A virtual 8-week mindfulness-based program (MORE) reduced daily pain intensity in people with lumbosacral radiculopathy (sciatica) compared with usual care, but did not improve disability, depression, or quality of life. Participants in the mindfulness group also reported greater increases in mindful reinterpretation of pain and trait mindfulness. The authors suggest that fear-avoidance behaviors may explain why pain relief did not translate into reduced disability in this long-duration chronic pain sample.
A qualitative analysis of session recordings from a clinical trial of Mindfulness-Oriented Recovery Enhancement (MORE) for patients with lumbosacral radicular pain identified four stages of how participants learn to relate to chronic pain: Pain Vigilance and Attention Dysregulation, Attention Regulation and its application to Experiential Avoidance, Metacognitive Awareness, and Pain Reappraisal. Some participants initially used attention skills to avoid pain rather than engage with it. The progression, termed the Vigilance-Avoidance Metacognition-Reappraisal (VA-MR) framework, suggests that therapeutic benefit requires a skilled therapist to guide patients through these stages, particularly navigating initial avoidance tendencies.