Is yoga really helpful in reducing pain in the low back?
In a recent study at Boston Medical Center, yoga was found to be as effective as physical therapy in reducing chronic low back pain. This is of great consequence since chronic low back pain is the most common pain problem in the country. The results of this research were presented by Dr. Robert B. Saper, M.D., director of integrative medicine at Boston Medical Center, at the 2016 Annual Meeting of the American Academy of Pain Management.
When exploring alternative methods of treatment of back pain, it is important to consult with highly skilled physiatrists, physicians well-versed in various types of nonsurgical and orthopedic rehabilitation.
Reasons for the Comparative Study
Previous studies had already shown that pain and function improve with both physical therapy (PT) and yoga and that both are capable of reducing the need for pain medication. Dr. Saper’s research was designed to evaluate the comparative effectiveness of the two. As he says, “To get a complementary health practice into mainstream health care, I would say that (at minimum) it has to be as effective as the conventional therapy, and perhaps offer other benefits, like cost-effectiveness.”
Methods of Comparative Research
The patients chosen for the Boston study were 320 adults who suffered from chronic back pain but had not been diagnosed with any obvious anatomical cause (e.g. scoliosis, spinal stenosis). Furthermore, the patients rated their back pain as “quite high,” on average 7 out of 10 on the pain scale. They considered themselves “quite disabled” by their back pain. Almost 75 percent of these patients were taking painkillers to alleviate their pain; 20 percent were taking opioids.
Dr. Saper points out that it was easy to recruit patients for the study since there are so many people suffering chronic back pain for whom previous treatments have not provided relief. The patients were divided randomly into three groups to receive one of the designated treatments: yoga, PT, or education.
The education group received a comprehensive book on back pain. The PT group had 15 one-on-one 60 minute sessions that included aerobic exercise. The yoga group received the following:
- Short briefing on yoga philosophy
- 75-minute weekly sessions with a very low student-to-teacher ratio
- Yoga mats on which to perform simple yoga poses
- DVD to practice yoga poses at home
Although the yoga classes were gentle, some patients, particularly those who were obese, experienced some difficulty following the directions.
Although the PT and yoga participants on average attended only little more than half of the available sessions, the two groups reported very similar results after 12 weeks. There were also similar results for pain scores. Approximately the same number of yoga and PT subjects reported feeling “very satisfied” or “very improved” after the program was completed. Yoga was shown to be as safe as either of the other treatments; only a few patients experienced temporary mild exacerbation of symptoms.
Besides the fact that patients did not attend the programs as regularly as the study required, it is not possible to assess whether any but a well-structured yoga program like the one offered during the research would be as effective. Researchers, now evaluating comparative costs, are also looking forward to finding ways to ensure greater participation in yoga programs.
- Catherine Bushnell, PhD, of the National Center for Complementary and Integrative Health at the National Institutes of Health, who also presented at the conference, provided evidence that yoga has a positive impact on the brain. The longer one practices yoga, the more profound the positive changes.
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