Mindfulness-Based Stress Reduction Alleviates Stress and Depression in Adults with Chronic Pain: A Randomized Controlled Trial

The primary aim of this study was to evaluate the effectiveness of Mindfulness-Based Stress Reduction (MBSR) in improving attention and pain-related outcomes, using a randomized controlled trial. Secondary aims included evaluating changes in mindfulness and pain acceptance following MBSR training and their role in improving outcomes, exploring the role of homework adherence in enhanced outcomes, and assessing stability of improvements long-term at 3-months follow up. Forty-nine adults with chronic pain between 18 and 80 years of age were randomized to an 8-week MBSR group or a Waitlist Control (WC) group that was then crossed over into the MBSR treatment. Outcome measures included pain intensity, pain disability, depression, anxiety, stress, mindfulness, pain acceptance, and performance on a change blindness task. Measures were administered prior to treatment, following the wait period for the WC group, following MBSR treatment, and 3-months subsequent to MBSR treatment completion. It was hypothesized that the MBSR group would demonstrate significant improvements in these outcomes, with the exception of pain severity, following treatment relative to the waitlist control group and that these benefits would be maintained at follow up. Linear regression analyses using changes scores of the outcomes revealed significantly greater reductions from pre-to-post treatment in the MBSR group compared to the WC group in depression and stress (ps < .05), and increases in mindfulness (p < .01). Multiple linear regression analyses using the entire sample demonstrated that increases in mindfulness significantly predicted decreases in depression (p < .05) and stress (p < .01) and increases in pain acceptance was significantly predictive of decreases in pain disability (p < .05). Significant correlations were obtained between the number of days engaging in practice and stress, pain acceptance, and attention. Benefits observed at post-treatment were maintained at 3-months follow up. Results suggest that mindfulness-based approaches can be integrated in pain clinics to facilitate patient recovery by reducing emotional distress

A parallel randomized controlled trial examining the effects of rhythmic sensory stimulation on fibromyalgia symptoms.

This double-blind, two-arm parallel randomized controlled trial investigated the effects of gamma-frequency rhythmic sensory stimulation on fibromyalgia. We were interested in whether rhythmic sensory stimulation would promote significant changes in fibromyalgia and associated symptoms, and whether treatment effects would differ between two distinct treatment parameters. Fifty patients with a formal diagnosis of fibromyalgia were randomly assigned to two test groups. One group received vibrotactile stimulation from a continuous sine wave single-frequency stimulation (40 Hz) for 30 minutes, five days per week, over five weeks, concomitant with usual care. The second group completed the same treatment protocol but received a different stimulation, consisting of random and intermittent complex wave gamma-range vibrotactile stimulation. Fibromyalgia symptoms, pain severity and interference, depression symptoms, quality of life and sleep quality were assessed at baseline and post-intervention. Results indicated that there were statistically significant changes from baseline to post-treatment in measures of fibromyalgia symptom severity, pain interference, depression, and sleep quality. However, treatment outcomes did not differ significantly between groups. These findings provide preliminary evidence that gamma-frequency rhythmic vibroacoustic stimulation may decrease fibromyalgia symptoms and ease associated comorbidities, opening new avenues for further investigation of the effects of rhythmic sensory stimulation on chronic pain conditions

Effects of Rhythmic Sensory Stimulation on Ehlers–Danlos Syndrome: A Pilot Study

Ehlers–Danlos syndrome (EDS) is a connective tissue disorder characterized by joint hypermobility and skin extensibility and is often accompanied by chronic pain. Rhythmic sensory stimulation (RSS) can be defined as the stimulation of the senses in a periodic manner within a range of low frequencies. Music plus sound delivered through a vibroacoustic device is a form of RSS and has demonstrated utility in managing pain. In this current study, we conducted an open-label pilot study of 15 patients with hypermobile EDS using RSS as the intervention. Posttreatment improvements were seen in 11 of the 15 patients (73%), whereas 3 of the 15 patients (20%) experienced worse outcomes. Of the 14 patients that completed the experiment, 6 participants (43%) were classified as “responders” to the device while 8 participants (57%) were classified as “nonresponders.” Responders demonstrated significant improvements in pain interference (51.5 ± 16 preintervention vs. 43.5 ± 16.4 postintervention BPI score) and depression symptoms (34.0 ± 15.9 preintervention vs. 26.8 ± 12.1 postintervention CESD score). Poststudy interviews confirm the improvements of pain interference, mood, and bowel symptoms. Furthermore, analysis of medical conditions within the responder group indicates that the presence of depression, anxiety, irritable bowel syndrome, and fibromyalgia may indicate a greater likelihood for patients to benefit with vibroacoustic applications. These results indicate a possible potential for RSS, delivered using a vibroacoustic device, in managing pain-related symptoms. Further research is necessary to elucidate the exact mechanism behind the physiological benefits of RSS.Peer Reviewe