Prayer for Pain and Anxiety in a Primary Care Setting: A Randomized Controlled Trial
In-person prayer modestly reduced pain and anxiety versus music.
*Randomized controlled trial; Level 2 (OCEBM).
Citation
Jacobson K, Zipp J, Jones B, et al. Prayer for Pain and Anxiety in a Primary Care Setting: A Randomized Controlled Trial. Ann Fam Med. 2026;24:192-197. doi:10.1370/afm.250302
Background
Many patients use prayer alongside medical care, but evidence for health effects is mixed. This study tested whether brief, in-person Christian prayer could reduce pain or anxiety after primary care visits.
Patients
180 primary care patients with pain of at least 4 on a 0-to-10 scale in the past week, anxiety of at least 10 on the 7-item anxiety scale, or both. Most participants were Black, female, low-income, and Christian. Patients not meeting symptom criteria were excluded.
Intervention
Five minutes of in-person Christian prayer by a trained volunteer, usually including gentle laying-on of hands.
Control
Five minutes of soft music after the medical visit.
Outcome
Pain score (0 to 10), immediate anxiety score (0 to 10), 7-item anxiety scale score (0 to 21), acceptability, and adverse events.
Follow-up Period
Immediate, 2 weeks, and 6 weeks.
Results
| Outcome | When improved versus music | Approximate added benefit |
|---|---|---|
| Pain | Immediately and 2 weeks | 1 to 2 points lower |
| Anxiety, 0-to-10 score | Immediately | About 2 points lower |
| 7-item anxiety scale | 2 and 6 weeks | About 2 points lower |
| Acceptability | After prayer | 97% neutral or favorable toward future availability |
Pain benefit was not significant at 6 weeks. No adverse events were reported. Analyses used mixed models with available follow-up data; 62 participants were missing by 6 weeks. Both groups received routine care; music was a comparison activity, not usual treatment. The anxiety scale change was statistically significant but below a commonly used 4-point clinically important difference.
Limitations
Participants and staff could not be blinded. Prayer included touch and personal attention, so effects may reflect comfort, expectation, touch, or regression to the mean. Outcomes were self-reported, follow-up loss was substantial, and findings may not generalize beyond similar underserved primary care populations.
Funding
Global Medical Research Institute MESH Grant; prayer-related author conflicts.
Clinical Application
Do not replace standard care; consider patient-requested prayer as optional, low-cost support when feasible and respectful.
Discussion
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In this unblinded RCT, 5-minute Christian proximal intercessory prayer vs music reduced pain by about 1–2 points immediately and at 2 weeks, and improved GAD-7 at 2 and 6 weeks (P=.04). How do blinding, touch/attention differences, and the study population affect validity, applicability, and practice change? In this randomized trial of proximal intercessory prayer versus music for pain and anxiety, which issue is least likely to be solved by randomization alone?