Yoga for Military Veterans with Chronic Low Back Pain: A Randomized Clinical Trial.


Author: Groessl EJ1, Liu L2, Chang DG3, Wetherell JL4, Bormann JE5, Atkinson JH4, Baxi S6, Schmalzl L7

Affiliation: <sup>1</sup>VA San Diego Healthcare System, San Diego, California; Department of Family Medicine and Public Health, University of California San Diego, San Diego, California. Electronic address: egroessl@ucsd.edu.

<sup>2</sup>VA San Diego Healthcare System, San Diego, California; Department of Family Medicine and Public Health, University of California San Diego, San Diego, California.

<sup>3</sup>VA San Diego Healthcare System, San Diego, California; Department of Orthopaedic Surgery, University of California San Diego, San Diego, California.

<sup>4</sup>VA San Diego Healthcare System, San Diego, California; Department of Psychiatry, University of California San Diego, San Diego, California.

<sup>5</sup>VA San Diego Healthcare System, San Diego, California; Hahn School of Nursing and Health Sciences, University of San Diego, San Diego, California; VA Center of Excellence in Stress and Mental Health, San Diego, California.

<sup>6</sup>VA San Diego Healthcare System, San Diego, California; Department of Medicine, University of California San Diego, San Diego, California.

<sup>7</sup>Department of Family Medicine and Public Health, University of California San Diego, San Diego, California; College of Science and Integrative Health, Southern California University of Health Sciences, Whittier, California.
Conference/Journal: Am J Prev Med.
Date published: 2017 Jul 17
Other:
  Pages: S0749-3797(17)30290-8   ,  Special Notes: doi: 10.1016/j.amepre.2017.05.019. [Epub ahead of print]   ,  Word Count: 312  
    INTRODUCTION: Chronic low back pain (cLBP) is prevalent, especially among military veterans. Many cLBP treatment options have limited benefits and are accompanied by side effects. Major efforts to reduce opioid use and embrace nonpharmacological pain treatments have resulted. Research with community cLBP patients indicates that yoga can improve health outcomes and has few side effects. The benefits of yoga among military veterans were examined.



DESIGN: Participants were randomized to either yoga or delayed yoga treatment in 2013-2015. Outcomes were assessed at baseline, 6 weeks, 12 weeks, and 6 months. Intention-to-treat analyses occurred in 2016.



SETTING/PARTICIPANTS: One hundred and fifty military veterans with cLBP were recruited from a major Veterans Affairs Medical Center in California.



INTERVENTION: Yoga classes (with home practice) were led by a certified instructor twice weekly for 12 weeks, and consisted primarily of physical postures, movement, and breathing techniques.



MAIN OUTCOME MEASURES: The primary outcome was Roland-Morris Disability Questionnaire scores after 12 weeks. Pain intensity was identified as an important secondary outcome.



RESULTS: Participant characteristics were mean age 53 years, 26% were female, 35% were unemployed or disabled, and mean back pain duration was 15 years. Improvements in Roland-Morris Disability Questionnaire scores did not differ between the two groups at 12 weeks, but yoga participants had greater reductions in Roland-Morris Disability Questionnaire scores than delayed treatment participants at 6 months -2.48 (95% CI= -4.08, -0.87). Yoga participants improved more on pain intensity at 12 weeks and at 6 months. Opioid medication use declined among all participants, but group differences were not found.



CONCLUSIONS: Yoga improved health outcomes among veterans despite evidence they had fewer resources, worse health, and more challenges attending yoga sessions than community samples studied previously. The magnitude of pain intensity decline was small, but occurred in the context of reduced opioid use. The findings support wider implementation of yoga programs for veterans.



TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT02524158.



Published by Elsevier Inc.



PMID: 28735778  DOI: 10.1016/j.amepre.2017.05.019