Can Yoga or Physical Therapy for Chronic Low Back Pain Improve Depression and Anxiety Among Adults from a Racially Diverse, Low-Income Community? A Secondary Analysis of a Randomized Controlled Trial.

Abstract Objective To determine and compare the effect of yoga, physical therapy (PT), and education on depressive and anxious symptoms in patients with chronic low back pain (cLBP) Design Secondary analysis of a randomized controlled trial Setting Academic safety-net hospital and 7 community health centers Participants 320 adults with cLBP Intervention Yoga classes, PT sessions, or an educational book Outcome Measure Depression and anxiety were measured using the Patient Health Questionnaire (PHQ-8) and Generalized Anxiety Disorder (GAD-7) scale, respectively, at baseline, 12, and 52 weeks. We identified baseline and mid-treatment (6-week) factors associated with clinically meaningful improvements in depressive (≥3 points) or anxious (≥2 points) symptoms at 12 weeks. Results Participants (female=64%, mean age=46.0 [SD=10.7]) were predominantly non-white (82%), low-income ( Conclusion In our secondary analysis we found that depression and anxiety, common in this sample of underserved adults with cLBP, may improve modestly with PT and yoga. However, effects were not superior to education. Improvements in pain and function are associated with a decrease in depressive symptoms. More research is needed to optimize the integration of physical and psychological well-being in PT and yoga.