Among the studies CST practitioners and supporters point to most often is a 2019 meta-analysis by Jäkel and von Hauenschild. It looked specifically at CST for chronic pain and reached more encouraging conclusions than several of the later, broader reviews. Working out what it found, and why later reviews don't necessarily overturn it, is part of getting an honest picture of the evidence.
The review included 10 randomised controlled trials and 681 patients, covering a range of chronic pain conditions: neck and back pain, migraine, and fibromyalgia. Not a general survey of CST across all conditions. A focused look at pain.
The conclusion was striking. "Significant and robust effects of CST on pain and function lasting up to six months." In a field where positive findings for complementary therapies tend to be modest and short-lived, that stood out.
What the review found
For chronic pain — a category that's notoriously hard to treat, where many conventional approaches give partial results at best — Jäkel and von Hauenschild found that CST produced meaningful improvements in pain intensity and physical function. Not just statistically significant blips. Effects described as robust and lasting up to six months after treatment ended.
The conditions covered: neck pain, low back pain, migraine, fibromyalgia. All conditions where people often feel that nothing quite works. They cycle through treatments, find partial relief, and plateau. A therapy that produces lasting improvements across that range would be genuinely significant.
The functional improvements arguably matter as much as the pain reductions. Chronic pain changes how people move, what they can do, how they take part in their lives. A therapy that improves function — not just pain scores — is reaching something deeper than symptom management.
Why later reviews disagreed
The 2024 Amendolara meta-analysis and the Ceballos-Laita systematic review both concluded that CST produces no significant effects. Both came after Jäkel and von Hauenschild and covered more studies. Does that mean the 2019 findings were wrong?
Not exactly. The difference is partly scope. The 2019 review was narrowly focused on chronic pain, which let it pool studies of similar populations and outcomes. Later reviews were broader, including conditions that might respond very differently to CST, and they applied different quality thresholds and methodological criteria. Different analytical choices produce different conclusions, even when drawing on overlapping sets of studies.
There's also which studies are included and why. As more CST trials have been published, the pool has grown more varied in quality. Jäkel and von Hauenschild may have been working with a set of trials that happened to be more consistent and comparable than the broader pool the later reviews picked up. That's not a criticism of any single review. It's a feature of how evidence synthesis works when the underlying literature is uneven.
What this means for chronic pain
The 2019 review is still a significant piece of the picture, particularly for people whose main concern is chronic pain. It's not the only data point, and it doesn't settle the broader questions about CST's evidence base. But it is the most focused, and in some ways the most directly relevant, analysis for this specific population.
Chronic pain patients often bring a particular kind of experience to CST. Years of trying different approaches. A complicated relationship with their own body. Sometimes a quiet exhaustion from the search for relief. The quality of the therapeutic relationship and the gentleness of the work are sometimes part of why CST feels different from what they've tried before, whatever the mechanism turns out to be.
Durability of effects — lasting up to six months — matters a lot for this population. A therapy that needs constant reinforcement to keep working is a real practical and financial burden for someone already managing a chronic condition. If even a portion of what the 2019 review found holds up in individual experience, that's a real contribution.
The 2019 Jäkel and von Hauenschild meta-analysis remains one of the more positive assessments of CST for chronic pain. Set alongside the more cautious later reviews, it's part of a complex evidence picture — one that warrants neither dismissal nor overclaiming, but careful individual assessment.