Management of Chronic Spine Pain for U.S. Military Veterans during the COVID-19 Pandemic: Development of Virtual Chiropractic and Yoga Group Education

ABSTRACT

Methods: An experienced yoga therapist and chiropractor collaborated to develop a manualized series of 4 virtual combination yoga and chiropractic classes tailored to the needs of primarily older veterans with chronic back pain. The sessions emphasized education about spine health with practical exercises and other self-care strategies to decrease back pain. Over 4 onehour sessions, a cohort of two to six veterans practiced these chiropractic principles (e.g. postural correction, abdominal bracing, spine sparing strategies), gentle yoga postures, and relaxation and mindfulness exercises, each class building on the one before. Results: Four veteran cohorts were conducted from February 2021 through August 2021. Veterans reported feeling better equipped to manage their back pain and were more active after engaging in these classes. Delivering the classes via telehealth not only facilitated veterans' participation during COVID-19, but also allowed for the inclusion of some rural veterans who often lack access to integrative pain management resources. Other veterans struggled to participate virtually however due to lack of comfort with technology, or not having adequate equipment, or bandwidth. Background: The COVID-19 pandemic has severely limited patients' access to in-person manual (e.g. chiropractic) and complementary and integrative therapies, such as yoga, to manage chronic back pain. We sought to pilot a series of virtual classes combining yoga therapy with education and exercises to improve spine health and increase veterans' selfmanagement of chronic back pain. Conclusion: Challenges in providing in-person spine care during COVID-19 have been overcome by this novel collaboration between chiropractic care and yoga therapy, emphasizing patient education, active care strategies and empowerment of veterans. Future courses will need to consider recruitment efforts as well as providing enhanced technical support to help close the digital divide.