Please select the eligibility criteria that correspond to the clinical trial below.
Title: Yoga Therapy to Improve Function Among Veterans With Chronic Low Back Pain
Brief Summary: Chronic low back pain (CLBP) is a prevalent condition among VA patients, but many current treatment options have limited effectiveness. In addition to chronic pain, people with chronic low back pain experience increased disability, psychological symptoms such as depression, and reduced health-related quality of life. This randomized controlled study will examine the impact of yoga therapy for improving function and decreasing pain in VA patients with chronic low back pain. Although not every VA patient with chronic low back pain will choose to do yoga, it is an inexpensive treatment modality that is increasingly appealing to many VA patients. If yoga is effective, it could become an additional low-cost option that the VA can offer to better serve Veterans with chronic low back pain.


Options:
A: Inclusion Criteria:

* non- specific low back pain,
* 18-60 years old,
* \> 90 points on the OMPSQ screening questionnaire for yellow flags and sufficient understanding of the Swedish language

Exclusion Criteria:

* presence of so called Red flags,
* pregnancy,
* comorbidities affecting the ability to perform the interventions,
* presently on sick leave for \> 8 weeks,
* ongoing regular weekly yoga practice or strength training.
B: Inclusion Criteria:

1. Enrolled in methadone maintenance treatment or buprenorphine treatment for 3 or more months;
2. Plan to continue this treatment for next 6 months;
3. Chronic pain, defined as pain duration for at least three months (Dworkin et al., 2012), a mean score of 4 or higher on the BPI Pain Interference Scale (C. S. Cleeland \& Ryan, 1994), and pain severity of 4 or higher on a Visual Analog Scale (0-10) indicating "worst pain in the last week"(Breivik et al., 2008; Jensen, Chen, \& Brugger, 2003);
4. No current psychosis;
5. Do not anticipate have surgery in the next 6 months;
6. Not currently taking yoga classes, not practicing yoga once per week or more often at home;
7. Not engaging in meditation once per week or more often;
8. Medically cleared by a primary care physician or SSTAR's OAT physician for mild-moderate physical activity (this is the only criterion NOT required for Phase 1 participants);
9. Not pregnant;
10. Aged 18 or older;
11. Proficiency in English sufficient to engage in informed consent in English and understand classes taught in English.

Exclusion Criteria:

-
C: Inclusion Criteria:

* Current non-specific low back pain persisting for at least 12 weeks
* 18-64 years old
* Mean low back pain intensity for the previous week of 4 or greater on a 0 to 10 numerical rating scale (0=no pain to 10=worst possible pain)
* English fluency sufficient to follow treatment instructions and answer survey questions.

Exclusion Criteria:

* New CLBP treatments started within the previous month or anticipated to begin in the next 3 months
* Known pregnancy
* Inability to understand English at a level necessary to understand treatment instructions and survey questions
* Previous back surgery or back fracture
* Specific CLBP pathologies (including spinal canal stenosis, severe scoliosis, spondylolisthesis, ankylosing spondylitis, large herniated disk)
* Severe or progressive neurological deficits
* Sciatica pain equal to or greater than back pain
* Active or recent cervical radiculopathy
* Active or planned worker's compensation, disability, or personal injury claims
* Lack of consent
* Significant participation in yoga or physical therapy in the last six months
* Has read The Back Pain Helpbook or the Back Book in the previous six months
* The principal investigator judges the participant to be unable to participate in the study due to serious medical and/or psychiatric comorbidities
* Has previously participated in the Yoga Dosing Study or the Physical Therapy Pilot
* Plans to move out of the Boston area in the next year
D: Inclusion Criteria:

* Has a VA primary care provider
* Diagnosis of chronic low back pain \> 6 months
* Willing to attend a yoga program or be assigned to delayed treatment with yoga
* Willing to complete 4 assessments
* English Literacy
* Has not begun new pain treatments or medications in the past month
* Willing to not change pain treatments (e.g., discontinue a treatment; increase medication dose) during the 12-week intervention period unless medically necessary

Exclusion Criteria:

* back surgery within the last 12 months
* back pain due to specific systemic problem (eg, lupus, scleroderma, fibromyalgia)
* morbid obesity (BMI \> 40)
* Significant sciatica or nerve compression \< 3 months or chronic lumbar radicular pain \> 3 months
* Unstable, serious coexisting medical illness (eg, CHF, cancer, COPD, morbid obesity; dementia)
* Unstable, serious psychiatric illness (e.g., unmanaged psychosis, active substance dependence)
* Insufficient data to rule out acute, metastatic disease, (unless primary care physician approves)
* Attended or practiced yoga \> 1x in the last 12 months
* Positive Romberg test (with or without sensory neuropathy)

Answer: D