title: Effectiveness of jyoti meditation for patients with chronic neck pain and psychological distress--a randomized controlled clinical trial.
abstract: Chronic neck pain is a common medical complaint partly mediated by psychosocial distress and having a high socioeconomic impact. There is preliminary evidence that stress reduction by meditation might be beneficial in chronic pain syndromes. We aimed to evaluate the effectiveness of an 8-week meditation program (jyoti meditation) in patients with chronic neck pain by means of a randomized clinical trial. Eighty-nine patients (aged 49.7 ± 10.5 years, 73 female) with chronic neck pain who scored >40 mm on a 100-mm visual analog scale and had concomitant increased perceived stress were randomized to an 8-week meditation program (jyoti meditation) with weekly 90-minute classes (n = 45) or to a home-based exercise program (n = 44) with a wait list offer for meditation. Both groups were instructed to practice at home. Outcomes were assessed at baseline and after 8 weeks. Primary outcome measure was change of mean pain at rest (visual analog scale score) from baseline to week 8. Secondary outcomes included pain at motion, functional disability, pain-related bothersomeness, perceived stress, quality of life, and psychological outcomes. Patients had neck pain for a mean of 11 years. Eighteen patients in the meditation group and 16 patients in the exercise group were lost to follow-up. Meditation training significantly reduced pain when compared to the exercise group after 8 weeks (reduction of 45.5 ± 23.3 mm to 21.6 ± 17.2 mm in the meditation group, and 43.8 ± 22.0 mm to 37.7 ± 21.5 mm in the exercise group; mean difference: 13.2 mm [95% confidence interval: 2.1, 24.4; P = .02]). Pain-related bothersomeness decreased more in the meditation group (group difference 11.0 mm [95% confidence interval: 1.0, 21.0; P = .03]). No significant treatment effects were found for pain at motion, psychological scores, and quality of life, although the meditation group showed nonsignificant greater improvements compared to the exercise group. In conclusion, meditation may support chronic pain patients in pain reduction and pain coping. Further well-designed studies including more active control comparisons and longer-term follow-up are warranted.
  
  
  CONCLUSIONS
  This article presents the results of a randomized controlled trial on the clinical effects of an 8-week meditation program or self-care exercise in patients with chronic neck pain. Meditation reduced pain at rest but not disability and might be a useful treatment option for pain management of chronic neck pain.
authors.affiliation: Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin, Berlin, Germany; Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Jeitler
authors.affiliation: Department for Psychiatry and Psychotherapy, University Hospital Salzburg, Salzburg, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Brunnhuber
authors.affiliation: Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin, Berlin, Germany; Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany.
authors.forename: Larissa
authors.initials: L
authors.lastname: Meier
authors.affiliation: Karl and Veronica Carstens Foundation, Essen, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Lüdtke
authors.affiliation: University Witten-Herdecke, Chair of Integrative Medicine, Witten, Germany.
authors.forename: Arndt
authors.initials: A
authors.lastname: Büssing
authors.affiliation: Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin, Berlin, Germany; Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Kessler
authors.affiliation: Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin, Berlin, Germany; Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany. Electronic address: a.michalsen@immanuel.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Michalsen
mesh_terms: D059350:Chronic Pain / Q000150:complications / Q000628:therapy*; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D019122:Meditation / Q000379:methods*; D008875:Middle Aged; D019547:Neck Pain / Q000150:complications / Q000628:therapy*; D010147:Pain Measurement; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D013315:Stress, Psychological / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome
keywords: Meditation; chronic neck pain; pain; randomized controlled trial; stress reduction