Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial.
BACKGROUND
Chronic low back pain is a common problem that has only modestly effective treatment options.


OBJECTIVE
To determine whether yoga is more effective than conventional therapeutic exercise or a self-care book for patients with chronic low back pain.


METHODS
Randomized, controlled trial.


METHODS
A nonprofit, integrated health care system.


METHODS
101 adults with chronic low back pain.


METHODS
12-week sessions of yoga or conventional therapeutic exercise classes or a self-care book.


METHODS
Primary outcomes were back-related functional status (modified 24-point Roland Disability Scale) and "bothersomeness" of pain (11-point numerical scale). The primary time point was 12 weeks. Clinically significant change was considered to be 2.5 points on the functional status scale and 1.5 points on the bothersomeness scale. Secondary outcomes were days of restricted activity, general health status, and medication use.


RESULTS
After adjustment for baseline values, back-related function in the yoga group was superior to the book and exercise groups at 12 weeks (yoga vs. book: mean difference, -3.4 [95% CI, -5.1 to - 1.6] [P < 0.001]; yoga vs. exercise: mean difference, -1.8 [CI, -3.5 to - 0.1] [P = 0.034]). No significant differences in symptom bothersomeness were found between any 2 groups at 12 weeks; at 26 weeks, the yoga group was superior to the book group with respect to this measure (mean difference, -2.2 [CI, -3.2 to - 1.2]; P < 0.001). At 26 weeks, back-related function in the yoga group was superior to the book group (mean difference, -3.6 [CI, -5.4 to - 1.8]; P < 0.001).


CONCLUSIONS
Participants in this study were followed for only 26 weeks after randomization. Only 1 instructor delivered each intervention.


CONCLUSIONS
Yoga was more effective than a self-care book for improving function and reducing chronic low back pain, and the benefits persisted for at least several months.
Sherman
Karen J
KJ
Group Health Cooperative and University of Washington, Seattle, Washington, USA. Sherman.k@ghc.org
Cherkin
Daniel C
DC
Erro
Janet
J
Miglioretti
Diana L
DL
Deyo
Richard A
RA
D000328:Adult; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care / Q000379:methods*; D016896:Treatment Outcome; D015013:Yoga