# Rage Against the Pain: An Alternative Yoga Program to Address Chronic Low Back Pain Among Veterans

> **NIH VA I21** · EDWARD HINES JR VA HOSPITAL · 2021 · —

## Abstract

Background: Low back pain is a leading cause of disability among US adults, and can drive opioid use
and associated adverse outcomes. VA considers low back pain a significant problem and is highly
motivated to take action to improve Veteran engagement in pain care (including complementary and
integrative treatments). Yoga is recommended as a front-line treatment for low back pain, however, yoga
adoption among Veterans is low. One potential barrier to adoption among Veterans may be their
perceptions of yoga, which for some, encompass long-held but often inaccurate beliefs of what engaging in
yoga entails and how their participation will be viewed by others. To facilitate uptake and sustained use of
yoga, we propose to offer Veterans a different yoga experience that imparts the same pain management
benefits but may better align with their preferences and resonate more with their interests. We call this yoga
program, Rage Against the Pain (RAP) `High Intensity Stretching'.
 Significance/Impact: If this study finds that RAP is feasible and acceptable to Veterans who experience
chronic low back pain, it will provide an innovative approach to address a top priority of the VA – using CIH
programs for pain management and opioid use reduction. Our long-term goal is to develop a scalable and
sustainable alternative yoga program to help Veterans with chronic pain who may not find other available
pain management options to be appealing or effective.
 Innovation: Our proposed RAP program promotes yoga as less of a meditative, introspective activity
done to quiet calming music and more of an expressive, active practice set to music commonly enjoyed
among many Veterans (e.g., rock, metal). The development of RAP (and the program name) reflects direct
Veteran feedback, and was inspired by “rage yoga.” We will draw upon and tailor the aspects of rage yoga
that make the most sense for Veteran health needs, adopting the beneficial aspects of the concept (e.g.,
traditional yoga poses, alternative music, outward self-expression).
 Specific Aims: Our overall goal is to develop and evaluate the RAP program, intended to improve
Veteran participation in yoga and by extension, outcomes among Veterans with chronic low back pain.
Specific Aims are to: (1) Develop the RAP program, which will encompass finalizing the program curriculum,
including music play-lists, cues for self-expression, and sets of yoga movements known to alleviate low
back pain; (2) Examine the feasibility and acceptability of offering RAP for Veterans with chronic low back
pain, and; (3) Gather preliminary data to provide the foundation for a future trial to examine the potential
effectiveness of RAP on Veterans' outcomes and medication use.
 Methodology: Veterans who experience chronic low back pain will be invited to participate; eligible
participants will be randomized into RAP or a Hatha yoga program. Classes will be 75 minutes long, held
once a week for 12 weeks, and taught by VA recreation therapis...

## Key facts

- **NIH application ID:** 9948199
- **Project number:** 1I21HX003134-01
- **Recipient organization:** EDWARD HINES JR VA HOSPITAL
- **Principal Investigator:** Bella Etingen
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-10-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9948199

## Citation

> US National Institutes of Health, RePORTER application 9948199, Rage Against the Pain: An Alternative Yoga Program to Address Chronic Low Back Pain Among Veterans (1I21HX003134-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9948199. Licensed CC0.

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