Yoga for chronic non-specific low back pain - PubMed (original) (raw)

Review

Yoga for chronic non-specific low back pain

L Susan Wieland et al. Cochrane Database Syst Rev. 2022.

Abstract

Background: Non-specific low back pain is a common, potentially disabling condition usually treated with self-care and non-prescription medication. For chronic low back pain, current guidelines recommend exercise therapy. Yoga is a mind-body exercise sometimes used for non-specific low back pain.

Objectives: To evaluate the benefits and harms of yoga for treating chronic non-specific low back pain in adults compared to sham yoga, no specific treatment, a minimal intervention (e.g. education), or another active treatment, focusing on pain, function, quality of life, and adverse events.

Search methods: We used standard, extensive Cochrane search methods. The latest search date was 31 August 2021 without language or publication status restrictions.

Selection criteria: We included randomized controlled trials of yoga compared to sham yoga, no intervention, any other intervention and yoga added to other therapies.

Data collection and analysis: We followed standard Cochrane methods. Our major outcomes were 1. back-specific function, 2. pain, 3. clinical improvement, 4. mental and physical quality of life, 5. depression, and 6.

Adverse events: Our minor outcome was 1. work disability. We used GRADE to assess certainty of evidence for the major outcomes.

Main results: We included 21 trials (2223 participants) from the USA, India, the UK, Croatia, Germany, Sweden, and Turkey. Participants were recruited from both clinical and community settings. Most were women in their 40s or 50s. Most trials used iyengar, hatha, or viniyoga yoga. Trials compared yoga to a non-exercise control including waiting list, usual care, or education (10 trials); back-focused exercise such as physical therapy (five trials); both exercise and non-exercise controls (four trials); both non-exercise and another mind-body exercise (qigong) (one trial); and yoga plus exercise to exercise alone (one trial). One trial comparing yoga to exercise was an intensive residential one-week program, and we analyzed this trial separately. All trials were at high risk of performance and detection bias because participants and providers were not blinded to treatment, and outcomes were self-assessed. We found no trials comparing yoga to sham yoga. Low-certainty evidence from 11 trials showed that there may be a small clinically unimportant improvement in back-specific function with yoga (mean difference [MD] -1.69, 95% confidence interval [CI] -2.73 to -0.65 on the 0- to 24-point Roland-Morris Disability Questionnaire [RMDQ], lower = better, minimal clinically important difference [MCID] 5 points; 1155 participants) and moderate-certainty evidence from nine trials showed a clinically unimportant improvement in pain (MD -4.53, 95% CI -6.61 to -2.46 on a 0 to 100 scale, 0 no pain, MCID 15 points; 946 participants) compared to no exercise at three months. Low-certainty evidence from four trials showed that there may be a clinical improvement with yoga (risk ratio [RR] 2.33, 95% CI 1.46 to 3.71; assessed as participant rating that back pain was improved or resolved; 353 participants). Moderate-certainty evidence from six trials showed that there is probably a small improvement in physical and mental quality of life (physical: MD 1.80, 95% CI 0.27 to 3.33 on the 36-item Short Form [SF-36] physical health scale, higher = better; mental: MD 2.38, 95% CI 0.60 to 4.17 on the SF-36 mental health scale, higher = better; both 686 participants). Low-certainty evidence from three trials showed little to no improvement in depression (MD -1.25, 95% CI -2.90 to 0.46 on the Beck Depression Inventory, lower = better; 241 participants). There was low-certainty evidence from eight trials that yoga increased the risk of adverse events, primarily increased back pain, at six to 12 months (RR 4.76, 95% CI 2.08 to 10.89; 43/1000 with yoga and 9/1000 with no exercise; 1037 participants). For yoga compared to back-focused exercise controls (8 trials, 912 participants) at three months, we found moderate-certainty evidence from four trials for little or no difference in back-specific function (MD -0.38, 95% CI -1.33 to 0.62 on the RMDQ, lower = better; 575 participants) and very low-certainty evidence from two trials for little or no difference in pain (MD 2.68, 95% CI -2.01 to 7.36 on a 0 to 100 scale, lower = better; 326 participants). We found very low-certainty evidence from three trials for no difference in clinical improvement assessed as participant rating that back pain was improved or resolved (RR 0.97, 95% CI 0.72 to 1.31; 433 participants) and very low-certainty evidence from one trial for little or no difference in physical and mental quality of life (physical: MD 1.30, 95% CI -0.95 to 3.55 on the SF-36 physical health scale, higher = better; mental: MD 1.90, 95% CI -1.17 to 4.97 on the SF-36 mental health scale, higher = better; both 237 participants). No studies reported depression. Low-certainty evidence from five trials showed that there was little or no difference between yoga and exercise in the risk of adverse events at six to 12 months (RR 0.93, 95% CI 0.56 to 1.53; 84/1000 with yoga and 91/1000 with non-yoga exercise; 640 participants).

Authors' conclusions: There is low- to moderate-certainty evidence that yoga compared to no exercise results in small and clinically unimportant improvements in back-related function and pain. There is probably little or no difference between yoga and other back-related exercise for back-related function at three months, although it remains uncertain whether there is any difference between yoga and other exercise for pain and quality of life. Yoga is associated with more adverse events than no exercise, but may have the same risk of adverse events as other exercise. In light of these results, decisions to use yoga instead of no exercise or another exercise may depend on availability, cost, and participant or provider preference. Since all studies were unblinded and at high risk of performance and detection bias, it is unlikely that blinded comparisons would find a clinically important benefit.

Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Conflict of interest statement

LSW: none.

NS: none.

KP: none.

SH was Managing Editor of the Cochrane Back and Neck review group until April 2020. She was not involved in the editorial decisions for this review.

RV is a volunteer researcher with Yoga Sangeeta, a non‐profit organization that promotes music for meditation and healing.

BB: none.

Figures

1

1

Study flow diagram.

2

2

Risk of bias summary: review authors' judgments about each risk of bias item for each included study.

3

3

Risk of bias graph: review authors' judgments about each risk of bias item presented as percentages across all included studies.

4

4

Funnel plot of comparison: 1 Yoga versus non‐exercise, outcome: 1.1.2 Back‐specific function at three to four months.

5

5

Funnel plot of comparison: 1 Yoga versus non‐exercise, outcome: 1.1.3 Back‐specific function at six months.

1.1

1.1. Analysis

Comparison 1: Yoga versus non‐exercise, Outcome 1: Back‐specific functional status

1.2

1.2. Analysis

Comparison 1: Yoga versus non‐exercise, Outcome 2: Pain

1.3

1.3. Analysis

Comparison 1: Yoga versus non‐exercise, Outcome 3: Clinical improvement

1.4

1.4. Analysis

Comparison 1: Yoga versus non‐exercise, Outcome 4: Physical quality of life

1.5

1.5. Analysis

Comparison 1: Yoga versus non‐exercise, Outcome 5: Mental quality of life

1.6

1.6. Analysis

Comparison 1: Yoga versus non‐exercise, Outcome 6: Depression

1.7

1.7. Analysis

Comparison 1: Yoga versus non‐exercise, Outcome 7: Adverse events

1.8

1.8. Analysis

Comparison 1: Yoga versus non‐exercise, Outcome 8: Measures of work disability (days)

2.1

2.1. Analysis

Comparison 2: Subgroup analyses for yoga versus non‐exercise, Outcome 1: Subgroup analysis by socioeconomic status (SES) for back‐specific functional status at 6 months

2.2

2.2. Analysis

Comparison 2: Subgroup analyses for yoga versus non‐exercise, Outcome 2: Subgroup analysis by SES for pain at 6 months

3.1

3.1. Analysis

Comparison 3: Sensitivity analyses for yoga versus non‐exercise, Outcome 1: Back‐specific functional status sensitivity analyses (higher‐quality studies)

3.2

3.2. Analysis

Comparison 3: Sensitivity analyses for yoga versus non‐exercise, Outcome 2: Back‐specific functional status sensitivity analyses (complete case)

3.3

3.3. Analysis

Comparison 3: Sensitivity analyses for yoga versus non‐exercise, Outcome 3: Back‐specific functional status sensitivity analyses (change values)

3.4

3.4. Analysis

Comparison 3: Sensitivity analyses for yoga versus non‐exercise, Outcome 4: Pain sensitivity analyses (higher‐quality studies)

3.5

3.5. Analysis

Comparison 3: Sensitivity analyses for yoga versus non‐exercise, Outcome 5: Pain sensitivity analyses (complete case)

3.6

3.6. Analysis

Comparison 3: Sensitivity analyses for yoga versus non‐exercise, Outcome 6: Pain sensitivity analyses (change values)

3.7

3.7. Analysis

Comparison 3: Sensitivity analyses for yoga versus non‐exercise, Outcome 7: Pain sensitivity analyses (standardized mean difference)

4.1

4.1. Analysis

Comparison 4: Sensitivity analyses for yoga versus exercise, Outcome 1: Back‐specific functional status sensitivity analyses (higher‐quality studies)

4.2

4.2. Analysis

Comparison 4: Sensitivity analyses for yoga versus exercise, Outcome 2: Back‐specific functional status sensitivity analyses (complete case)

4.3

4.3. Analysis

Comparison 4: Sensitivity analyses for yoga versus exercise, Outcome 3: Back‐specific functional status sensitivity analyses (change values)

4.4

4.4. Analysis

Comparison 4: Sensitivity analyses for yoga versus exercise, Outcome 4: Pain sensitivity analyses (complete case)

4.5

4.5. Analysis

Comparison 4: Sensitivity analyses for yoga versus exercise, Outcome 5: Pain sensitivity analyses (change values)

4.6

4.6. Analysis

Comparison 4: Sensitivity analyses for yoga versus exercise, Outcome 6: Pain sensitivity analyses (standardized mean difference)

5.1

5.1. Analysis

Comparison 5: Yoga versus exercise, Outcome 1: Back‐specific functional status

5.2

5.2. Analysis

Comparison 5: Yoga versus exercise, Outcome 2: Pain

5.3

5.3. Analysis

Comparison 5: Yoga versus exercise, Outcome 3: Clinical improvement

5.4

5.4. Analysis

Comparison 5: Yoga versus exercise, Outcome 4: Physical quality of life

5.5

5.5. Analysis

Comparison 5: Yoga versus exercise, Outcome 5: Mental quality of life

5.6

5.6. Analysis

Comparison 5: Yoga versus exercise, Outcome 6: Adverse events

5.7

5.7. Analysis

Comparison 5: Yoga versus exercise, Outcome 7: Measures of work disability

6.1

6.1. Analysis

Comparison 6: Yoga versus qigong, Outcome 1: Back‐specific functional status

6.2

6.2. Analysis

Comparison 6: Yoga versus qigong, Outcome 2: Pain

6.3

6.3. Analysis

Comparison 6: Yoga versus qigong, Outcome 3: Physical quality of life

6.4

6.4. Analysis

Comparison 6: Yoga versus qigong, Outcome 4: Mental quality of life

6.5

6.5. Analysis

Comparison 6: Yoga versus qigong, Outcome 5: Depression

7.1

7.1. Analysis

Comparison 7: Sensitivity analyses for yoga versus qigong, Outcome 1: Pain sensitivity analysis (standardized mean difference)

8.1

8.1. Analysis

Comparison 8: Yoga plus exercise versus exercise alone, Outcome 1: Back‐specific functional status at short–intermediate term (10 weeks)

8.2

8.2. Analysis

Comparison 8: Yoga plus exercise versus exercise alone, Outcome 2: Pain at short–intermediate term (10 weeks)

9.1

9.1. Analysis

Comparison 9: Sensitivity analyses for yoga plus an intervention versus that intervention alone: yoga plus exercise compared to exercise alone, Outcome 1: Pain sensitivity analysis (standardized mean difference)

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References

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References to studies excluded from this review

Anon 2006 {published data only}
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Anon 2009 {published data only}
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    1. NCT03651232. Prenatal yoga for pregnancy related back pain. clinicaltrials.gov/ct2/show/NCT03651232 (first received 29 August 2018).
Horng 2006 {published data only}
    1. Horng MS. Yoga improves function in patients with chronic low back pain. Journal of Clinical Outcomes Management 2006;13(3):140-1.
Jacob 2017 {published data only}
    1. Jacob AM, Kathyayani BV. A study to assess the effectiveness of yogic postures on back pain among beedi rolling women in a selected rural area at Mangalore. International Journal of Nursing Education 2017;9(2):1-5.
Kim 2014 {published data only}
    1. Kim SS, Min WK, Kim JH, Lee BH. The effects of VR-based Wii Fit yoga on physical function in middle-aged female LBP patients. Journal of Physical Therapy Science 2014;26(4):549-52. [PMID: ] - PMC - PubMed
Kumar 2011 {published data only}
    1. Kumar A, Telles S, Balkrishna A. A follow up study with back pain patients. Indian Journal of Physiology and Pharmacology 2011;55:70-1.
Lee 2014 {published data only}
    1. Lee M, Moon W, Kim J. Effect of yoga on pain, brain-derived neurotrophic factor, and serotonin in premenopausal women with chronic low back pain. Evidence-based Complementary and Alternative Medicine 2014;2014:203173. [PMID: ] - PMC - PubMed
Manik 2017 {published data only}
    1. Manik RK, Mahapatra AK, Gartia R, Bansal S, Patnaik A. Effect of selected yogic practices on pain and disability in patients with lumbar spondylitis. International Journal of Yoga 2017;10(2):81-7. [PMID: ] - PMC - PubMed
Michalsen 2012 {published data only}
    1. Michalsen A, Jeitler M, Brunnhuber S, Ludtke R, Bussing A, Musial F, et al. Iyengar yoga for distressed women: a 3-armed randomized controlled trial. Evidence-based Complementary and Alternative Medicine 2012;2012:408727. [PMID: ] - PMC - PubMed
Monro 2015 {published data only}
    1. Monro R, Bhardwaj AK, Gupta RK, Telles S, Allen B, Little P. Disc extrusions and bulges in nonspecific low back pain and sciatica: exploratory randomised controlled trial comparing yoga therapy and normal medical treatment. Journal of Back and Musculoskeletal Rehabilitation 2015;28(2):383-92. [PMID: ] - PubMed
Namdar 2021 {published data only}
    1. Namdar P, Hoseini N, Dehghankar L, Yekefallah L, Noorian S, Golestaneh F, et al. The effect of hatha yoga on low back pain and sleep quality on nulliparus pregnant women: a clinical trial study. Practising Midwife 2021;24(7):24-30.
NCT02806323 {published data only}
    1. NCT02806323. Individually tailored yoga program for the treatment of chronic neck and back pain [An individually tailored yoga program for the treatment of chronic neck and back pain in a low-income population: a feasibility study]. clinicaltrials.gov/ct2/show/NCT02806323 (first received 20 June 2016).
NCT03324659 {published data only}
    1. NCT03324659. Meditation and exercise to treat chronic back pain (MedExT) [Combined meditation and exercise as a treatment for patients with chronic back pain]. clinicaltrials.gov/ct2/show/NCT03324659 (first received 30 October 2017).
NCT03504085 {published data only}
    1. NCT03504085. Overcoming pain through yoga in the military (OPTYM) [Mind/body interventions for chronic low back and neck pain in military personnel]. clinicaltrials.gov/ct2/show/NCT03504085 (first received 20 April 2018).
NCT03840304 {published data only}
    1. NCT03840304. Effectiveness of Yoga@Work program [Effectiveness of Yoga@Work program on neck and shoulder pain in Information Technology (IT) employees]. clinicaltrials.gov/ct2/show/NCT03840304 (first received 15 February 2019).
NCT04074109 {published data only}
    1. NCT04074109. Feasibility of at-home telehealth yoga for treating chronic pain. clinicaltrials.gov/ct2/show/NCT04074109 (first received 29 August 2019).
NCT04089618 {published data only}
    1. NCT04089618. Meditation based lifestyle modification in chronic pain (MBLM-P). clinicaltrials.gov/ct2/show/nct04089618 (first received 13 September 2019).
NCT04113460 {published data only}
    1. NCT04113460. The effectiveness yoga@work among office workers with chronic nonspecific neck pain (CNNP) [The effectiveness yoga@work among office workers with chronic nonspecific neck pain (CNNP): a randomised controlled trial]. clinicaltrials.gov/ct2/show/NCT04113460 (first received 2 October 2019).
NCT04281238 {published data only}
    1. NCT04281238. The effects of yoga training in ankylosing spondylitis patients. clinicaltrials.gov/ct2/show/NCT04281238 (first received 24 February 2020).
NCT04296344 {published data only}
    1. NCT04296344. Group acupuncture therapy with modified yoga (GAPYOGA) [Group acupuncture therapy with modified yoga for chronic neck, low back and OA pain in safety net setting for an underserved population (GAPYOGA)]. clinicaltrials.gov/ct2/show/NCT04296344 (first received 5 March 2020).
NCT04773743 {published data only}
    1. NCT04773743. Remotely delivered yoga program for chronic low back pain. clinicaltrials.gov/show/NCT04773743 First received 26 February 2021.
Patil 2015 {published data only}
    1. Patil NJ, Nagarathna R, Tekur P, Patil DN, Nagendra HR, Subramanya P. Designing, validation, and feasibility of integrated yoga therapy module for chronic low back pain. International Journal of Yoga 2015;8(2):103-8. [PMID: ] - PMC - PubMed
Pushpika Attanayake 2010 {published data only}
    1. Pushpika Attanayake AM, Somarathna KI, Vyas GH, Dash SC. Clinical evaluation of selected Yogic procedures in individuals with low back pain. AYU 2010;31(2):245-50. [PMID: ] - PMC - PubMed
Sakuma 2012 {published data only}
    1. Sakuma Y, Sasaki-Otomaru A, Ishida S, Kanoya Y, Arakawa C, Mochizuki Y, et al. Effect of a home-based simple yoga program in child-care workers: a randomized controlled trial. Journal of Alternative and Complementary Medicine 2012;18(8):769-76. [PMID: ] - PubMed
Saper 2013 {published data only}
    1. Boah A, Kwong L, Weinberg J, Sherman K, Saper R. Characteristics of treatment adherence in low-income minority participants in a yoga dosing study for chronic low back pain. BMC Complementary and Alternative Medicine 2012;12(Suppl 1):116. [DOI: 10.1186/1472-6882-12-S1-P116] - DOI
    1. Cerrada C, Weinberg J, Dresner D, Boah A, Sherman K, Saper R. Comparison of paper surveys and computer-assisted telephone interviews in a randomized controlled trial of yoga for low back pain. BMC Complementary and Alternative Medicine 2012;12(Suppl 1):370. [DOI: 10.1186/1472-6882-12-S1-P370] - DOI
    1. Cerrada CJ, Weinberg J, Sherman KJ, Saper RB. Inter-method reliability of paper surveys and computer assisted telephone interviews in a randomized controlled trial of yoga for low back pain. BMC Research Notes 2014;7:227. [PMID: ] - PMC - PubMed
    1. Keosaian J, Dresner D, Cerrada C, Kwong L, Goodman N, Tam M, et al. Recruitment strategies for community-based yoga research in a predominant minority population. BMC Complementary and Alternative Medicine 2012;12(Suppl 1):183. [DOI: 10.1186/1472-6882-12-S1-P183] - DOI
    1. Keosaian JE, Lemaster CM, Dresner D, Godersky ME, Paris R, Sherman KJ, et al. "We're all in this together": a qualitative study of predominantly low income minority participants in a yoga trial for chronic low back pain. Complementary Therapies in Medicine 2016;24:34-9. [PMID: ] - PMC - PubMed
Schmid 2019 {published data only}
    1. Schmid AA, Fruhauf CA, Sharp JL, Puymbroeck M, Bair MJ, Portz JD. Yoga for people with chronic pain in a community-based setting: a feasibility and pilot RCT. Journal of Evidence-Based Integrative Medicine 2019;24:2515690X19863763. [DOI: 10.1177/2515690X19863763] [PMID: ] - DOI - PMC - PubMed
    1. Schmid AA, Puymbroeck M, Fruhauf CA, Bair MJ, Portz JD. Yoga improves occupational performance, depression, and daily activities for people with chronic pain. Work 2019;63(2):181-9. [DOI: 10.3233/WOR-192919] [PMID: ] - DOI - PubMed
Selfridge 2012 {published data only}
    1. Selfridge N. Yay yoga! More evidence for helping low back pain. Alternative Medicine Alert 2012;15(3):33-5.
Sharma 2019 {published data only}
    1. Sharma N, John PJ, Meghwal N, Owen A, Mishra V. Effect of yoga therapy on patients with chronic musculoskeletal pain: a prospective randomised wait list-controlled trial. Clinical Medicine 2019;19(3):s87.
Telles 2009 {published data only}
    1. Telles S, Dash M, Naveen KV. Effect of yoga on musculoskeletal discomfort and motor functions in professional computer users. Work 2009;33(3):297-306. [PMID: ] - PubMed
Telles 2016 {published data only}
    1. Telles S, Bhardwaj AK, Gupta RK, Sharma SK, Monro R, Balkrishna A. A randomized controlled trial to assess pain and magnetic resonance imaging-based (MRI-based) structural spine changes in low back pain patients after yoga practice. Medical Science Monitor 2016;22:3228-47. - PMC - PubMed
    1. Telles S, Sharma SK, Gupta RK, Bhardwaj AK, Balkrishna A. Heart rate variability in chronic low back pain patients randomized to yoga or standard care. BMC Complementary and Alternative Medicine 2016;16(1):279. [PMID: ] - PMC - PubMed
Uebelacker 2019 {published data only}
    1. Uebelacker LA, Noppen D, Tremont G, Bailey G, Abrantes A, Stein M. A pilot study assessing acceptability and feasibility of hatha yoga for chronic pain in people receiving opioid agonist therapy for opioid use disorder. Journal of Substance Abuse Treatment 2019;105:19-27. [DOI: 10.1016/j.jsat.2019.07.015] [PMID: ] - DOI - PMC - PubMed
Whitehead 2018 {published data only}
    1. Whitehead PB. The effect of yoga on chronic nonspecific low back pain. American Journal of Nursing 2018;118(2):64. [PMID: ] - PubMed

References to studies awaiting assessment

CTRI/2018/01/011243 {published data only}
    1. CTRI/2018/01/011243. Effect of yoga based relaxation technique on sustained attention in chronic low back pain (CLBP) patients: a randomized controlled trial. apps.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2018/01/011243 (first received 10 January 2018).
Hartfiel 2017 {published data only}
    1. Hartfiel N, Clarke G, Havenhand J, Phillips C, Edwards RT. Cost-effectiveness of yoga for managing musculoskeletal conditions in the workplace. Occupational Medicine 2017;67:687–95. - PMC - PubMed
IRCT20150531022498N27 {published data only}
    1. IRCT20150531022498N27. Comparison of two methods of yoga and pilates exercise training in women with chronic mechanical low back pain [Comparison of two methods of yoga and pilates exercise training on pain and selected indicators of physical fitness, body composition and disability in women with chronic mechanical low back pain]. en.irct.ir/trial/34662 (first received 5 November 2018).
Krishna 2020 {published data only}
    1. Krishna D, Deepeshwar S, Devi B. Yoga-based relaxation technique facilitates sustained attention in patients with low back pain: a pilot study. Advances in Mind-Body Medicine 2020;34(3):11-7. [PMID: ] - PubMed
Krokhmal 2017 {published data only}
    1. Krokhmal S, Vyshlova I, Karpov S. New approach of correction anxiety, depression and sleep disturbances in patients with chronic non-specific lower back pain. Journal of the Neurological Sciences 2017;381(Suppl 1):978.
Lalkate 2020 {published data only}
    1. Lalkate S, Agrawal R, Agashe GK. A comparative study effectiveness of conventional physiotherapy versus yoga therapy on pain, core muscle endurance, lumbar flexion range of motion and functional disability in patients with chronic mechanical low back pain. Indian Journal of Physiotherapy & Occupational Therapy 2020;14(4):177-82.
Michalson 2021 {published data only}
    1. Bussing A, Jung S, Lotzke D, Recchia DR, Robens S, Ostermann T, et al. Randomized clinical trial to treat patients with chronic back pain: a comparison of the efficacy of yoga, eurythmy therapy and standard physiotherapy. BMC Complementary and Alternative Medicine 2017;17(Suppl 1):P27.
    1. Bussing A, Poier D, Ostermann T, Kroz M, Michalsen A. Treatment of chronic lower back pain: study protocol of a comparative effectiveness study on yoga, eurythmy therapy, and physiotherapeutic exercises [2018]. Complementary Medicine Research 2018;25(1):24-9. - PubMed
    1. Michalsen A, Jeitler M, Kessler CS, Steckhan N, Robens S, Ostermann T, et al. Yoga, eurythmy therapy and standard physiotherapy (YES-Trial) for patients with chronic non-specific low back pain: a three-armed randomized controlled trial. Journal of Pain 2021;22(10):1233-45. [DOI: 10.1016/j.jpain.2021.03.154] [PMID: ] - DOI - PubMed
NCT02552992 {published data only}
    1. NCT02552992. Yoga for chronic low back pain and its mechanism of action: impact of strength and stretch (YoMA II). clinicaltrials.gov/ct2/show/NCT02552992 (first received 18 August 2015).
NCT03432169 {published data only}
    1. NCT03432169. Yoga vs stretching in veterans with chronic lower back pain: does mindfulness matter? clinicaltrials.gov/ct2/show/NCT03432169 (first received 14 February 2018).
Rae 2020 {published data only}
    1. Rae L, Dougherty P, Evertz N. Yoga vs stretching in veterans with chronic lower back pain and the role of mindfulness: a pilot randomized controlled trial. Journal of Chiropractic Medicine 2020;19(2):101-10. [DOI: 10.1016/j.jcm.2019.10.005] [PMID: ] - DOI - PMC - PubMed
Saper 2016 {published data only}
    1. Lemaster C, Plumb D, Wang S, Femia A, Elwy AR, Saper R. Recruitment of veterans for a yoga research study for chronic low back pain. Journal of Alternative and Complementary Medicine 22;6:A80.
    1. NCT02224183. Veterans Back to Health: a study comparing yoga and education for veterans with chronic low back pain. clinicaltrials.gov/ct2/show/NCT02224183 (first received: 20 August 2014).
    1. Saper RB, Lemaster CM, Elwy AR, Paris R, Herman PM, Plumb DN, et al. Yoga versus education for veterans with chronic low back pain: study protocol for a randomized controlled trial. Trials 2016;17(1):224. - PMC - PubMed

References to ongoing studies

CTRI/2018/09/015851 {published data only}
    1. CTRI/2018/09/015851. To study the effectiveness of yoga in back pain [To study the effectiveness of yoga postures in the management of chronic non specific low back pain]. www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=28388 (first received 26 September 2018).
CTRI/2018/10/016132 {published data only}
    1. CTRI/2018/10/016132. A study to compare the effect of yoga and back school exercise for the treatment of low back pain in school teachers [Effectiveness of back school exercise versus yogasana among school teachers with chronic low back pain: a randomized controlled trial]. www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=28760 (first received 24 October 2018).
CTRI/2020/04/024951 {published data only}
    1. CTRI/2020/04/024951. Yoga therapy for management of chronic low back pain. www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2020/04/024951 (first received 30 April 2020).
CTRI/2020/05/025396 {published data only}
    1. CTRI/2020/05/025396. Yoga therapy versus usual care for chronic low back pain. www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=42949 (first received 27 May 2020).
CTRI/2020/12/029944 {published data only}
    1. CTRI/2020/12/029944. Effectiveness of yoga and mindfulness meditation on low back pain in computer users. www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2020/12/029944 (first received 21 December 2020).
CTRI/2021/03/031733 {published data only}
    1. CTRI/2021/03/031733. Effectiveness of yoga therapy versus Pilates exercises in school teachers with non-specific chronic low back pain. www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2021/03/031733 (first received 5 March 2021).
CTRI/2021/03/031735 {published data only}
    1. CTRI/2021/03/031735. An additional effect of yoga therapy in bank employees with chronic low back pain. www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2021/03/031735 (first received 5 March 2021).
CTRI/2021/03/031736 {published data only}
    1. CTRI/2021/03/031736. Effects of yoga therapy in university professors with chronic low back pain. www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2021/03/031736 (first received 5 March 2021).
NCT03816007 {published data only}
    1. NCT03816007. Yoga and mantram for chronic pain and PTSD [An enhanced mind-body intervention to reduce disability and pain in veterans with PTSD]. clinicaltrials.gov/ct2/show/NCT03816007 (first received 25 January 2019).
NCT04000685 {published data only}
    1. NCT04000685. The effects of different exercise approaches in patients with chronic low back pain [The effects of different exercise approaches on physical and cognitive variables in patients with chronic low back pain]. clinicaltrials.gov/ct2/show/nct04000685 (first received 27 June 2019).
NCT04142177 {published data only}
    1. NCT04142177. Sequential and Comparative Evaluation of Pain Treatment Effectiveness Response (SCEPTER). clinicaltrials.gov/show/NCT04142177 (first received 29 October 2019).
NCT04203888 {published data only}
    1. NCT04203888. Personalized trial for chronic lower back pain [Re-engineering precision therapeutics through N-of-1 trials]. clinicaltrials.gov/ct2/show/NCT04203888 (first received 18 December 2019).
NCT04270617 {published data only}
    1. NCT04270617. The effect of yoga practice on chronic back pain [A prospective, randomized-controlled study to evaluate the effect of a standardized yoga practice on chronic back pain]. clinicaltrials.gov/ct2/show/NCT04270617 (first received 17 February 2020).
NCT04721639 {published data only}
    1. NCT04721639. To observe the effect of Sphinx Pose (Salamba Bhujangasana) among health care providers with chronic low back pain. clinicaltrials.gov/show/NCT04721639 (first received 22 January 2021).
NCT04723225 {published data only}
    1. NCT04723225. Effectiveness of cat-cow yoga in managing chronic low back pain. clinicaltrials.gov/show/NCT04723225 (first received 25 January 2021).
NCT04787094 {published data only}
    1. NCT04787094. The effect of yoga and stabilization exercises in individuals with chronic low back pain. clinicaltrials.gov/show/NCT04787094 (first received 8 March 2021).
NCT04824547 {published data only}
    1. NCT04824547. Evaluation of long-term continuity of exercises in low back pain individuals. clinicaltrials.gov/show/NCT04824547 (first received 1 April 2021).
PACTR202001829834757 {published data only}
    1. PACTR202001829834757. Physical activity effectiveness for chronic non-specific low back pain treatment in Burundi. pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9580 (first received 27 January 2020).

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References to other published versions of this review

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