10 hours/10 weeks	VAS (pain): P = NS**	Neither muscle relaxation training nor a no-treatment control group are effective in reducing pain associated with rheumatoid arthritis.	−
Lundgren [63]	68, Rheumatoid arthritis	NT	31 (13%)	ND	VAS (pain): P = NS**		−
Gay [24]	41, Osteoarthritis pain	Relaxation	14 (7%)	4 hours/8 weeks	VAS (pain): P < 0.0004 (hypnosis/relaxation, hypnosis/WLC), P = NS (relaxation/WLC) at week 4; P < 0.003 (hypnosis/WLC, relaxation/WLC), P = NS (hypnosis/relaxation) at PT; P < 0.004 (hypnosis/WLC), P = NS (hypnosis/relaxation, relaxation/WLC) at month 3, P = NS (all groups) at month 6	Hypnosis is more effective than both relaxation and WLC in reducing osteoarthritis pain at 4 weeks; however, both hypnosis and relaxation are equally more effective than WLC at 8 weeks. None of the groups were effective at 6 months.	−
Gay [24]	41, Osteoarthritis pain	Hypnosis	14 (7%)	4 hours/8 weeks			−
WLC	13 (23%)	ND
Biofeedback (N = 13)
Kapitza [76]	42, Chronic low back pain	Respiratory feedback	21 (0%)	7.5 hours/15 days	Pain Diary (pain): P < 0.02** (respiratory biofeedback, pain at rest/during activity), P = 0.014** (placebo biofeedback, pain during activity) at month 3; P = NS** (placebo biofeedback, pain at rest), P = NS	Respiratory biofeedback is more effective than placebo biofeedback in reducing pain 3 months post intervention.	+
Kapitza [76]	42, Chronic low back pain	Placebo biofeedback	21 (0%)	7.5 hours/15 days			+
Scharff [80]	36, Migraine in children	Handwarming biofeedback	13 (0%)	4.5 hours/6 weeks	Headache Index (headache intensity): P = Sig** (all groups), P = NS (all groups) at month 12	Both handwarming biofeedback and handcooling biofeedback seem to be equally effective in reducing headache intensity over time.	+
Scharff [80]	36, Migraine in children	Handcooling biofeedback	11 (9%)	4.5 hours/6 weeks			+
WLC	12 (8%)	ND
Bruhn [82]	28, Chronic muscle contraction headache	EMG biofeedback	14 (7%)	5.3 hours/8 weeks	Headache Diary (headache intensity): P < 0.01 (biofeedback) at last 2 weeks of therapy; P = ND (UC); P = ND	EMG biofeedback therapy is effective in reducing severe muscle contraction headaches at posttest; no between group differences were reported.	−
Bruhn [82]	28, Chronic muscle contraction headache	UC	14 (29%)	ND			−
Kayiran [83]	40, Fibromyalgia	Neurofeedback sensory motor training	20 (10%)	10 hours/4 weeks	VAS (pain intensity): P < 0.05 at every PT visit	Neurofeedback Sensory Motor Training is more effective than escitalopram in reducing pain associated with fibromyalgia.	−
Kayiran [83]	40, Fibromyalgia	Escitalopram	20 (10%)	560 mg/8 weeks	VAS (pain intensity): P < 0.05 at every PT visit		−
Babu [84]	30, Fibromyalgia	EMG biofeedback	15 (0%)	4.5 hours/6 days	VAS (pain): P = 0.000	EMG biofeedback is more effective than sham biofeedback in reducing fibromyalgia pain.	−
Babu [84]	30, Fibromyalgia	Sham biofeedback	15 (0%)	4.5 hours/6 days	VAS (pain): P = 0.000		−
Nelson [85]	42, Fibromyalgia	LENS	21 (24%)	ND/ND	NRS (pain intensity): P < 0.001** (LENS, pain intensity of past 24 h); P = NS** (placebo, pain intensity of past 24 h); P = ND** (both groups, current pain intensity); P = ND	LENS treatment is more effective than placebo biofeedback at alleviating fibromyalgia pain.	−
Nelson [85]	42, Fibromyalgia	Placebo biofeedback	21 (24%)	ND/ND			−
Ma [86]	60, Neck and/or shoulder pain	Biofeedback	15 (33%)	24 hours/6 weeks	VAS (pain): P < 0.04 (biofeedback, active exercise, PassTx), P = NS (education), P = Sig (education/other groups), P = NS (active exercise/ PassTx) at PT; P = 0.00 (biofeedback/other groups) at PT, month 6;	Biofeedback was more effective than active exercise, passive treatment, and an education group in reducing neck and shoulder pain.	−
		Biofeedback	15 (33%)	24 hours/6 weeks	P < 0.02 (active exercise/ PassTx, education), P = NS (PassTx /education) at month 6
		Active exercise	ND	57.3 hours/6 weeks
		PassTx	ND	7 hours/6 weeks
Education book	15 (40%)	ND/6 weeks
Simon [87]	30, Chronic constipation	EMG biofeedback	15 (0%)	6 hours/1 month	10-Point Likert Scale (pain): P < 0.01 (biofeedback) at FU; P = NS (counseling); P = Sig	EMG biofeedback is more effective than counseling for reducing pain associated with chronic constipation in elderly patients.	−
Simon [87]	30, Chronic constipation	Counseling	15 (0%)	6 hours/1 month			−
Newton-John [78]	44, Chronic low back pain	EMG biofeedback	16 (38%)	8 hours/4 wks	Pain Diary (pain severity): P < 0.007 (biofeedback/WLC, CBT/WLC); P = NS (biofeedback/CBT)	Both CBT and EMG biofeedback were equally more effective than WLC in reducing self-monitored chronic low back pain.	−
Newton-John [78]	44, Chronic low back pain	CBT	16 (19%)	8 hours/4 weeks			−
WLC	12 (ND)	ND
Bohm-Starke [88]	35, Provoked vestibulodynia	Surface EMG biofeedback	17 (0%)	40 hours/4 months	VAS (pain intensity): P = NS**	Both surface EMG biofeedback and topical lidocaine were equally effective in decreasing gastrointestinal tract, shoulder, joint, and back pain symptoms at 6 months post intervention.	−
		Surface EMG biofeedback	17 (0%)	40 hours/4 months	SF-36 Pain Subscale (bodily pain): P = NS**
		Topical lidocaine	18 (0%)	ND/4 months	SF-36 Pain Subscale (bodily pain): P = NS**
Subjective Outcome and Bodily Pain (pain): P < 0.01**(gastrointestinal tract, joint, shoulder, back pain), P = NS at FU		Topical lidocaine	18 (0%)	ND/4 months
Holroyd [81]	43, Tension headache	Decrease/High	43 (12%)	5 hours/12 weeks	Headache Recordings (headache intensity): P < 0.05** (Decrease/High, Increase/High, Increase/Moderate); P = NS	All EMG biofeedback groups were equally more effective than the decrease/moderate group in improving tension headache pain scores.	−
		Decrease/Moderate		5 hours/12 weeks
		Increase/High		5 hours/12 weeks
Increase/Moderate	5 hours/12 weeks
Nouwen [77]	20, Chronic low back pain	EMG biofeedback	10 (0%)	10 hours/3 weeks	Back Pain Log (pain): P = NS**	Neither EMG biofeedback nor WLC are effective in alleviating low back pain.	−
Nouwen [77]	20, Chronic low back pain	WLC	10 (0%)	MD	Back Pain Log (pain): P = NS**		−
Bush [79]	72, Chronic low back pain	Biofeedback	23 (9%)	4 hours/ND	Daily Low Back Pain Record (pain severity): P = NS (all groups)	Neither EMG biofeedback nor placebo is effective in treating chronic low back pain in a nonhospitalized population.	−
		Placebo	24 (4%)	4 hours/ND
		WLC	25 (0%)	ND
MPQ—PPI (present pain severity): P = NS (all groups) at PT		WLC	25 (0%)	ND
Guided Imagery/Self-Hypnosis (N = 6)
Menzies [95]	48, Fibromyalgia	GI	24 (0%)	ND/10 weeks	SF-MPQ PPI Subscale (present pain intensity): P = NS**	Neither guided imagery nor usual care were effective in reducing fibromyalgia pain.	+
Menzies [95]	48, Fibromyalgia	UC	24 (0%)	ND/10 weeks	SF-MPQ PPI Subscale (present pain intensity): P = NS**		+
SF- MPQ VAS Subscale (pain): P = NS**		UC	24 (0%)	ND/10 weeks
Fors [96]	58, Fibromyalgia	GI	17 (0%)	0.5 hours/1 day	VAS (pain): P < 0.001 (GI and patient education) at PT; P < 0.05 (GI/pain-related talk, patient education/pain-related talk); P = NS (GI/patient education); P = NS (pain-related talk)	Both guided imagery and patient education are equally more effective than a pain-related talk group in reducing short-term fibromyalgia pain.	−
Fors [96]	58, Fibromyalgia	Pain-related talk	19 (0%)	0.5 hours/1 day			−
Patient education	22 (0%)	0.5 hours/1 day
van Tilburg [97]	34, Abdominal pain	GI + SMC	19 (16%)	ND/8 weeks	Abdominal Pain Index (parent report of pain intensity and pain severity): P < 0.05** (GI + SMC), P = ND at PT, FU	Guided imagery plus standard medical care is effective in reducing pain associated with the abdomen.	−
van Tilburg [97]	34, Abdominal pain	SMC	15 (0%)	ND			−
Patterson [98]	21, Physical trauma injuries	VRH	21 (22%)	8 hours/1 day	GRS (pain): P < 0.05** (VRH, NT, pain intensity, pain unpleasantness), P < 0.05** (VRH, least pain intensity in past 8h), P < 0.05** (NT, least pain intensity in past 8h), P = NS at PT	VRH is effective in reducing pain intensity and unpleasantness associated with physical trauma injuries, whereas the control group reported increases in these areas; no significant between group differences were noted.	−
Patterson [98]	21, Physical trauma injuries	Virtual reality/NT	21 (22%)	ND			−
Carrico [99]	30, Insterstitial cystitis	GI	15 (27%)	46.7 hours/8 weeks	VAS (pain): P = 0.027 (GI), P = NS (WLC), P = NS at PT	Guided imagery is effective in reducing insterstitial cystitis pain, whereas the control group indicated no changes; no significant difference between groups were noted.	−
Carrico [99]	30, Insterstitial cystitis	WLC	15 (7%)	46.7 hours/8 weeks			−
Lewandowski [100]	44, Chronic pain	GI	22 (5%)	21 minutes/3 days	VAS (pain intensity): P < 0.05 at day 4, 5; P = NS at day 2, 3	Guided imagery is effective in reducing chronic pain.	−
Lewandowski [100]	44, Chronic pain	WLC	22 (5%)	ND		Guided imagery is effective in reducing chronic pain.	−
Autogenic Training (N = 2)
Asbury [23]	53, Cardiac syndrome x	AT	27 (15%)	12 hours/8 weeks	Symptom Monitoring Diary (symptom severity): P < 0.001** (AT), P = NS at PT	Autogenic training is effective in reducing cardiac symptom pain symptom severity; no between group differences noted.	−
Asbury [23]	53, Cardiac syndrome x	Symptom monitoring	26 (4%)	ND			−
VanDyck [107]	71, Chronic tension headaches	AT	71 (23%)	10 hours/7 weeks	Headache Index (pain intensity): P < 0.05** (AT, hypnotic imagery) over time; ES: d = 0.45	Both autogenic training and future-oriented hypnotic imagery were equally effective in reducing chronic pain.	−
VanDyck [107]	71, Chronic tension headaches	Future-oriented hypnotic imagery	71 (23%)	10 hours/7 weeks			−

ACoT = Acceptance and Commitment Therapy; AT = autogenic training; AIMS2 = Arthritis Impact Measurement Scales 2; ASA = Affect Self-Awareness; BPI = Brief Pain Inventory; CBST = cognitive behavioral skills training; CBT = cognitive behavioral therapy; DMT = Dynamic Muscle Training; EFR = Elements of Functional Relaxation; EMG = electromyography; ES = effect size; GRS = Graphic Rating Scale; IC-SIPI = Interstitial Cystitis Symptom Index and Problem Index; LENS = low energy neurofeedback system; MBSR = Mindfulness-Based Stress Reduction; MIP = Multidisciplinary Intervention Program; MPQ = McGill Pain Questionnaire; NDI = Neck Disability Index; NAT = no adjunct treatment; NPS = Neuropathic Pain Scale; ND = not described; NS = not significant; NT = no treatment; OA = osteoarthritis; OMPQ = Orebro Musculoskeletal Pain Questionnaire; PassTx = passive treatment; PMD = positive mood distraction; PMR = progressive muscle relaxation; PPI = present pain intensity; PPS = Pain Perception Scale; PT = physical therapy; SC = standard care; SF-36 = Medical Outcomes Study Short Form; SGT = structured group social support therapy; SMUBT = Single Motor Unit Biofeedback Training; SF-MPQ = Short-Form McGill Pain Questionnaire; SF-PQ = Short-Form Pain Questionnaire; SHR = Self-Help Relaxation; Sig = significant but P value not given; SMC = standard medical care; SGT = structured group social support therapy; TAR = Therapist Assisted Relaxation; TENS = transcutaneous electrical nerve stimulation; TT = therapeutic touch; TX = treatment; UC = usual care; VRH = virtual reality hypnosis; WLC = wait list control.

Subset of study results were also reported in Hollinghurst S, Sharp D, Ballard K, et al. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain: Economic evaluation. BMJ. 2008;337:a2656; all relevant results from both studies reported here.

Result reporting for two interventions: Outcome Name (construct measured): P value (group or groups that showed significance) at time point, if reported by the article's authors.

Result reporting for two or more interventions: Outcome Name (construct measured): P value (group 1/group 2) at time point, if reported by the article's authors. Note that groups compared with each other are listed following the P value.

Authors report power achieved.

Authors report power not achieved.

Numbers reflect overall sample.

Within groups.

Between groups.

Table 2

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Characteristics of mind–body therapy studies

Citation	Total Participants, Condition	Interventions	# Assigned (Dropout %)	Dosage (Total Hours/Time Period)	Relevant Pain Outcomes	Conclusions	Quality
Meditation/Mindfulness (N = 11)
Hsu et al. [40]	45, Fibromyalgia	ASA	24 (13%)	7.5 hours/3 weeks	BPI (pain severity): P = 0.03 at PT; P < 0.01 at FU; ES: d = 1.14 at PT, d = 1.46 at FU	ASA is more effective than WLC for reducing pain and number of painful body regions post intervention and at 6 months follow-up.	+
Hsu et al. [40]	45, Fibromyalgia	WLC	21 (0%)	ND	BPI (number of painful body regions): P < 0.001 at PT; P = 0.001 at FU		+
Wong [39]	100, Chronic pain	MBSR	51 (20%)	19 hours/8 weeks	NRS (pain): p < 0.05** (both groups); P = NS	Both MBSR and MIP programs are equally effective in reducing chronic pain intensity.	+
Wong [39]	100, Chronic pain	MIP	49 (8%)	12 hours/ND	NRS (pain): p < 0.05** (both groups); P = NS		+
Morone [30]	40, Chronic low back pain	Meditation	20 (20%)	12 hours/8 weeks	SF-MPQ (pain): P = Sig** (both groups) over time; P = NS	Both the meditation and the education program are equally effective in improving chronic low back pain.	+
Morone [30]	40, Chronic low back pain	Education	20 (5%)	12 hours/8 weeks	SF-36 Pain Subscale (pain intensity): P = Sig** (meditation) over time; P = NS at FU		+
Schmidt [34]	177, Fibromyalgia	MBSR	59 (10%)	19 hours/8 wks	PPS (sensory and affective pain): P = NS**	None of the groups (MBSR, active control, WLC) were effective in treating fibromyalgia pain.	+
Schmidt [34]	177, Fibromyalgia	WLC	59 (0%)	ND	PPS (sensory and affective pain): P = NS**		+
Active control	59 (5%)	12 hours/8 weeks
Morone [31]	37, Chronic low back pain	Meditation	19 (32%)	12 hours/8 weeks	SF-MPQ (pain intensity): P = NS; ES: d = 0.32	Neither meditation nor WLC was effective in improving chronic low back pain.	+
Morone [31]	37, Chronic low back pain	WLC	18 (5%)	ND	SF-36 Pain Subscale (pain): P = NS; ES: d = 0.16		+
Esmer [35]	40, Failed back surgery syndrome	MBSR	19 (21%)	12 hours/8 weeks	VAS (pain): P < 0.021 at wk 12; P = Sig at FU; ES: d = 1.02	MBSR is more effective than WLC in reducing pain associated with failed back surgery syndrome.	−
Esmer [35]	40, Failed back surgery syndrome	WLC	21 (24%)	ND			−
Ehrlich [32]^*	579, Chronic low back pain	Alexander technique (6 tx)	579 (20%)	ND	Von Korff Scale (pain): P = Sig (Alexander technique 24, exercise/control) at month 12	Both 6 lessons and 24 lessons with Alexander Technique, followed by exercise, are equally effective in treating chronic back pain.	−
		Alexander technique (24 tx)		ND
		Massage		ND
		Exercise		ND
Normal care	ND
Wong [36]	100, Chronic pain	MBSR	100 (ND)	ND	NRS (pain intensity): P = Sig** (both groups) at mo 6; P = NS	Both MBSR and the education program are equally effective in improving chronic pain intensity.	−
Wong [36]	100, Chronic pain	Education	100 (ND)	ND			−
Carson [33]	43, Chronic low back pain	Loving-kindness meditation	43 (ND)	12 hours/8 weeks	MPQ (pain intensity): P = Sig (meditation); P = NS (UC); ES: d = 0.42	A meditation program is effective in lowering chronic low back pain scores.	−
Carson [33]	43, Chronic low back pain	UC	43 (ND)	ND/8 weeks			−
BPI (usual pain, worst pain): P < 0.01** (meditation, usual pain); P = 0.05** (meditation, worst pain); P = ND; ES: d = 0.42		UC		ND/8 weeks
Plews-Ogan [37]	30, Musculoskeletal pain	MBSR	10 (30%)	12 hours/8 weeks	NRS (pain sensation and unpleasantness): P = Sig (massage, unpleasantness) at FU; P = NS** (MBSR, SC); P = NS	MBSR is not effective for reducing musculoskeletal pain; however, massage is more effective than SC for reducing musculoskeletal pain.	−
Plews-Ogan [37]	30, Musculoskeletal pain	Massage	10 (10%)	8 hours/8 weeks			−
SC	10 (20%)	ND
Teixeira [38]	22, Diabetic neuropathy	Meditation	11 (9%)	1 hour/1 day	NPS (pain intensity): P = NS** at PT ES: d = 0.16	Neither mindfulness meditation nor attention-placebo effectively reduced pain associated with diabetic neuropathy.	−
Teixeira [38]	22, Diabetic neuropathy	Attention-placebo	11 (9%)	1 hour/1 day	NPS (pain intensity): P = NS** at PT ES: d = 0.16		−
Relaxation (N = 22)
Stenstrom [54]	54, Inflammatory rheumatic disease	PMR	27 (0%)	ND/12 months	Nottingham Health Profile Pain Subscale (pain): P = NS at PT	PMR shows minor improvements in the reduction of pain; no differences between groups noted.	+
Stenstrom [54]	54, Inflammatory rheumatic disease	DMT	27 (0%)	ND/12 months			+
AIMS2 Pain Impact Subscale (pain): P < 0.05** (relaxation), P = NS at PT		DMT	27 (0%)	ND/12 months
Mehling [52]	36, Chronic low back pain	Breathing	18 (11%)	9 hours/6 weeks	VAS (pain intensity): P < 0.005 (both groups) at PT; P < 0.005 (both groups), P = NS at FU	Both breath therapy and physical therapy were equally effective in reducing pain and disability associated with low back pain.	+
Mehling [52]	36, Chronic low back pain	PT	18 (33%)	9 hours/6 weeks			+
SF-36 (bodily pain): P < 0.005 (both groups) at PT; P < 0.005 (both groups), P = NS at FU		PT	18 (33%)	9 hours/6 weeks
Larsson [55]	41, Chronic headaches	TAR	14 (14%)	8.25 hours/ND	Headache Activity (headache activity): P < 0.05e (TAR/SM), P < 0.05e (SHR/SM) at PT and post-booster; P < 0.01d (SHR) over time; P < 0.01d (TAR) at FU; P = NSe (TAR/SHR)	Both therapist and self-help relaxation are equally more effective than no treatment for reducing chronic headache pain.	+
Larsson [55]	41, Chronic headaches	SHR	16 (13%)	ND/ND			+
Self-monitoring (SM)	11 (9%)	ND
Poole [51]	234, Chronic low back pain	Relaxation	82 (30%)	6 hours/6 weeks	SF-36 Pain Subscale (pain): P < .0005** (all groups) over time; P = NS	Relaxation, usual care, and reflexology are all equally effective in reducing chronic low back pain.	+
		UC	75 (43%)	ND
		Reflexology	77 (16%)	6 hours/6 weeks
VAS (pain): P = NS**		Reflexology	77 (16%)	6 hours/6 weeks
Anderson [57]	59, Cancer pain	Relaxation	16 (63%)	3.3 hours/2 weeks	BPI (pain): P < 0.05 (WLC/all groups, worst pain) at wk 7; P < 0.05** (PMD, WLC, pain severity) at PT; P < 0.05** (positive mood, WLC, average pain) at PT	Distraction and WLC were equally effective in improving pain severity, while positive mood and WLC were equally effective in improving average pain scores. Furthermore, both relaxation and distraction groups reported immediate posttreatment pain reduction.	+
		PMD	16 (44%)	3.3 hours/2 weeks
		Distraction	13 (46%)	3.3 hours/2 weeks
		WLC	14 (43%)	ND
Pain Intensity Rating (pain): P < 0.03** (relaxation, PMD) at PT		WLC	14 (43%)	ND
Boyce [56]	105, Irritable bowel syndrome	Relaxation	36 (64%)	4 hours/8 weeks	SF-36 (bodily pain): P < 0.01** (all groups) over time; P < 0.05 (UC) over time	All groups were equally effective in treating pain associated with irritable bowel syndrome.	+
Boyce [56]	105, Irritable bowel syndrome	CBT	35 (49%)	8 hours/8 weeks			+
UC	34 (38%)	0.75 hours + 190.4 g psyllium hus/ND
Trautmann [49]	65, Migraine, tension headache or combined migraine/tension headache	Applied relaxation	22 (14%)	ND/6 weeks	Headache Diary (headache intensity): P = NS**; ES: d = 0.0 (CBT), d = −0.27 (AR), d = −0.11 (EDU)	None of the groups (applied relaxation, education, cognitive behavioral therapy) are effective for reducing intensity of recurrent headache pain.	+
Trautmann [49]		Education	19 (47%)	ND/6 weeks			+
CBT	24 (54%)	ND/6 weeks
Hammond [50]	183, Fibromyalgia	Relaxation	86 (28%)	10 hours/10 weeks	FIQ (pain): P = NS**	Neither the relaxation nor the patient education are effective in reducing fibromyalgia pain.	+
Hammond [50]	183, Fibromyalgia	Education	97 (27%)	20 hours/10 weeks	FIQ (pain): P = NS**		+
Gustavsson [53]	37, Long-lasting neck pain	Applied relaxation	18 (11%)	10.5 hours/7 weeks	Ordinal Scale of Pain (pain intensity): P = NS**	Neither the relaxation group nor treatment as usual group effectively reduced neck pain.	+
Gustavsson [53]	37, Long-lasting neck pain	UC	19 (11%)	ND	Ordinal Scale of Pain (pain intensity): P = NS**		+
Wahlund [60]	122, Temporo-mandibular disorders	Relaxation	41 (17%)	ND/ND	VAS (pain): P < 0.01 (occlusal appliance/ brief information); P = NS (relaxation/occlusal appliance); P = ND** (relaxation/brief information)	Occlusal appliance is more effective than brief information training in the reduction of pain intensity associated with temporomandibular disorders; no significant differences between the occlusal appliance and the relaxation training group or relaxation and brief information groups.	−
Wahlund [60]	122, Temporo-mandibular disorders	Occlusal appliance	42 (12%)	ND			−
Brief information	39 (0%)	0.5 hours/1 day
Larsson [65]	48, Tension headache	Relaxation	31 (0%)	ND/5 weeks	Headache Index (headache parameters): P < 0.05(peak intensity, headache frequency, headache free days), P = NS (headache duration) at PT	Relaxation training program is more effective than WLC in reducing tension headache pain.	−
Larsson [65]	48, Tension headache	WLC	17 (0%)	ND			−
Loew [64]	54, Tension headache	EFR	27 (11%)	0.75 hours/1 day	Standardized Pain Diary (pain intensity): P = 0.003(intense pain), P = 0.03(medium pain) at PT	EFR is more effective than an unspecified intervention in reducing tension headache pain intensity.	−
Loew [64]	54, Tension headache	Unspecified intervention	27 (56%)	0.75 hours/1 day			−
Larsson [67]	26, Chronic tension-type headache	Relaxation	13 (0%)	4.2 hours/5 weeks	Headache Activity (headache): P < 0.05	School-based, nurse-administered relaxation training program is more effective than no treatment in reducing chronic tension-type headaches in school children.	−
Larsson [67]	26, Chronic tension-type headache	NT	13 (0%)	ND	Headache Activity (headache): P < 0.05		−
Larsson [66]	32, Chronic headaches	Relaxation training	12 (9%)	4.2 hours/5 weeks	Headache Activity (headache parameters): P = NS (all groups, headache intensity); P = Sig (relaxation/information contact, headache sum); P = Sig (relaxation/NT, headache sum) at PT; P = NS (headache sum score) at FU	Relaxation is more effective than information contact and no treatment in reducing weekly headache intensity at end of treatment; however, no differences were noted at follow up.	−
Larsson [66]	32, Chronic headaches	Information contact	13 (0%)	ND/ND			−
NT	7 (0%)	ND
Thorsell [61]	115, Chronic pain	Applied relaxation	61 (46%)	3 hours/2 days	OMPQ (pain intensity): P = NS (applied relaxation) at PT, months 6, 12; P < 0.05 (ACT) at PT, month 6; P = ND; ES: d = −0.37 (ACT at PT), d = −0.47 (ACT at month 12)	Applied relaxation is not as effective as ACT in treating chronic pain symptoms.	−
Thorsell [61]	115, Chronic pain	ACT	54 (43%)	3 hours/2 days			−
McGrath [62]	99, Migraine	Relaxation training	32 (38%)	6 hours/6 weeks	Headache Diary (headache): P < 0.05** (all groups) over time; P = NS	Both relaxation and placebo treatments are equally effective in reducing migraine pain.	−
McGrath [62]	99, Migraine	Placebo	37 (43%)	6 hours/6 weeks			−
Own best efforts	30 (30%)	ND
Blanchard [69]	39, Tension headache	PMR + home practice (PMR+)	39 (15%)	ND/8 weeks	Headache Diary (headache): P = 0.005 (PMR+), P = 0.04 (PMR), P = Sig (PMR+, PMR/WLC), P = NS (PMR+/PMR) at PT	Both PMR + home practice and PMR are equally more effective than WLC in reducing headache intensity.	−
Blanchard [69]	39, Tension headache	PMR	39 (15%)	ND/8 weeks			−
WLC	ND
Barsky [59]	168, Rheumatoid arthritis	Relaxation response	44 (27%)	6.7 hours/ND	Rheumatoid Arthritis Symptom Questionnaire (pain): P < 0.001 (all groups) over time, month 6; P = Sig (education), P = NS** (CBT, relaxation), P = NS (all groups) at month 12 ES: d = 0.26–0.35 (at PT)	Relaxation, arthritis education, and CBT are all equally effective in reducing pain.	−
Barsky [59]	168, Rheumatoid arthritis	Arthritis education	56 (21%)	6.7 hours/ND			−
CBT	68 (16%)	12 hours/ND
Linton [58]	15, Chronic pain	Applied relaxation	15 (0%)	6 hours/4 weeks	5-Point Likert Scale (pain intensity): P = Sig (applied relaxation/WLC) at PT; P = Sig** (all groups) over time	Although all groups were effective in reducing pain, applied relaxation seems to be more effective than applied relaxation + operant conditioning and WLC.	−
Linton [58]	15, Chronic pain	Applied relaxation + operant conditioning	15 (0%)	ND/4 weeks			−
WLC	ND
Funch [68]	57, Chronic temporomandibular joint pain	Relaxation	30 (0%)	1 hour/ND	6-Point Likert Scale (pain rating): P = NS**	Neither relaxation nor biofeedback is effective in reducing chronic temporomandibular joint pain.	−
Funch [68]	57, Chronic temporomandibular joint pain	Biofeedback	27 (0%)	0.2 hours/1 day	6-Point Likert Scale (pain rating): P = NS**		−
Lundgren [63]	68, Rheumatoid arthritis	Relaxation training	37 (11%)	10 hours/10 weeks	VAS (pain): P = NS**	Neither muscle relaxation training nor a no-treatment control group are effective in reducing pain associated with rheumatoid arthritis.	−
Lundgren [63]	68, Rheumatoid arthritis	NT	31 (13%)	ND	VAS (pain): P = NS**		−
Gay [24]	41, Osteoarthritis pain	Relaxation	14 (7%)	4 hours/8 weeks	VAS (pain): P < 0.0004 (hypnosis/relaxation, hypnosis/WLC), P = NS (relaxation/WLC) at week 4; P < 0.003 (hypnosis/WLC, relaxation/WLC), P = NS (hypnosis/relaxation) at PT; P < 0.004 (hypnosis/WLC), P = NS (hypnosis/relaxation, relaxation/WLC) at month 3, P = NS (all groups) at month 6	Hypnosis is more effective than both relaxation and WLC in reducing osteoarthritis pain at 4 weeks; however, both hypnosis and relaxation are equally more effective than WLC at 8 weeks. None of the groups were effective at 6 months.	−
Gay [24]	41, Osteoarthritis pain	Hypnosis	14 (7%)	4 hours/8 weeks			−
WLC	13 (23%)	ND
Biofeedback (N = 13)
Kapitza [76]	42, Chronic low back pain	Respiratory feedback	21 (0%)	7.5 hours/15 days	Pain Diary (pain): P < 0.02** (respiratory biofeedback, pain at rest/during activity), P = 0.014** (placebo biofeedback, pain during activity) at month 3; P = NS** (placebo biofeedback, pain at rest), P = NS	Respiratory biofeedback is more effective than placebo biofeedback in reducing pain 3 months post intervention.	+
Kapitza [76]	42, Chronic low back pain	Placebo biofeedback	21 (0%)	7.5 hours/15 days			+
Scharff [80]	36, Migraine in children	Handwarming biofeedback	13 (0%)	4.5 hours/6 weeks	Headache Index (headache intensity): P = Sig** (all groups), P = NS (all groups) at month 12	Both handwarming biofeedback and handcooling biofeedback seem to be equally effective in reducing headache intensity over time.	+
Scharff [80]	36, Migraine in children	Handcooling biofeedback	11 (9%)	4.5 hours/6 weeks			+
WLC	12 (8%)	ND
Bruhn [82]	28, Chronic muscle contraction headache	EMG biofeedback	14 (7%)	5.3 hours/8 weeks	Headache Diary (headache intensity): P < 0.01 (biofeedback) at last 2 weeks of therapy; P = ND (UC); P = ND	EMG biofeedback therapy is effective in reducing severe muscle contraction headaches at posttest; no between group differences were reported.	−
Bruhn [82]	28, Chronic muscle contraction headache	UC	14 (29%)	ND			−
Kayiran [83]	40, Fibromyalgia	Neurofeedback sensory motor training	20 (10%)	10 hours/4 weeks	VAS (pain intensity): P < 0.05 at every PT visit	Neurofeedback Sensory Motor Training is more effective than escitalopram in reducing pain associated with fibromyalgia.	−
Kayiran [83]	40, Fibromyalgia	Escitalopram	20 (10%)	560 mg/8 weeks	VAS (pain intensity): P < 0.05 at every PT visit		−
Babu [84]	30, Fibromyalgia	EMG biofeedback	15 (0%)	4.5 hours/6 days	VAS (pain): P = 0.000	EMG biofeedback is more effective than sham biofeedback in reducing fibromyalgia pain.	−
Babu [84]	30, Fibromyalgia	Sham biofeedback	15 (0%)	4.5 hours/6 days	VAS (pain): P = 0.000		−
Nelson [85]	42, Fibromyalgia	LENS	21 (24%)	ND/ND	NRS (pain intensity): P < 0.001** (LENS, pain intensity of past 24 h); P = NS** (placebo, pain intensity of past 24 h); P = ND** (both groups, current pain intensity); P = ND	LENS treatment is more effective than placebo biofeedback at alleviating fibromyalgia pain.	−
Nelson [85]	42, Fibromyalgia	Placebo biofeedback	21 (24%)	ND/ND			−
Ma [86]	60, Neck and/or shoulder pain	Biofeedback	15 (33%)	24 hours/6 weeks	VAS (pain): P < 0.04 (biofeedback, active exercise, PassTx), P = NS (education), P = Sig (education/other groups), P = NS (active exercise/ PassTx) at PT; P = 0.00 (biofeedback/other groups) at PT, month 6;	Biofeedback was more effective than active exercise, passive treatment, and an education group in reducing neck and shoulder pain.	−
		Biofeedback	15 (33%)	24 hours/6 weeks	P < 0.02 (active exercise/ PassTx, education), P = NS (PassTx /education) at month 6
		Active exercise	ND	57.3 hours/6 weeks
		PassTx	ND	7 hours/6 weeks
Education book	15 (40%)	ND/6 weeks
Simon [87]	30, Chronic constipation	EMG biofeedback	15 (0%)	6 hours/1 month	10-Point Likert Scale (pain): P < 0.01 (biofeedback) at FU; P = NS (counseling); P = Sig	EMG biofeedback is more effective than counseling for reducing pain associated with chronic constipation in elderly patients.	−
Simon [87]	30, Chronic constipation	Counseling	15 (0%)	6 hours/1 month			−
Newton-John [78]	44, Chronic low back pain	EMG biofeedback	16 (38%)	8 hours/4 wks	Pain Diary (pain severity): P < 0.007 (biofeedback/WLC, CBT/WLC); P = NS (biofeedback/CBT)	Both CBT and EMG biofeedback were equally more effective than WLC in reducing self-monitored chronic low back pain.	−
Newton-John [78]	44, Chronic low back pain	CBT	16 (19%)	8 hours/4 weeks			−
WLC	12 (ND)	ND
Bohm-Starke [88]	35, Provoked vestibulodynia	Surface EMG biofeedback	17 (0%)	40 hours/4 months	VAS (pain intensity): P = NS**	Both surface EMG biofeedback and topical lidocaine were equally effective in decreasing gastrointestinal tract, shoulder, joint, and back pain symptoms at 6 months post intervention.	−
		Surface EMG biofeedback	17 (0%)	40 hours/4 months	SF-36 Pain Subscale (bodily pain): P = NS**
		Topical lidocaine	18 (0%)	ND/4 months	SF-36 Pain Subscale (bodily pain): P = NS**
Subjective Outcome and Bodily Pain (pain): P < 0.01**(gastrointestinal tract, joint, shoulder, back pain), P = NS at FU		Topical lidocaine	18 (0%)	ND/4 months
Holroyd [81]	43, Tension headache	Decrease/High	43 (12%)	5 hours/12 weeks	Headache Recordings (headache intensity): P < 0.05** (Decrease/High, Increase/High, Increase/Moderate); P = NS	All EMG biofeedback groups were equally more effective than the decrease/moderate group in improving tension headache pain scores.	−
		Decrease/Moderate		5 hours/12 weeks
		Increase/High		5 hours/12 weeks
Increase/Moderate	5 hours/12 weeks
Nouwen [77]	20, Chronic low back pain	EMG biofeedback	10 (0%)	10 hours/3 weeks	Back Pain Log (pain): P = NS**	Neither EMG biofeedback nor WLC are effective in alleviating low back pain.	−
Nouwen [77]	20, Chronic low back pain	WLC	10 (0%)	MD	Back Pain Log (pain): P = NS**		−
Bush [79]	72, Chronic low back pain	Biofeedback	23 (9%)	4 hours/ND	Daily Low Back Pain Record (pain severity): P = NS (all groups)	Neither EMG biofeedback nor placebo is effective in treating chronic low back pain in a nonhospitalized population.	−
		Placebo	24 (4%)	4 hours/ND
		WLC	25 (0%)	ND
MPQ—PPI (present pain severity): P = NS (all groups) at PT		WLC	25 (0%)	ND
Guided Imagery/Self-Hypnosis (N = 6)
Menzies [95]	48, Fibromyalgia	GI	24 (0%)	ND/10 weeks	SF-MPQ PPI Subscale (present pain intensity): P = NS**	Neither guided imagery nor usual care were effective in reducing fibromyalgia pain.	+
Menzies [95]	48, Fibromyalgia	UC	24 (0%)	ND/10 weeks	SF-MPQ PPI Subscale (present pain intensity): P = NS**		+
SF- MPQ VAS Subscale (pain): P = NS**		UC	24 (0%)	ND/10 weeks
Fors [96]	58, Fibromyalgia	GI	17 (0%)	0.5 hours/1 day	VAS (pain): P < 0.001 (GI and patient education) at PT; P < 0.05 (GI/pain-related talk, patient education/pain-related talk); P = NS (GI/patient education); P = NS (pain-related talk)	Both guided imagery and patient education are equally more effective than a pain-related talk group in reducing short-term fibromyalgia pain.	−
Fors [96]	58, Fibromyalgia	Pain-related talk	19 (0%)	0.5 hours/1 day			−
Patient education	22 (0%)	0.5 hours/1 day
van Tilburg [97]	34, Abdominal pain	GI + SMC	19 (16%)	ND/8 weeks	Abdominal Pain Index (parent report of pain intensity and pain severity): P < 0.05** (GI + SMC), P = ND at PT, FU	Guided imagery plus standard medical care is effective in reducing pain associated with the abdomen.	−
van Tilburg [97]	34, Abdominal pain	SMC	15 (0%)	ND			−
Patterson [98]	21, Physical trauma injuries	VRH	21 (22%)	8 hours/1 day	GRS (pain): P < 0.05** (VRH, NT, pain intensity, pain unpleasantness), P < 0.05** (VRH, least pain intensity in past 8h), P < 0.05** (NT, least pain intensity in past 8h), P = NS at PT	VRH is effective in reducing pain intensity and unpleasantness associated with physical trauma injuries, whereas the control group reported increases in these areas; no significant between group differences were noted.	−
Patterson [98]	21, Physical trauma injuries	Virtual reality/NT	21 (22%)	ND			−
Carrico [99]	30, Insterstitial cystitis	GI	15 (27%)	46.7 hours/8 weeks	VAS (pain): P = 0.027 (GI), P = NS (WLC), P = NS at PT	Guided imagery is effective in reducing insterstitial cystitis pain, whereas the control group indicated no changes; no significant difference between groups were noted.	−
Carrico [99]	30, Insterstitial cystitis	WLC	15 (7%)	46.7 hours/8 weeks			−
Lewandowski [100]	44, Chronic pain	GI	22 (5%)	21 minutes/3 days	VAS (pain intensity): P < 0.05 at day 4, 5; P = NS at day 2, 3	Guided imagery is effective in reducing chronic pain.	−
Lewandowski [100]	44, Chronic pain	WLC	22 (5%)	ND		Guided imagery is effective in reducing chronic pain.	−
Autogenic Training (N = 2)
Asbury [23]	53, Cardiac syndrome x	AT	27 (15%)	12 hours/8 weeks	Symptom Monitoring Diary (symptom severity): P < 0.001** (AT), P = NS at PT	Autogenic training is effective in reducing cardiac symptom pain symptom severity; no between group differences noted.	−
Asbury [23]	53, Cardiac syndrome x	Symptom monitoring	26 (4%)	ND			−
VanDyck [107]	71, Chronic tension headaches	AT	71 (23%)	10 hours/7 weeks	Headache Index (pain intensity): P < 0.05** (AT, hypnotic imagery) over time; ES: d = 0.45	Both autogenic training and future-oriented hypnotic imagery were equally effective in reducing chronic pain.	−
VanDyck [107]	71, Chronic tension headaches	Future-oriented hypnotic imagery	71 (23%)	10 hours/7 weeks			−

Citation	Total Participants, Condition	Interventions	# Assigned (Dropout %)	Dosage (Total Hours/Time Period)	Relevant Pain Outcomes	Conclusions	Quality
Meditation/Mindfulness (N = 11)
Hsu et al. [40]	45, Fibromyalgia	ASA	24 (13%)	7.5 hours/3 weeks	BPI (pain severity): P = 0.03 at PT; P < 0.01 at FU; ES: d = 1.14 at PT, d = 1.46 at FU	ASA is more effective than WLC for reducing pain and number of painful body regions post intervention and at 6 months follow-up.	+
Hsu et al. [40]	45, Fibromyalgia	WLC	21 (0%)	ND	BPI (number of painful body regions): P < 0.001 at PT; P = 0.001 at FU		+
Wong [39]	100, Chronic pain	MBSR	51 (20%)	19 hours/8 weeks	NRS (pain): p < 0.05** (both groups); P = NS	Both MBSR and MIP programs are equally effective in reducing chronic pain intensity.	+
Wong [39]	100, Chronic pain	MIP	49 (8%)	12 hours/ND	NRS (pain): p < 0.05** (both groups); P = NS		+
Morone [30]	40, Chronic low back pain	Meditation	20 (20%)	12 hours/8 weeks	SF-MPQ (pain): P = Sig** (both groups) over time; P = NS	Both the meditation and the education program are equally effective in improving chronic low back pain.	+
Morone [30]	40, Chronic low back pain	Education	20 (5%)	12 hours/8 weeks	SF-36 Pain Subscale (pain intensity): P = Sig** (meditation) over time; P = NS at FU		+
Schmidt [34]	177, Fibromyalgia	MBSR	59 (10%)	19 hours/8 wks	PPS (sensory and affective pain): P = NS**	None of the groups (MBSR, active control, WLC) were effective in treating fibromyalgia pain.	+
Schmidt [34]	177, Fibromyalgia	WLC	59 (0%)	ND	PPS (sensory and affective pain): P = NS**		+
Active control	59 (5%)	12 hours/8 weeks
Morone [31]	37, Chronic low back pain	Meditation	19 (32%)	12 hours/8 weeks	SF-MPQ (pain intensity): P = NS; ES: d = 0.32	Neither meditation nor WLC was effective in improving chronic low back pain.	+
Morone [31]	37, Chronic low back pain	WLC	18 (5%)	ND	SF-36 Pain Subscale (pain): P = NS; ES: d = 0.16		+
Esmer [35]	40, Failed back surgery syndrome	MBSR	19 (21%)	12 hours/8 weeks	VAS (pain): P < 0.021 at wk 12; P = Sig at FU; ES: d = 1.02	MBSR is more effective than WLC in reducing pain associated with failed back surgery syndrome.	−
Esmer [35]	40, Failed back surgery syndrome	WLC	21 (24%)	ND			−
Ehrlich [32]^*	579, Chronic low back pain	Alexander technique (6 tx)	579 (20%)	ND	Von Korff Scale (pain): P = Sig (Alexander technique 24, exercise/control) at month 12	Both 6 lessons and 24 lessons with Alexander Technique, followed by exercise, are equally effective in treating chronic back pain.	−
		Alexander technique (24 tx)		ND
		Massage		ND
		Exercise		ND
Normal care	ND
Wong [36]	100, Chronic pain	MBSR	100 (ND)	ND	NRS (pain intensity): P = Sig** (both groups) at mo 6; P = NS	Both MBSR and the education program are equally effective in improving chronic pain intensity.	−
Wong [36]	100, Chronic pain	Education	100 (ND)	ND			−
Carson [33]	43, Chronic low back pain	Loving-kindness meditation	43 (ND)	12 hours/8 weeks	MPQ (pain intensity): P = Sig (meditation); P = NS (UC); ES: d = 0.42	A meditation program is effective in lowering chronic low back pain scores.	−
Carson [33]	43, Chronic low back pain	UC	43 (ND)	ND/8 weeks			−
BPI (usual pain, worst pain): P < 0.01** (meditation, usual pain); P = 0.05** (meditation, worst pain); P = ND; ES: d = 0.42		UC		ND/8 weeks
Plews-Ogan [37]	30, Musculoskeletal pain	MBSR	10 (30%)	12 hours/8 weeks	NRS (pain sensation and unpleasantness): P = Sig (massage, unpleasantness) at FU; P = NS** (MBSR, SC); P = NS	MBSR is not effective for reducing musculoskeletal pain; however, massage is more effective than SC for reducing musculoskeletal pain.	−
Plews-Ogan [37]	30, Musculoskeletal pain	Massage	10 (10%)	8 hours/8 weeks			−
SC	10 (20%)	ND
Teixeira [38]	22, Diabetic neuropathy	Meditation	11 (9%)	1 hour/1 day	NPS (pain intensity): P = NS** at PT ES: d = 0.16	Neither mindfulness meditation nor attention-placebo effectively reduced pain associated with diabetic neuropathy.	−
Teixeira [38]	22, Diabetic neuropathy	Attention-placebo	11 (9%)	1 hour/1 day	NPS (pain intensity): P = NS** at PT ES: d = 0.16		−
Relaxation (N = 22)
Stenstrom [54]	54, Inflammatory rheumatic disease	PMR	27 (0%)	ND/12 months	Nottingham Health Profile Pain Subscale (pain): P = NS at PT	PMR shows minor improvements in the reduction of pain; no differences between groups noted.	+
Stenstrom [54]	54, Inflammatory rheumatic disease	DMT	27 (0%)	ND/12 months			+
AIMS2 Pain Impact Subscale (pain): P < 0.05** (relaxation), P = NS at PT		DMT	27 (0%)	ND/12 months
Mehling [52]	36, Chronic low back pain	Breathing	18 (11%)	9 hours/6 weeks	VAS (pain intensity): P < 0.005 (both groups) at PT; P < 0.005 (both groups), P = NS at FU	Both breath therapy and physical therapy were equally effective in reducing pain and disability associated with low back pain.	+
Mehling [52]	36, Chronic low back pain	PT	18 (33%)	9 hours/6 weeks			+
SF-36 (bodily pain): P < 0.005 (both groups) at PT; P < 0.005 (both groups), P = NS at FU		PT	18 (33%)	9 hours/6 weeks
Larsson [55]	41, Chronic headaches	TAR	14 (14%)	8.25 hours/ND	Headache Activity (headache activity): P < 0.05e (TAR/SM), P < 0.05e (SHR/SM) at PT and post-booster; P < 0.01d (SHR) over time; P < 0.01d (TAR) at FU; P = NSe (TAR/SHR)	Both therapist and self-help relaxation are equally more effective than no treatment for reducing chronic headache pain.	+
Larsson [55]	41, Chronic headaches	SHR	16 (13%)	ND/ND			+
Self-monitoring (SM)	11 (9%)	ND
Poole [51]	234, Chronic low back pain	Relaxation	82 (30%)	6 hours/6 weeks	SF-36 Pain Subscale (pain): P < .0005** (all groups) over time; P = NS	Relaxation, usual care, and reflexology are all equally effective in reducing chronic low back pain.	+
		UC	75 (43%)	ND
		Reflexology	77 (16%)	6 hours/6 weeks
VAS (pain): P = NS**		Reflexology	77 (16%)	6 hours/6 weeks
Anderson [57]	59, Cancer pain	Relaxation	16 (63%)	3.3 hours/2 weeks	BPI (pain): P < 0.05 (WLC/all groups, worst pain) at wk 7; P < 0.05** (PMD, WLC, pain severity) at PT; P < 0.05** (positive mood, WLC, average pain) at PT	Distraction and WLC were equally effective in improving pain severity, while positive mood and WLC were equally effective in improving average pain scores. Furthermore, both relaxation and distraction groups reported immediate posttreatment pain reduction.	+
		PMD	16 (44%)	3.3 hours/2 weeks
		Distraction	13 (46%)	3.3 hours/2 weeks
		WLC	14 (43%)	ND
Pain Intensity Rating (pain): P < 0.03** (relaxation, PMD) at PT		WLC	14 (43%)	ND
Boyce [56]	105, Irritable bowel syndrome	Relaxation	36 (64%)	4 hours/8 weeks	SF-36 (bodily pain): P < 0.01** (all groups) over time; P < 0.05 (UC) over time	All groups were equally effective in treating pain associated with irritable bowel syndrome.	+
Boyce [56]	105, Irritable bowel syndrome	CBT	35 (49%)	8 hours/8 weeks			+
UC	34 (38%)	0.75 hours + 190.4 g psyllium hus/ND
Trautmann [49]	65, Migraine, tension headache or combined migraine/tension headache	Applied relaxation	22 (14%)	ND/6 weeks	Headache Diary (headache intensity): P = NS**; ES: d = 0.0 (CBT), d = −0.27 (AR), d = −0.11 (EDU)	None of the groups (applied relaxation, education, cognitive behavioral therapy) are effective for reducing intensity of recurrent headache pain.	+
Trautmann [49]		Education	19 (47%)	ND/6 weeks			+
CBT	24 (54%)	ND/6 weeks
Hammond [50]	183, Fibromyalgia	Relaxation	86 (28%)	10 hours/10 weeks	FIQ (pain): P = NS**	Neither the relaxation nor the patient education are effective in reducing fibromyalgia pain.	+
Hammond [50]	183, Fibromyalgia	Education	97 (27%)	20 hours/10 weeks	FIQ (pain): P = NS**		+
Gustavsson [53]	37, Long-lasting neck pain	Applied relaxation	18 (11%)	10.5 hours/7 weeks	Ordinal Scale of Pain (pain intensity): P = NS**	Neither the relaxation group nor treatment as usual group effectively reduced neck pain.	+
Gustavsson [53]	37, Long-lasting neck pain	UC	19 (11%)	ND	Ordinal Scale of Pain (pain intensity): P = NS**		+
Wahlund [60]	122, Temporo-mandibular disorders	Relaxation	41 (17%)	ND/ND	VAS (pain): P < 0.01 (occlusal appliance/ brief information); P = NS (relaxation/occlusal appliance); P = ND** (relaxation/brief information)	Occlusal appliance is more effective than brief information training in the reduction of pain intensity associated with temporomandibular disorders; no significant differences between the occlusal appliance and the relaxation training group or relaxation and brief information groups.	−
Wahlund [60]	122, Temporo-mandibular disorders	Occlusal appliance	42 (12%)	ND			−
Brief information	39 (0%)	0.5 hours/1 day
Larsson [65]	48, Tension headache	Relaxation	31 (0%)	ND/5 weeks	Headache Index (headache parameters): P < 0.05(peak intensity, headache frequency, headache free days), P = NS (headache duration) at PT	Relaxation training program is more effective than WLC in reducing tension headache pain.	−
Larsson [65]	48, Tension headache	WLC	17 (0%)	ND			−
Loew [64]	54, Tension headache	EFR	27 (11%)	0.75 hours/1 day	Standardized Pain Diary (pain intensity): P = 0.003(intense pain), P = 0.03(medium pain) at PT	EFR is more effective than an unspecified intervention in reducing tension headache pain intensity.	−
Loew [64]	54, Tension headache	Unspecified intervention	27 (56%)	0.75 hours/1 day			−
Larsson [67]	26, Chronic tension-type headache	Relaxation	13 (0%)	4.2 hours/5 weeks	Headache Activity (headache): P < 0.05	School-based, nurse-administered relaxation training program is more effective than no treatment in reducing chronic tension-type headaches in school children.	−
Larsson [67]	26, Chronic tension-type headache	NT	13 (0%)	ND	Headache Activity (headache): P < 0.05		−
Larsson [66]	32, Chronic headaches	Relaxation training	12 (9%)	4.2 hours/5 weeks	Headache Activity (headache parameters): P = NS (all groups, headache intensity); P = Sig (relaxation/information contact, headache sum); P = Sig (relaxation/NT, headache sum) at PT; P = NS (headache sum score) at FU	Relaxation is more effective than information contact and no treatment in reducing weekly headache intensity at end of treatment; however, no differences were noted at follow up.	−
Larsson [66]	32, Chronic headaches	Information contact	13 (0%)	ND/ND			−
NT	7 (0%)	ND
Thorsell [61]	115, Chronic pain	Applied relaxation	61 (46%)	3 hours/2 days	OMPQ (pain intensity): P = NS (applied relaxation) at PT, months 6, 12; P < 0.05 (ACT) at PT, month 6; P = ND; ES: d = −0.37 (ACT at PT), d = −0.47 (ACT at month 12)	Applied relaxation is not as effective as ACT in treating chronic pain symptoms.	−
Thorsell [61]	115, Chronic pain	ACT	54 (43%)	3 hours/2 days			−
McGrath [62]	99, Migraine	Relaxation training	32 (38%)	6 hours/6 weeks	Headache Diary (headache): P < 0.05** (all groups) over time; P = NS	Both relaxation and placebo treatments are equally effective in reducing migraine pain.	−
McGrath [62]	99, Migraine	Placebo	37 (43%)	6 hours/6 weeks			−
Own best efforts	30 (30%)	ND
Blanchard [69]	39, Tension headache	PMR + home practice (PMR+)	39 (15%)	ND/8 weeks	Headache Diary (headache): P = 0.005 (PMR+), P = 0.04 (PMR), P = Sig (PMR+, PMR/WLC), P = NS (PMR+/PMR) at PT	Both PMR + home practice and PMR are equally more effective than WLC in reducing headache intensity.	−
Blanchard [69]	39, Tension headache	PMR	39 (15%)	ND/8 weeks			−
WLC	ND
Barsky [59]	168, Rheumatoid arthritis	Relaxation response	44 (27%)	6.7 hours/ND	Rheumatoid Arthritis Symptom Questionnaire (pain): P < 0.001 (all groups) over time, month 6; P = Sig (education), P = NS** (CBT, relaxation), P = NS (all groups) at month 12 ES: d = 0.26–0.35 (at PT)	Relaxation, arthritis education, and CBT are all equally effective in reducing pain.	−
Barsky [59]	168, Rheumatoid arthritis	Arthritis education	56 (21%)	6.7 hours/ND			−
CBT	68 (16%)	12 hours/ND
Linton [58]	15, Chronic pain	Applied relaxation	15 (0%)	6 hours/4 weeks	5-Point Likert Scale (pain intensity): P = Sig (applied relaxation/WLC) at PT; P = Sig** (all groups) over time	Although all groups were effective in reducing pain, applied relaxation seems to be more effective than applied relaxation + operant conditioning and WLC.	−
Linton [58]	15, Chronic pain	Applied relaxation + operant conditioning	15 (0%)	ND/4 weeks			−
WLC	ND
Funch [68]	57, Chronic temporomandibular joint pain	Relaxation	30 (0%)	1 hour/ND	6-Point Likert Scale (pain rating): P = NS**	Neither relaxation nor biofeedback is effective in reducing chronic temporomandibular joint pain.	−
Funch [68]	57, Chronic temporomandibular joint pain	Biofeedback	27 (0%)	0.2 hours/1 day	6-Point Likert Scale (pain rating): P = NS**		−
Lundgren [63]	68, Rheumatoid arthritis	Relaxation training	37 (11%)	10 hours/10 weeks	VAS (pain): P = NS**	Neither muscle relaxation training nor a no-treatment control group are effective in reducing pain associated with rheumatoid arthritis.	−
Lundgren [63]	68, Rheumatoid arthritis	NT	31 (13%)	ND	VAS (pain): P = NS**		−
Gay [24]	41, Osteoarthritis pain	Relaxation	14 (7%)	4 hours/8 weeks	VAS (pain): P < 0.0004 (hypnosis/relaxation, hypnosis/WLC), P = NS (relaxation/WLC) at week 4; P < 0.003 (hypnosis/WLC, relaxation/WLC), P = NS (hypnosis/relaxation) at PT; P < 0.004 (hypnosis/WLC), P = NS (hypnosis/relaxation, relaxation/WLC) at month 3, P = NS (all groups) at month 6	Hypnosis is more effective than both relaxation and WLC in reducing osteoarthritis pain at 4 weeks; however, both hypnosis and relaxation are equally more effective than WLC at 8 weeks. None of the groups were effective at 6 months.	−
Gay [24]	41, Osteoarthritis pain	Hypnosis	14 (7%)	4 hours/8 weeks			−
WLC	13 (23%)	ND
Biofeedback (N = 13)
Kapitza [76]	42, Chronic low back pain	Respiratory feedback	21 (0%)	7.5 hours/15 days	Pain Diary (pain): P < 0.02** (respiratory biofeedback, pain at rest/during activity), P = 0.014** (placebo biofeedback, pain during activity) at month 3; P = NS** (placebo biofeedback, pain at rest), P = NS	Respiratory biofeedback is more effective than placebo biofeedback in reducing pain 3 months post intervention.	+
Kapitza [76]	42, Chronic low back pain	Placebo biofeedback	21 (0%)	7.5 hours/15 days			+
Scharff [80]	36, Migraine in children	Handwarming biofeedback	13 (0%)	4.5 hours/6 weeks	Headache Index (headache intensity): P = Sig** (all groups), P = NS (all groups) at month 12	Both handwarming biofeedback and handcooling biofeedback seem to be equally effective in reducing headache intensity over time.	+
Scharff [80]	36, Migraine in children	Handcooling biofeedback	11 (9%)	4.5 hours/6 weeks			+
WLC	12 (8%)	ND
Bruhn [82]	28, Chronic muscle contraction headache	EMG biofeedback	14 (7%)	5.3 hours/8 weeks	Headache Diary (headache intensity): P < 0.01 (biofeedback) at last 2 weeks of therapy; P = ND (UC); P = ND	EMG biofeedback therapy is effective in reducing severe muscle contraction headaches at posttest; no between group differences were reported.	−
Bruhn [82]	28, Chronic muscle contraction headache	UC	14 (29%)	ND			−
Kayiran [83]	40, Fibromyalgia	Neurofeedback sensory motor training	20 (10%)	10 hours/4 weeks	VAS (pain intensity): P < 0.05 at every PT visit	Neurofeedback Sensory Motor Training is more effective than escitalopram in reducing pain associated with fibromyalgia.	−
Kayiran [83]	40, Fibromyalgia	Escitalopram	20 (10%)	560 mg/8 weeks	VAS (pain intensity): P < 0.05 at every PT visit		−
Babu [84]	30, Fibromyalgia	EMG biofeedback	15 (0%)	4.5 hours/6 days	VAS (pain): P = 0.000	EMG biofeedback is more effective than sham biofeedback in reducing fibromyalgia pain.	−
Babu [84]	30, Fibromyalgia	Sham biofeedback	15 (0%)	4.5 hours/6 days	VAS (pain): P = 0.000		−
Nelson [85]	42, Fibromyalgia	LENS	21 (24%)	ND/ND	NRS (pain intensity): P < 0.001** (LENS, pain intensity of past 24 h); P = NS** (placebo, pain intensity of past 24 h); P = ND** (both groups, current pain intensity); P = ND	LENS treatment is more effective than placebo biofeedback at alleviating fibromyalgia pain.	−
Nelson [85]	42, Fibromyalgia	Placebo biofeedback	21 (24%)	ND/ND			−
Ma [86]	60, Neck and/or shoulder pain	Biofeedback	15 (33%)	24 hours/6 weeks	VAS (pain): P < 0.04 (biofeedback, active exercise, PassTx), P = NS (education), P = Sig (education/other groups), P = NS (active exercise/ PassTx) at PT; P = 0.00 (biofeedback/other groups) at PT, month 6;	Biofeedback was more effective than active exercise, passive treatment, and an education group in reducing neck and shoulder pain.	−
		Biofeedback	15 (33%)	24 hours/6 weeks	P < 0.02 (active exercise/ PassTx, education), P = NS (PassTx /education) at month 6
		Active exercise	ND	57.3 hours/6 weeks
		PassTx	ND	7 hours/6 weeks
Education book	15 (40%)	ND/6 weeks
Simon [87]	30, Chronic constipation	EMG biofeedback	15 (0%)	6 hours/1 month	10-Point Likert Scale (pain): P < 0.01 (biofeedback) at FU; P = NS (counseling); P = Sig	EMG biofeedback is more effective than counseling for reducing pain associated with chronic constipation in elderly patients.	−
Simon [87]	30, Chronic constipation	Counseling	15 (0%)	6 hours/1 month			−
Newton-John [78]	44, Chronic low back pain	EMG biofeedback	16 (38%)	8 hours/4 wks	Pain Diary (pain severity): P < 0.007 (biofeedback/WLC, CBT/WLC); P = NS (biofeedback/CBT)	Both CBT and EMG biofeedback were equally more effective than WLC in reducing self-monitored chronic low back pain.	−
Newton-John [78]	44, Chronic low back pain	CBT	16 (19%)	8 hours/4 weeks			−
WLC	12 (ND)	ND
Bohm-Starke [88]	35, Provoked vestibulodynia	Surface EMG biofeedback	17 (0%)	40 hours/4 months	VAS (pain intensity): P = NS**	Both surface EMG biofeedback and topical lidocaine were equally effective in decreasing gastrointestinal tract, shoulder, joint, and back pain symptoms at 6 months post intervention.	−
		Surface EMG biofeedback	17 (0%)	40 hours/4 months	SF-36 Pain Subscale (bodily pain): P = NS**
		Topical lidocaine	18 (0%)	ND/4 months	SF-36 Pain Subscale (bodily pain): P = NS**
Subjective Outcome and Bodily Pain (pain): P < 0.01**(gastrointestinal tract, joint, shoulder, back pain), P = NS at FU		Topical lidocaine	18 (0%)	ND/4 months
Holroyd [81]	43, Tension headache	Decrease/High	43 (12%)	5 hours/12 weeks	Headache Recordings (headache intensity): P < 0.05** (Decrease/High, Increase/High, Increase/Moderate); P = NS	All EMG biofeedback groups were equally more effective than the decrease/moderate group in improving tension headache pain scores.	−
		Decrease/Moderate		5 hours/12 weeks
		Increase/High		5 hours/12 weeks
Increase/Moderate	5 hours/12 weeks
Nouwen [77]	20, Chronic low back pain	EMG biofeedback	10 (0%)	10 hours/3 weeks	Back Pain Log (pain): P = NS**	Neither EMG biofeedback nor WLC are effective in alleviating low back pain.	−
Nouwen [77]	20, Chronic low back pain	WLC	10 (0%)	MD	Back Pain Log (pain): P = NS**		−
Bush [79]	72, Chronic low back pain	Biofeedback	23 (9%)	4 hours/ND	Daily Low Back Pain Record (pain severity): P = NS (all groups)	Neither EMG biofeedback nor placebo is effective in treating chronic low back pain in a nonhospitalized population.	−
		Placebo	24 (4%)	4 hours/ND
		WLC	25 (0%)	ND
MPQ—PPI (present pain severity): P = NS (all groups) at PT		WLC	25 (0%)	ND
Guided Imagery/Self-Hypnosis (N = 6)
Menzies [95]	48, Fibromyalgia	GI	24 (0%)	ND/10 weeks	SF-MPQ PPI Subscale (present pain intensity): P = NS**	Neither guided imagery nor usual care were effective in reducing fibromyalgia pain.	+
Menzies [95]	48, Fibromyalgia	UC	24 (0%)	ND/10 weeks	SF-MPQ PPI Subscale (present pain intensity): P = NS**		+
SF- MPQ VAS Subscale (pain): P = NS**		UC	24 (0%)	ND/10 weeks
Fors [96]	58, Fibromyalgia	GI	17 (0%)	0.5 hours/1 day	VAS (pain): P < 0.001 (GI and patient education) at PT; P < 0.05 (GI/pain-related talk, patient education/pain-related talk); P = NS (GI/patient education); P = NS (pain-related talk)	Both guided imagery and patient education are equally more effective than a pain-related talk group in reducing short-term fibromyalgia pain.	−
Fors [96]	58, Fibromyalgia	Pain-related talk	19 (0%)	0.5 hours/1 day			−
Patient education	22 (0%)	0.5 hours/1 day
van Tilburg [97]	34, Abdominal pain	GI + SMC	19 (16%)	ND/8 weeks	Abdominal Pain Index (parent report of pain intensity and pain severity): P < 0.05** (GI + SMC), P = ND at PT, FU	Guided imagery plus standard medical care is effective in reducing pain associated with the abdomen.	−
van Tilburg [97]	34, Abdominal pain	SMC	15 (0%)	ND			−
Patterson [98]	21, Physical trauma injuries	VRH	21 (22%)	8 hours/1 day	GRS (pain): P < 0.05** (VRH, NT, pain intensity, pain unpleasantness), P < 0.05** (VRH, least pain intensity in past 8h), P < 0.05** (NT, least pain intensity in past 8h), P = NS at PT	VRH is effective in reducing pain intensity and unpleasantness associated with physical trauma injuries, whereas the control group reported increases in these areas; no significant between group differences were noted.	−
Patterson [98]	21, Physical trauma injuries	Virtual reality/NT	21 (22%)	ND			−
Carrico [99]	30, Insterstitial cystitis	GI	15 (27%)	46.7 hours/8 weeks	VAS (pain): P = 0.027 (GI), P = NS (WLC), P = NS at PT	Guided imagery is effective in reducing insterstitial cystitis pain, whereas the control group indicated no changes; no significant difference between groups were noted.	−
Carrico [99]	30, Insterstitial cystitis	WLC	15 (7%)	46.7 hours/8 weeks			−
Lewandowski [100]	44, Chronic pain	GI	22 (5%)	21 minutes/3 days	VAS (pain intensity): P < 0.05 at day 4, 5; P = NS at day 2, 3	Guided imagery is effective in reducing chronic pain.	−
Lewandowski [100]	44, Chronic pain	WLC	22 (5%)	ND		Guided imagery is effective in reducing chronic pain.	−
Autogenic Training (N = 2)
Asbury [23]	53, Cardiac syndrome x	AT	27 (15%)	12 hours/8 weeks	Symptom Monitoring Diary (symptom severity): P < 0.001** (AT), P = NS at PT	Autogenic training is effective in reducing cardiac symptom pain symptom severity; no between group differences noted.	−
Asbury [23]	53, Cardiac syndrome x	Symptom monitoring	26 (4%)	ND			−
VanDyck [107]	71, Chronic tension headaches	AT	71 (23%)	10 hours/7 weeks	Headache Index (pain intensity): P < 0.05** (AT, hypnotic imagery) over time; ES: d = 0.45	Both autogenic training and future-oriented hypnotic imagery were equally effective in reducing chronic pain.	−
VanDyck [107]	71, Chronic tension headaches	Future-oriented hypnotic imagery	71 (23%)	10 hours/7 weeks			−

Result reporting for two interventions: Outcome Name (construct measured): P value (group or groups that showed significance) at time point, if reported by the article's authors.

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