BACKGROUND: Previous studies have demonstrated that once-weekly yoga classes are effective for chronic low back pain (cLBP) in white adults with high socioeconomic status. The comparative effectiveness of twice-weekly classes and generalizability to racially diverse low income populations are unknown. METHODS: We conducted a 12-week randomized, parallel-group, dosing trial for 95 adults recruited from an urban safety-net hospital and five community health centers comparing once-weekly (n = 49) versus twice-weekly (n = 46) standardized yoga classes supplemented by home practice. Primary outcomes were change from baseline to 12 weeks in pain (11-point scale) and back-related function (23-point modified Roland-Morris Disability Questionnaire). RESULTS: 82% of participants were nonwhite; 77% had annual household incomes < $40,000. The sample's baseline mean pain intensity (6.9 (SD 1.6)) and function (13.7 (SD 5.0)) reflected moderate to severe back pain and impairment. Pain and back-related function improved within both groups (p < 0.001). However, there were no differences between once-weekly and twice-weekly groups for pain reduction (-2.1 (95% CI -2.9 to -1.3) versus -2.4 (95% CI -3.1 to -1.8), p = 0.62) or back-related function (-5.1 (95% CI -7.0 to -3.2) versus -4.9 (95% CI -6.5 to -3.3), p = 0.83). CONCLUSIONS: Twelve weeks of once-weekly or twice-weekly yoga classes were similarly effective for predominantly low income minority adults with moderate to severe chronic low back pain. This trial is registered with ClinicalTrials.gov NCT01761617.

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