Effect of Iyengar yoga therapy for chronic low back pain Kimberly Anne Williams a, * , John Petronis b , David Smith c , David Goodrich d , Juan Wu e , Neelima Ravi f , Edward J. Doyle Jr a , R. Gregory Juckett g , Maria Munoz Kolar h , Richard Gross i , Lois Steinberg j a Dept. Community Medicine, West Virginia University School of Medicine, Morgantown, WV 26505, USA b Division of Physical Therapy, Department of Human Performance and Exercise Science, West Virginia School of Medicine, Morgantown, WV 26505, USA c Dept. Biochemistry/Molecular Pharmacology, West Virginia University School of Medicine, Morgantown, WV 26505, USA d Dept. Health Promotion/Risk Reduction, West Virginia University School of Nursing, Morgantown, WV, USA e Center for International Data Evaluation & Analysis, University of California, San Francisco, CA, USA f Cardiac Arrhymia Center, Washington Hospital Center, Washington, DC, USA g Family Medicine, West Virginia University School of Medicine, Morgantown, WV, USA h Internal Medicine, West Virginia University School of Medicine, Morgantown, WV, USA i Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Morgantown, WV, USA j BKS Iyengar Institute of Champaign-Urbana, IL, USA Received 29 July 2004; received in revised form 2 February 2005; accepted 14 February 2005 Abstract Low back pain is a significant public health problem and one of the most commonly reported reasons for the use of Complementary Alternative Medicine. A randomized control trial was conducted in subjects with non-specific chronic low back pain comparing Iyengar yoga therapy to an educational control group. Both programs were 16 weeks long. Subjects were primarily self-referred and screened by primary care physicians for study of inclusion/exclusion criteria. The primary outcome for the study was functional disability. Secondary outcomes including present pain intensity, pain medication usage, pain-related attitudes and behaviors, and spinal range of motion were measured before and after the interventions. Subjects had low back pain for 11.2G1.54 years and 48% used pain medication. Overall, subjects presented with less pain and lower functional disability than subjects in other published intervention studies for chronic low back pain. Of the 60 subjects enrolled, 42 (70%) completed the study. Multivariate analyses of outcomes in the categories of medical, functional, psychological and behavioral factors indicated that significant differences between groups existed in functional and medical outcomes but not for the psychological or behavioral outcomes. Univariate analyses of medical and functional outcomes revealed significant reductions in pain intensity (64%), functional disability (77%) and pain medication usage (88%) in the yoga group at the post and 3-month follow-up assessments. These preliminary data indicate that the majority of self-referred persons with mild chronic low back pain will comply to and report improvement on medical and functional pain-related outcomes from Iyengar yoga therapy. q 2005 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved. Keywords: Back pain; Yoga; Functional disability; Pain 1. Introduction Low back pain (LBP) is a public health problem that has reached epidemic proportions (Shelerud, 1998). In the US, 70–85% of the population has had at least one episode of back pain sometime in their life (Andersson, 1999). LBP is one of the most commonly reported reasons for use of Complementary Alternative Medicine (CAM) (Eisenberg et al., 1993, 1998). An estimated 14.9 million Americans practice yoga, 21% of which use it for treating neck and back pain (Saper et al., 2002). Astanga yoga is comprised of eight limbs including moral injunctions, rules for personal conduct, postures, breath control, sense withdrawal, concentration, meditation and self-realization (Taimini, 1986). Of the many styles of Pain 115 (2005) 107–117 www.elsevier.com/locate/pain 0304-3959/$20.00 q 2005 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved. doi:10.1016/j.pain.2005.02.016 * Corresponding author. Tel.: C1 304 293 7559; fax: C1 304 293 6685. E-mail address: kwilliams@hsc.wvu.edu (K.A. Williams).