Self-managed Complementary and Integrative Health Approaches for Chronic Pain and PTSD: An Umbrella Review
In brief
Self-managed yoga, meditation and tai chi provide modest relief for chronic pain and PTSD
An umbrella review of 27 systematic reviews found that self-guided yoga, mindfulness meditation and tai chi/qigong modestly reduce symptoms in adults with chronic pain or PTSD, with only mild, temporary side effects. Benefits differed by condition and comparator, and study quality was moderate, suggesting these low-risk approaches may be useful, especially for patients with both disorders, but stronger trials are needed.
- Journal
- Journal of general internal medicine (Q1)
- Published
- 16 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Belle Zaccari, Travis I Lovejoy, Vanessa Somohano, Joshua Kaplan, Robin A Paynter, Devan Kansagara, et al.
- PMID
- 42463629
- DOI
- 10.1007/s11606-026-10613-1
Why clinicians should know about it
- Picked for Anesthesiology and Pain Medicine (top studies of the week, 19 July 2026).
- Picked for Complementary and Alternative Medicine (top studies of the week, 19 July 2026): Umbrella review of self-managed CIH for pain/PTSD
- Picked for Internal Medicine (top studies of the week, 19 July 2026).
Abstract
BACKGROUND: Chronic pain and posttraumatic stress disorder (PTSD) have shared, often overlapping pathophysiology. Treatment options include complementary and integrative health (CIH) interventions, which have been summarized in numerous systematic reviews and meta-analyses (SR/MAs). OBJECTIVE: This umbrella review describes and evaluates SR/MAs of self-managed CIH modalities for chronic pain or PTSD. METHODS: We registered our protocol and conducted a literature search in October 2022 of Ovid MEDLINE ALL, Ovid APA PsycInfo, and Ovid EBM Reviews Cochrane Central Register of Controlled Trials; an updated search was conducted in January of 2026 of Ovid MEDLINE, Cochrane Database of Systematic Reviews, and APA PsycInfo. Reviews of RCTs published in or after 2017 involving adults with chronic pain or PTSD and limited to CIH interventions that do not require the presence of a provider were retrieved. Two reviewers independently conducted selection, data extraction, and assessment of SR/MA quality using the Revised Assessment of Multiple Systematic Reviews Tool. We extracted study aims, search dates, number of articles and subjects, patient population, interventions, dose, adverse events, comparators, outcomes, and summary estimates for symptom reduction. We followed PRISMA reporting guidelines. RESULTS: We included 27 (chronic pain (n = 16) and PTSD (n = 11) SR/MAs of yoga, meditation/mindfulness, and tai chi/qigong. Methodological quality scores ranged from 29 to 42 out of 44 points. Efficacy of CIH varied by condition, intervention, and comparator type. Mild adverse events and increases in existing symptoms may arise temporarily when practicing mindfulness, yoga, or tai chi. The length of each intervention session ranged from 30 to 150 min for 8-54 sessions depending on the CIH modality. CONCLUSIONS: Self-managed CIH for chronic pain and PTSD is well documented and may be effective for individuals with comorbid chronic pain and PTSD with low risk of adverse events. CIH approaches that could be used for simultaneous treatment of CP + PTSD should consider interventions that include mindfulness and movement. TRIAL REGISTRATION: PROSPERO Trial CRD42022369478.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.