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Abstract

Background and Objective
This systematic review and meta-analysis investigated the effect of Mindfulness Based Stress Reduction (MBSR) on pain severity, quality of life, pain catastrophising, and depression for people living with Fibromyalgia (FM) at short and long term follow up.

Databases and Data Treatment
MEDLINE, EMBASE, CENTRAL, ClinicalTrials.gov, WHO Trial Registry, CINAHL and PsychInfo were searched from inception to December 2025 for English language full papers. Randomised and non-randomised trials were included where MBSR was compared with no treatment, usual care or any active control; online MBSR interventions were excluded.

Results
The search identified 566 records, of which 11 original trials and 1153 participants were included, 1097 of whom were women. A predefined risk of bias tool was used to assess included studies. Fixed effect model meta-analysis showed improvements in favour of MBSR compared with active controls at long term follow up in quality of life (SMD −0.2635 [95% CI −0.4725, −0.0545]) and pain catastrophising (SMD −0.5375 [95% CI −0.8323, −0.2428]). Significant effects on pain severity (SMD −0.2966 [95% CI −0.4939, −0.0992]) and depression (SMD −0.4452 [95% CI −0.6502, −0.2402]) were only present at short term follow up versus passive control. Grading of Recommendations Assessment, Development and Evaluation (GRADE) determined the certainty of outcomes ranging from very low to moderate.

Conclusions
MBSR improves pain catastrophising and quality of life in people with FM at short and long term follow up; pain severity and depression were not significantly alleviated versus active control. OSF Registration: DOI 10.17605/OSF.IO/TJ5HX.

Significance Statement
This meta-analysis reveals that, among individuals living with fibromyalgia, mindfulness based stress reduction does not significantly reduce pain severity, updating the guidance from the last review in 2013. Mindfulness based stress reduction does however have a small positive effect on quality of life compared with other active treatments, at both short and long term follow up. This suggests there is a long lasting, mindfulness specific mechanism that improves quality of life.

Publication Type:	Article
Additional Information:	© 2026 The Author(s). European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC ®. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords:	chronic pain, meditation, persistent pain
Subjects:	R Medicine > R Medicine (General)
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Psychology & Neuroscience
SWORD Depositor:	Symplectic Administrator

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