Protocol for mindfulness-oriented recovery enhancement (MORE) in the management of lumbosacral radiculopathy/radiculitis symptoms: A randomized controlled trial

Wexler, Ryan S; Fox, Devon J.; Edmond, Hannah; Lemau, Johnny; ZuZero, Danielle; Bollen, Melissa; Montenegro, Diane; Parikshak, Anand; Thompson, Austin R.; Carlson, Nels; Carlson, Hans; Wentz, Anna E.; Bradley, Ryan; Hanes, David A.; Zwickey, Heather; Pickworth, Courtney K.

doi:10.1016/j.conctc.2022.100962

Cited by 2 publications

(6 citation statements)

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“…Despite the growing body of evidence on MBIs, it remains a small area of interest that is not included in evidence maps and systematic reviews on psychological interventions for chronic pain. 9 , 37 , 51 This article shares findings from self-report questionnaires in the trial described by Wexler et al, 75 which were collected during the peak of the COVID-19 pandemic. The primary aims of this research are to evaluate the impact of MORE on disability, pain, quality of life, depression, mindful reinterpretation of pain, and trait mindfulness scores as compared to treatment-as-usual (TAU) in patients with LR.…”

Section: Introductionmentioning

confidence: 83%

“…This study adheres to Consolidated Standards of Reporting Trials (CONSORT) guidelines, is registered at clinicaltrials.gov (NCT04818606), and was approved by the National University of Natural Medicine (NUNM) IRB (IRB#: KP112720). Data were collected following the previously described protocol by Wexler et al (2022) with only minor protocol modifications; these changes are described in detail below. 75…”

Section: Methodsmentioning

confidence: 99%

“…Data were collected following the previously described protocol by Wexler et al (2022) with only minor protocol modifications; these changes are described in detail below. 75…”

Section: Methodsmentioning

confidence: 99%

“… 4 , 13 , 20 , 58 , 59 In addition to symptom-specific questionnaires, a demographics and health history questionnaire was designed by the study team to capture information on diagnosis, condition duration, and past and current treatments. With the exception of the MRPS, all questionnaires are described in detail in the original study protocol, 75 including their rationale for use in this subpopulation.…”

Section: Methodsmentioning

confidence: 99%

“…Randomization adhered to the previously published protocol. 75 Three sequential cohorts of 24 to 46 (12–23 per group) participants were recruited into the study and underwent group assignment through simple randomization using a random number generator. Although this deviates from optimal cohort volume for psychotherapeutic interventions, larger cohorts were necessary because of study resource limitations.…”

Section: Methodsmentioning

confidence: 99%

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

Wexler,

Fox,

ZuZero

et al. 2024

PR9

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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.

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Section: Introductionmentioning

confidence: 83%

Section: Methodsmentioning

confidence: 99%

“…Data were collected following the previously described protocol by Wexler et al (2022) with only minor protocol modifications; these changes are described in detail below. 75…”

Section: Methodsmentioning

confidence: 99%