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. 2024 Mar 14;9(2):e1132.
doi: 10.1097/PR9.0000000000001132. eCollection 2024 Apr.

Virtually delivered Mindfulness-Oriented Recovery Enhancement (MORE) reduces daily pain intensity in patients with lumbosacral radiculopathy: a randomized controlled trial

Ryan S Wexler  1   2 , Devon J Fox  1 , Danielle ZuZero  1 , Melissa Bollen  1 , Anand Parikshak  1 , Hannah Edmond  1 , Johnny Lemau  1 , Diane Montenegro  1 , Jillian Ramirez  1 , Sophia Kwin  1 , Austin R Thompson  3 , Hans L Carlson  3 , Lynn M Marshall  3 , Thomas Kern  4 , Scott D Mist  4 , Ryan Bradley  1   5 , Douglas A Hanes  1 , Heather Zwickey  1 , Courtney K Pickworth  1
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Virtually delivered Mindfulness-Oriented Recovery Enhancement (MORE) reduces daily pain intensity in patients with lumbosacral radiculopathy: a randomized controlled trial

Ryan S Wexler et al. Pain Rep. .

Abstract

Introduction: Lumbosacral radiculopathy (LR), also known as sciatica, is a common type of radiating neurologic pain involving burning, tingling, and numbness in the lower extremities. It has an estimated lifetime prevalence as high as 43%.

Objectives: The objective of this randomized controlled trial was to evaluate the impact of virtually delivered Mindfulness-Oriented Recovery Enhancement (MORE) on patients with LR during the COVID-19 pandemic.

Methods: Potentially eligible patients were identified using electronic health record queries and phone screenings. Participants were then randomized to MORE or treatment-as-usual (TAU) for 8 weeks, with pain intensity assessed daily. At baseline and follow-up visits, participants completed questionnaires assessing the primary outcome, disability, as well as quality of life, depression, mindful reinterpretation of pain, and trait mindfulness.

Results: In our study, patients undergoing virtual delivery of MORE had greater improvements in daily pain intensity (P = 0.002) but not in disability (P = 0.09), depression (P = 0.26), or quality of life (P = 0.99 and P = 0.89, SF-12 physical and mental component scores, respectively), relative to TAU patients. In addition, patients in MORE experienced significantly greater increases in mindful reinterpretation of pain (P = 0.029) and trait mindfulness (P = 0.035).

Conclusion: Among patients with lumbar radiculopathy, MORE significantly reduced daily pain intensity but did not decrease disability or depression symptoms. Given the long duration of symptoms in our sample, we hypothesize the discrepancy between changes in daily pain intensity and disability is due to fear avoidance behaviors common in patients with chronic pain. As the first trial of a mindfulness intervention in patients with LR, these findings should inform future integrative approaches to LR treatment, particularly when considering the increasing use of virtual interventions throughout the COVID-19 pandemic.

Keywords: Chronic low back pain; Integrative pain management; Lumbosacral radiculopathy; Mindfulness-Oriented Recovery Enhancement; Mindfulness-based interventions.

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Conflict of interest statement

The authors have no conflict of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1.
Figure 1.
CONSORT diagram. CONSORT, Consolidated Standards of Reporting Trials.
See this image and copyright information in PMC

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