Yoga for Back Pain in Adolescent Scoliosis

Scoliosis, the most prevalent spinal pathology in children and adolescents, is characterized by a coronal plane spinal curvature more than 10 degrees. Adolescent Idiopathic Scoliosis (AIS) is estimated to impact upwards of 5% of the population with a 3:1 female to male ratio. Treatment options are dictated by curve magnitude and future growth potential. Observation, bracing, supportive physical therapy may be recommended. Research has consistently demonstrated an increasing prevalence of low back pain (LBP) in both children and adolescents over the last few decades. Recent meta-analysis showed that amongst adolescence with LBP, scoliosis is the highest associated abnormality. In addition, biopsychosocial factors are also highly associated with the presence of back pain amongst the AIS population. AIS has been shown to be significantly associated with decreased sleep quality, and depression that is coupled with chronic and/or episodic LBP. This research suggests that patients with AIS should have a psychosocial profile in addition to curve magnitude, and LBP level monitoring. According to the National Health Interview Survey, 20% of alternative health practitioners state that the practitioners participate in yoga classes for general back pain. The popularity of yoga in the US has increased to an estimated 35 million in 2017, and has become the most utilized complementary health approach. Results of these studies support not only physiological improvement in flexibility, relaxation, and body awareness, but also reduces oxidative stress and inflammation, increases release of neurotransmitters, anxiety and increases pain tolerance resulting in psychological improvement as well. The investigator's study will utilize a well-define a twenty-minute yoga protocol that will be added to some patients undergoing symptomatic non-operative scoliosis treatment. The investigators will measure the angle to see if there is change, the investigator's primary focus will be on reduction of back pain in AIS. This study consists of a randomized clinical trial with non-operative AIS patients at Johns Hopkins Hospital. The trial will consist of two branches of non-operative AIS patients: 1. Patients that brace, 2. Patients who do not brace. This allocation will be achieved through random assignment to either the patient's standard of care as prescribed with or without the addition of yoga.