Context: Patients suffering from chronic low back pain (cLBP) are often unsatisfied with medical care and seek alternative therapies. Many mind-body techniques claim to help patients with LBP by enhancing “body awareness” which includes proprioception deficient in cLBP but have not been rigorously studied in cLBP.

BT is a western mind-body therapy integrating body-awareness, breathing, meditation, and movement. Preliminary data suggest benefits from BT for proprioception and LBP.

Objective: To assess the effect of Breath Therapy on cLBP.

Design: Randomized controlled trial.

Setting: Academic medical center.

Subjects: 36 patients with cLBP.

Interventions: Breath Therapy (BT) versus Physical therapy (PT).

Main Outcome Measures: Pain by visual analog scale (VAS), function by Roland Scale, overall health by SF-36 at baseline, 6-8 weeks, and 6 months. Balance as a potential surrogate measure for proprioception and body-awareness.

Results: Pre to post intervention patients in both groups improved in pain (VAS: -2.7 with BT, -2.4 with PT; SF-36: +14.9 with BT and +21.0 with PT). BT recipients improved in function (Roland: –4.8) and in the physical and emotional role (SF-36: +15.5 and 14.3). PT recipients improved in vitality (SF-36: +15.0). Average improvements were not different between groups. At 6-8 weeks results showed a trend favoring BT, at 6-months favoring PT. Balance measures showed no improvements and no correlations with other outcomes.

Conclusions: Patients suffering from cLBP improved significantly with BT. Changes in standard LBP measures of pain and disability were comparable to those from high-quality, extended PT. BT was safe. Qualitative data suggested improved coping skills and new insight into the effect of stress on the body from BT. Balance measures did not seem to be valid measures of clinical change in LBP.