Poster Presentation: Effects of Pranayama Yoga Breathing on Chronic Low Back Pain :A Randomized Controlled Trial
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CAN A BIOPSYCHOSOCIAL MODEL OF THE 3-PART PRANAYAMA (YOGA BREATHING TECHNIQUE IMPROVE PAIN, DISABILITY STATUS, AND QUALITY OF LIFE IN INDIVIDUALS WITH CHRONIC LOW BACK PAIN?
This poster on the Effects of Pranayama for Back Pain Randomized Controlled Trial was presented by Dr. Mohammad Hadadzadeh and Dr. Jessica Tierney at the American Physical Therapy Association (APTA)'s Combined Sections Meeting on Saturday, February 14th in the Orthopedics Section.
ABSTRACT
Background
Chronic LBP (CLBP) is a major cause of work loss, participation restriction and reduced quality of life, with more than 100% increase in prevalence in the last decade. The management guidelines recommend a biopsychosocial model of care. While the multifaceted approach of pranayama yoga has potential to fit in this model, the evidence is non-conclusive, and leading organizations lack specific practice recommendations on this intervention.
Purpose
To determine the effectiveness of pranayama in patients with CLBP measured by SF-36, McGill Pain Questionnaire (McGill-PQ), and Oswestry Disability Index (ODI).
Methods / Materials
Participants:
28 adults with CLBP
Study Design:
Single-blinded RCT. Upon IRB approval and obtaining written consent, participants were randomly (block randomization) allocated into Pranayama (PG) or control (CG) groups through concealed envelope method. Assessors of the outcomes were masked to the allocation of subjects.
Sample size calculation (power of 90%, α=0.05, minimal detectable change of 10 for SF-36,and attrition rate of 20%) revealed nPG=21. For feasibility reasons, a ratio of (3/1) was used to recruit total N=28.
Eligibility Criteria:
Inclusion Criteria: Individuals with CLBP (at least three months), age 18 or older who were able to lay in supine hook-lying position for 30 minutes and gave consent to commit to a 2 day/week practice including transportation to/from a local yoga studio.
Exclusion Criteria: Individuals who had practiced yoga more than 1 time per week within the past 3 months, or with any history of back surgery, or diagnosed with any cardiopulmonary disease that limited their daily activities or produced any abnormal breathing patterns.
Intervention:
Pranayama Group (PG): (nPG=21) One week initial training with 2 days/week of supervised Dirgha pranayama (three-part breath) and followed a 2 day/week home practice monitored with a log-book for a total of 8 weeks.
Control Group (CG): (nCG=7) only physician instructions, after baseline followed the evaluation. They returned to the studio for follow up evaluation. At the end, participants were given access to the eight-week breathing program (website address or CDs), an hour-long yoga & education intervention, as well as a voucher for a complimentary yoga class at the studio.
Outcome Measures:
SF-36, McGill Pain Questionnaire (McGPQ), and Oswestry Disability Index (ODI) were used to quantify changes in quality of life, pain, and disability status, respectively.
Instruments:
Yoga mats, blocks, and bolsters as well as studio space provided by a local yoga studio and a certified yoga instructor.
iPad 2 used for recording app and trainings that were posted on a website that was created for this study for free access following the end of the experiment.
Compact discs were purchased to record the audio interventions for participants who were unable to access the internet.
Data Analysis:
Descriptive analysis and One one-way repeated measures ANOVA with an Intention-to-Treat approach was utilized to compare the effects of the intervention within groups and between groups. The level of significance was kept at p≤ 0.05 with power of 90%. IBM SPSS Statistics v-23 software was used to run the statistical tests.
Results
19 out of 28 subjects (age 47.7±3.33 years) (M/F:7/12) fully completed the study protocol with a follow up at week 8.
Both groups were similar at baseline with respect to demographic and clinical characteristics except BMI. Statistical tests were adjusted for this covariate.
SF-36 was significantly improved in pranayama group (113.28±37.07-to-144.77±38.80) compared with control (121.01±19.64-to-145.16±28.45) group (p=0.002). Further post-hoc analysis of SF-36 subsets revealed significant improvement in the Physical Component Score in favor of pranayama (53.17±20.53-to-72.38±18.93) compared with control (56.09±21.80-to-72.50±17.27) group (p=0.002). Mental Component Score of SF-36 showed marginally significant improvement in favor of pranayama group (63.94±28.94-to-72.40±20.80) compared with control (64.92±14.61 to 72.66±16.54) group (p=0.05).
McGill-PQ and ODI after adjustment for BMI however showed some improvement but statistically non-significant. Results are summarized in table and graphs below.
Conclusion
8 weeks of the pranayama intervention improved quality of life, reduced pain, and may have improved disability status in CLBP.
Dirgha Pranayama (a 3-part breathing practice of yoga) has the potential to improve outcomes of CLBP. However, evidence is scarce. Due to its accessibility and easy usage as a home exercise, pranayama may offer a simple and cost-effective intervention to the epidemic of CLBP.
Further research is warranted.
THE COMBINED SECTIONS MEETING
Dr. Jessie Tierney and Dr. Mohammad Hadadzadeh presented the poster at APTA's Combined Sections Meeting on February 14, 2026 in Anaheim, CA.
THE INTERVENTION:
AN INVITATION TO TRY IT YOURSELF
The researchers have made the entire intervention available for free (make sure to use the Coupon Code – JUSTBREATHE – at checkout) on this website.
ACKNOWLEDGEMENTS
Special thanks to the original research team, Kaitlyn Herzog, Cody Benavides, Lindsay Schooler, and Happy Goat Yoga in Wheeling WV.
DOWNLOAD THE POSTER
Click for a downloadable PDF of the poster:
CITATION
Hadadzadeh M, Tierney J, Herzog K, Benavides C, Schooler L. Effects of Pranayama Yoga Breathing on Chronic Low Back Pain: A Randomized Controlled Trial. Poster presented at: American Physical Therapy Association Combined Sections Meeting; February 14, 2026; Anaheim, CA. Presented by Hadadzadeh M, Tierney J.
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