Evaluating Yoga for Chronic Low Back Pain

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Back problems are among the moist prevalent conditions afflicting adults and are a leading reason for using complementary or alternative medical (CAM therapies). Despite the common use of CAM therapies for back pain, little is known about how they compare with conventional treatments. Although there have been numerous randomized trials evaluating the effectiveness of spinal manipulation and acupuncture for back pain, no trials could be identified that evaluated yoga. This study will lay the groundwork for a full-scale trial that compares yoga with conventional exercise and usual care for chronic low back pain. During Phase I of this project, we will develop, test, and refine individual components of such a randomized clinical trial. This will include specification of protocols in the yoga and exercise groups, subject selection criteria, and recruitment and retention strategies. During Phase II, we will use the study components developed during Phase I to conduct a pilot trial of these interventions. We will randomized 30 persons with chronic low back pain to each of the following groups: yoga, a conventional therapeutic exercise program, and usual care. We will measure each treatment's impact on symptoms, function, quality of live, and back pain-related utilization and costs of care after 6 weeks, 122 weeks, and 6 months. The pilot study will permit us to identify and resolve unanticipated problems, to estimate the samples required for an adequately powered full-scale trial, and to obtain preliminary estimates of the effectiveness and safety of yoga and the therapeutic exercise program. At the conclusion of this project, we will be well-positioned to prepare a competitive grant proposal to evaluate the effectiveness of yoga as a treatment for persons with chronic low back pain.