Yoga, Physical Therapy, or Education for Chronic Low Back Pain

• DOI: 10.7326/m16-2579
• Publication Date: 2017-06-19T22:30:49Z
• Authors: Robert B. Saper; Chelsey Lemaster; Anthony Delitto; Karen J. Sherman; Patricia M. Herman; Ekaterina Sadikova; Joel Stevans; Julia E. Keosaian; Christian J. Cerrada; Alexandra L. Femia; Eric J. Roseen; Paula Gardiner; Katherine Gergen ...; Carol Faulkner; Janice Weinberg
• Keywords: Hatha yoga

Yoga is effective for mild to moderate chronic low back pain (cLBP), but its comparative effectiveness with physical therapy (PT) unknown. Moreover, little known about yoga's in underserved patients more severe functional disability and pain.To determine whether yoga noninferior PT cLBP.12-week, single-blind, 3-group randomized noninferiority trial subsequent 40-week maintenance phase. (ClinicalTrials.gov: NCT01343927).Academic safety-net hospital 7 affiliated community health centers.320 predominantly low-income, racially diverse adults nonspecific cLBP.Participants received 12 weekly classes, 15 visits, or an educational book newsletters. The phase compared drop-in classes versus home practice booster sessions practice.Primary outcomes were back-related function, measured by the Roland Morris Disability Questionnaire (RMDQ), pain, 11-point scale, at weeks. Prespecified margins 1.5 (RMDQ) 1.0 (pain). Secondary included medication use, global improvement, satisfaction intervention, health-related quality of life.One-sided 95% lower confidence limits 0.83 0.97 (pain), demonstrating PT. However, was not superior education either outcome. similar most secondary outcomes. participants 21 22 percentage points less likely, respectively, than use Improvements groups maintained 1 year no differences between strategies. Frequency adverse events, mostly self-limited joint did differ groups.Participants blinded treatment assignment. group had disproportionate loss follow-up.A manualized program cLBP function pain.National Center Complementary Integrative Health National Institutes Health.