A randomized trial comparing yoga, stretching, and a self-care book for chronic low back pain.
BACKGROUND
Chronic low back pain is a common problem lacking highly effective treatment options. Small trials suggest that yoga may have benefits for this condition. This trial was designed to determine whether yoga is more effective than conventional stretching exercises or a self-care book for primary care patients with chronic low back pain.


METHODS
A total of 228 adults with chronic low back pain were randomized to 12 weekly classes of yoga (92 patients) or conventional stretching exercises (91 patients) or a self-care book (45 patients). Back-related functional status (modified Roland Disability Questionnaire, a 23-point scale) and bothersomeness of pain (an 11-point numerical scale) at 12 weeks were the primary outcomes. Outcomes were assessed at baseline, 6, 12, and 26 weeks by interviewers unaware of treatment group.


RESULTS
After adjustment for baseline values, 12-week outcomes for the yoga group were superior to those for the self-care group (mean difference for function, -2.5 [95% CI, -3.7 to -1.3]; P < .001; mean difference for symptoms, -1.1 [95% CI, -1.7 to -0.4]; P < .001). At 26 weeks, function for the yoga group remained superior (mean difference, -1.8 [95% CI, -3.1 to -0.5]; P < .001). Yoga was not superior to conventional stretching exercises at any time point.


CONCLUSIONS
Yoga classes were more effective than a self-care book, but not more effective than stretching classes, in improving function and reducing symptoms due to chronic low back pain, with benefits lasting at least several months.


BACKGROUND
clinicaltrials.gov Identifier: NCT00447668.
Group Health Research Institute, Seattle, WA 98101, USA. sherman.k@ghc.org
Karen J
KJ
Sherman
Daniel C
DC
Cherkin
Robert D
RD
Wellman
Andrea J
AJ
Cook
Rene J
RJ
Hawkes
Kristin
K
Delaney
Richard A
RA
Deyo
D000368:Aged; D001877:Books; D002908:Chronic Disease; D059350:Chronic Pain / Q000628:therapy*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D052580:Muscle Stretching Exercises; D010147:Pain Measurement; D012648:Self Care; D016896:Treatment Outcome; D015013:Yoga