Table 3.

Mind-body Therapies: Best Clinical Evidence.

Clinical ConditionLevel of EvidenceSource of Evidence (Total Number of Patients)Implications for Practice
After myocardial infarctionStrongTwo positive meta-analyses43,52 (12,879)In addition to the current emphasis on exercise and nutrition, MBTs (that focus on the development of self-regulation skills, such as relaxation and the management of anger, hostility, and general stress reactivity) should be included as part of cardiac rehabilitation
Cancer symptoms (disease and treatment related)StrongPositive results from 2 meta-analysis53,71 (∼6,166)MBTs (eg, relaxation, hypnosis, supportive group therapy) should be strongly considered as adjunctive therapy for cancer patients, given these therapies’ showed efficacy in improving mood, quality of life, and coping with both the disease and treatment-related side effects
Incontinence disordersStrongPositive results from 1 meta-analysis98; AHCPR guidelines (240)Biofeedback-assisted muscle retraining in the treatment of urinary incontinence. Can also be effective for fecal incontinence, although additional research is needed
Surgical outcomesStrongPositive findings from 2 meta-analyses42,50 (∼6,904)MBTs (eg, relaxation, guided imagery, hypnosis, instructional interventions) can be recommended as part of presurgical preparation, although additional research is needed to determine the relative efficacy and cost-effectiveness of these different approaches
InsomniaStrongPositive results from meta-analyses (4,009); NIH Consensus PanelMBTs (eg, muscle relaxation, cognitive-behavioral and behavioral therapies, such as stimulus control) should be considered in the treatment of insomnia. Additional research is required to determine how MBTs might be effectively combined with pharmacotherapy
HeadacheStrongPositive results from 2 meta-analyses46,49 (∼3,083)The combination of relaxation and thermal biofeedback can be recommended as treatment for recurrent migraine, while the use of relaxation or muscle biofeedback can be recommended as adjunctive or stand-alone therapies for tension headaches
Chronic low back painStrongPositive findings from 1 high-quality meta-analysis62 (1,349)Multi-component MBTs that include some combination of stress management, coping skills training, or cognitive restructuring should be strongly considered as adjunctive therapies in medical management of chronic low back pain
Osteoarthritis, rheumatoid arthritisModerate-strongPositive findings from meta-analyses36,61 (though effect sizes generally small and frequently diminished with time) (4,337)Multimodal MBTs (that combine education with such approaches as relaxation, imagery, biofeedback, and cognitive behavioral counseling) should be considered as potentially effective adjunctive treatments for osteoarthritis and rheumatoid arthritis
HypertensionModeratePositive results from 1 meta-analysis (1,651)51 but contradictory findings in 2 others44,108MBTs (particularly multi-component as opposed to single-component interventions, such as stand-alone relaxation therapies) can be potentially useful adjuncts in the medical management of hypertension