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 selfcare 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≲λτ∀.001; mean difference for symptoms, -1.1 [95% CI, -1.7 to -0.4]; P≲λτ ∀.001). At 26 weeks, function for the yoga group remained superior (mean difference, -1.8 [95% CI, -3.1 to -0.5]; P≲λτ∀.001). Yoga was not superior to conventional stretching exercises at any time point. Conclusion: Yoga classes were more effective than a selfcare 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. Trial Registration: clinicaltrials.gov Identifier: NCT00447668