Yoga vs. Education for Veterans With Chronic Low Back Pain

Chronic low back pain (cLBP) is the most common pain condition in the military, causing
substantial physical and psychological suffering, reduction in force readiness, and high
economic cost. Yoga has been studied in 10 RCTs in civilian populations with cLBP suggesting
it may be effective in reducing pain intensity, improving back-related function, and
lowering pain medication use. Multiple differences exist between civilian and military
populations with cLBP, making it necessary to adapt and test yoga for cLBP in military
populations. This study's primary aim is to evaluate the effectiveness of yoga for reducing
pain in military personnel and Veterans with cLBP through a structured, reproducible 12-week
series of hatha yoga classes, supplemented with home practice, compared to an education
group. Additionally, the enormous mental health burden often shouldered by returning
military personnel presents another important distinguishing factor. Thus, the study's
secondary aim is to assess yoga's capacity to reduce post-traumatic stress symptoms (PTSS).
The third aim is to evaluate the cost-effectiveness of yoga for cLBP at 3 months and 6
months from the perspective of the provider, the Veteran, and the Veterans Health
Administration. The fourth and final aim is to evaluate the effect of back pain and yoga on
marital and family functioning. The proposed RCT will (1) establish a structured
reproducible yoga protocol uniquely suited to Veterans populations with cLBP; (2) develop
web-based delivery systems to assist Veterans in yoga home practice; (3) increase our
knowledge of the feasibility and impact of yoga for Veterans' cLBP and psychological
comorbidities. These results will help determine whether yoga is an effective modality for
addressing cLBP in a Veteran population.