Effectiveness of Integrated Approach of Yoga Therapy (IAYT) Versus Usual Care in Management on Chronic Low Back Pain Patients: a Randomized Controlled Pilot Study

Abstract This is a controlled randomized trial which evaluated the clinical and molecular changes resulting from Integrated approach of yoga therapy (IAYT) as an adjunct regimen and compared it with usual care for the management of chronic low back pain patients.­­ We enrolled 29 adult patients with chronic low back pain (CLBP). Patients were randomly divided into two groups. Control group received the usual care of treatment as per institutional protocol. The yoga group received IAYT as an adjunct to usual care. Primary outcomes were pain Intensity assessed by verbal numerical rating scale (VNRS) and functional ability assessed by Modified Oswestry Disability Index (MODI). Secondary outcomes were pain catastrophizing, quality of life, fear of movement related to CLBP, type of pain, levels of ß-Endorphin and TNF α and Salivary CGRP. All parameters were measured at baseline, one month, and three months. Significant decrease in VNRS score at 1 and 3 months was observed in both the groups with yoga group showing a more significant reduction in pain over time than the control group (p=0.036). MODI improved significantly only in the yoga group at 1 and 3 months. Intergroup comparison revealed significantly better MODI over time in the yoga group (p< 0.001). DN4, PDQ, PCS, HADS (anxiety) and Euro QOL had a statistically significant improvement at 1 month and 3 months in the Yoga group compared to the Control group. The HADS (depression) had a statistically significant reduction scores in yoga group at 3 months compared to control group (p=0.012). There was a significant reduction in TNF- α values in the yoga group compared to baseline(p=0.004). IAYT therapy helped in addressing the psychological components of pain and improved quality of life patients with chronic low back pain compared to usual care.