Virtually delivered Mindfulness-Oriented Recovery Enhancement (MORE) reduces daily pain intensity in patients with lumbosacral radiculopathy: a randomized controlled trial.
Ryan S Wexler, Devon J Fox, Danielle Zuzero, Melissa Bollen, Anand Parikshak, Hannah Edmond, Johnny Lemau, Diane Montenegro, Jillian Ramirez, Sophia Kwin, Austin R Thompson, Hans L Carlson, Lynn M. Marshall, Thomas Kern, Scott D Mist, Ryan Bradley, Douglas A Hanes, Heather Zwickey, Courtney K Pickworth
PAIN Reports April 1, 2024 DOI: 10.1097/PR9.0000000000001132 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Population | Patients with lumbosacral radiculopathy (sciatica) identified through electronic health records and phone screenings |
| Intervention | Mindfulness-Oriented Recovery Enhancement (MORE) |
| Duration | 8-week intervention |
| Topics | Meditation |
| Keywords | Integrative pain management Lumbosacral radiculopathy Mindfulness-oriented recovery enhancement Mindfulness-based interventions |
| Citations | 6 |
| Key findings | Virtual Mindfulness-Oriented Recovery Enhancement significantly reduced daily pain intensity but did not decrease disability or depression symptoms in patients with lumbosacral radiculopathy. |
Abstract
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%. 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. 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. 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). 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.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 2
- Development of a Multicomponent Mindfulness and Movement Program for Lumbosacral Radicular Pain: A Mixed Methods Protocol Research Square February 27, 2026
- "Noticing the Way that I'm Noticing Pain": A Qualitative Analysis of Therapeutic Progression in Mindfulness-Oriented Recovery Enhancement for Patients with Lumbosacral Radicular Pain. Mindfulness 2026
Cites 16
- Mindfulness-based interventions: an overall review British Medical Bulletin April 21, 2021
- Restructuring reward processing with Mindfulness-Oriented Recovery Enhancement: novel therapeutic mechanisms to remediate hedonic dysregulation in addiction, stress, and pain. Annals of the New York Academy of Sciences April 1, 2016
- The Mindful Reappraisal of Pain Scale (MRPS): Validation of a New Measure of Psychological Mechanisms of Mindfulness-Based Analgesia. Mindfulness 2023
- Mindfulness-Oriented Recovery Enhancement for Addictive Behavior, Psychiatric Distress, and Chronic Pain: A Multilevel Meta-Analysis of Randomized Controlled Trials. Mindfulness September 15, 2022
- Protocol for mindfulness-oriented recovery enhancement (MORE) in the management of lumbosacral radiculopathy/radiculitis symptoms: A randomized controlled trial. Contemporary Clinical Trials Communications August 2022
and 11 more in the library