Improve Physical and Mental Health in Trauma Victims with Bikram Yoga

Improve Physical and Mental Health in Trauma Victims with Bikram Yoga

 

By John M. de Castro, Ph.D.

 

The steamy temps “allow you to increase their range of motion and stretch deeper within each pose,” since heat makes muscles more pliable, says Numbers. Unlike stretching it out in a standard cool yoga studio, the heat will have you feeling like a pro and extending further than you thought you could.” – Aryelle Siclait

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. Trauma can produce troubling physical and psychological symptoms that need to be addressed. There are a number of therapies that have been developed to treat the effects of trauma. One of which, mindfulness training has been found to be particularly effective. Yoga practice is a mindfulness practice that has been shown to be helpful for trauma survivors.

 

Yoga is a mindfulness practice that has been shown to improve physical well-being and cardiovascular health. Bikram Yoga is somewhat unique yoga practice as it employs a set sequence of 26 poses (asanas) and two breathing exercises. It is practiced in a heated environment (105°F, 40.6°C, 40% humidity) and there is a unique programmed instructional dialogue. The hot environment is thought to soften the muscles making them more pliable and loosen the joints making them more flexible allowing the practitioner to go deeper into poses. The sweating that occurs is thought to help remove toxins and impurities.

 

In today’s Research News article “#MindinBody – feasibility of vigorous exercise (Bikram yoga versus high intensity interval training) to improve persistent pain in women with a history of trauma: a pilot randomized control trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714085/), Flehr and colleagues recruited adult pre-menopausal women who had persistent pain and who had experienced trauma. They were randomly assigned to receive 8 weeks of 3 sessions per week of Bikram Yoga (90 minutes) or High Intensity Interval Training (45 minutes). The women were measured before and after training for pain severity, pain interference with quality of life, health, anxiety, depression, perceived stress, disorders of extreme stress, self-efficacy, life stressors, mindfulness, body size, and electrocardiogram (EKG) measures.

 

They found that pain significantly decreased for both groups. On the other hand, Bikram Yoga produced significantly greater improvements in physical functioning, mental health, and heart rate variability with moderate to large effect sizes. No intervention related injuries were reported. Heart rate variability has been shown to measure greater parasympathetic nervous system activity reflecting better overall health.

 

The results suggest that although both programs produced decreased pain intensity, Bikram Yoga was superior to a comparable high intensity exercise in improving the physical and mental health of trauma survivors with persistent pain. A strength of the study is that the Bikram Yoga intervention was compared to another high intensity exercise program, thus reducing the likelihood of participant expectancy effects. Hence Bikram Yoga appears to be a safe and effective treatment for women who have experienced trauma. It would be interesting in the future to compare the Bikram Yoga program to a comparable yoga program practiced at room temperature.

 

So, improve physical and mental health in trauma victims with Bikram Yoga.

 

Hot yoga addresses all aspects of physical fitness including muscular strength, endurance, flexibility and weight loss. . . . There is no other style of yoga that addresses the overall health of the body in such a comprehensive way.” – Peter Mason

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Flehr, A., Barton, C., Coles, J., Gibson, S. J., Lambert, G. W., Lambert, E. A., … Dixon, J. B. (2019). #MindinBody – feasibility of vigorous exercise (Bikram yoga versus high intensity interval training) to improve persistent pain in women with a history of trauma: a pilot randomized control trial. BMC complementary and alternative medicine, 19(1), 234. doi:10.1186/s12906-019-2642-1

 

Abstract

Background

The neurobiology of persistent pain shares common underlying psychobiology with that of traumatic stress. Modern treatments for traumatic stress often involve bottom-up sensorimotor retraining/exposure therapies, where breath, movement, balance and mindfulness, are used to target underlying psychobiology. Vigorous exercise, in particular Bikram yoga, combines many of these sensorimotor/exposure therapeutic features. However, there is very little research investigating the feasibility and efficacy of such treatments for targeting the underlying psychobiology of persistent pain.

Methods

This study was a randomized controlled trail (RCT) comparing the efficacy of Bikram yoga versus high intensity interval training (HIIT), for improving persistent pain in women aged 20 to 50 years. The participants were 1:1 randomized to attend their assigned intervention, 3 times per week, for 8 weeks. The primary outcome measure was the Brief Pain Inventory (BPI) and further pain related biopsychosocial secondary outcomes, including SF-36 Medical Outcomes and heart rate variability (HRV), were also explored. Data was collected pre (t0) and post (t1) intervention via an online questionnaire and physiological testing.

Results

A total of 34 women were recruited from the community. Analyses using ANCOVA demonstrated no significant difference in BPI (severity plus interference) scores between the Bikram yoga (n = 17) and the HIIT (n = 15). Women in the Bikram yoga group demonstrated significantly improved SF-36 subscale physical functioning: [ANCOVA: F(1, 29) = 6.17, p = .019, partial eta-squared effect size (ηp2) = .175 and mental health: F(1, 29) = 9.09, p = .005, ηp2 = .239; and increased heart rate variability (SDNN): F(1, 29) = 5.12, p = .013, ηp2 = .150, scores compared to the HIIT group. Across both groups, pain was shown to decrease, no injuries were experienced and retention rates were 94% for Bikram yoga and 75% for HIIT .

Conclusions

Bikram yoga does not appear a superior exercise compared to HIIT for persistent pain. However, imporvements in quality of life measures and indicator of better health were seen in the Bikram yoga group. The outcomes of the present study suggest vigorous exercise interventions in persistent pain cohorts are feasible.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714085/

 

Improve Chronic Low Back Pain in Low Income Patients with Yoga

Improve Chronic Low Back Pain in Low Income Patients with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga’s focus on balance and steadiness encourages your body to develop defenses against the causes of back pain, which include weak abdominal and pelvic muscles, as well lack of flexibility in the hips. When you strengthen these muscles, you improve your posture, which reduces the load on your back, and thus reduces the aches you feel. In addition, stretching can increase flexibility by increasing blood flow to tight muscles.” – Annie Hauser

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses.

 

Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Yoga practice has been shown to have a myriad of health benefits. These include relief of chronic painYoga practice has also been shown to be effective for the relief of chronic low-back pain.  Many forms of yoga focus on the proper alignment of the spine, which could directly address the source of back and neck pain for many individuals. The majority of the research, though, has focused on relatively affluent populations. There is a need to study the effectiveness of yoga practice for low back pain in low-income populations.

 

In today’s Research News article “Physical and Physiological Effects of Yoga for an Underserved Population with Chronic Low Back Pain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746048/), Colgrove and colleagues recruited adult low-income minority group members who had chronic low back pain and assigned them to a wait-list control condition or to receive yoga training twice a week for 60 minutes for 12 weeks. They were measured before and after training for pain, disability, muscle strength, and flexibility. Blood was drawn and the inflammatory marker TNF-α was measured. Finally, they underwent Magnetic Resonance Imaging (MRI) of their brains.

 

They found that in comparison to baseline and the wait-list control group, the yoga group had significantly lower levels of pain, improved abdominal strength, and improved spinal and hip flexibility. Although trends were present there were too few participants to detect significant changes in TNF-α levels or in the brain scans.

 

This was a pilot study assessing feasibility and as such enrolled only a small number of patients. Nevertheless, the results showed that yoga practice improves the pain levels, core strength, and flexibility of low-income minority patients with chronic low back pain. These results are similar to those seen with affluent non-minority populations. These encouraging results support conducting a large randomized controlled clinical study.

 

So, improve chronic low back pain in low income patients with yoga.

 

Yoga is one of the more effective tools for helping soothe low back pain. The practice helps to stretch and strengthen muscles that support the back and spine, such as the paraspinal muscles that help you bend your spine, the multifidus muscles that stabilize your vertebrae, and the transverse abdominis in the abdomen, which also helps stabilize your spine.” – Matthew Sloan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Colgrove, Y. M., Gravino-Dunn, N. S., Dinyer, S. C., Sis, E. A., Heier, A. C., & Sharma, N. K. (2019). Physical and Physiological Effects of Yoga for an Underserved Population with Chronic Low Back Pain. International Journal of Yoga, 12(3), 252–264. doi:10.4103/ijoy.IJOY_78_18

 

Abstract

Background:

Yoga has been shown useful in reducing chronic low back pain (CLBP) through largely unknown mechanisms. The aim of this pilot study is to investigate the feasibility of providing yoga intervention to a predominantly underserved population and explore the potential mechanisms underlying yoga intervention in improving CLBP pain.

Methods:

The quasi-experimental within-subject wait-listed crossover design targeted the recruitment of low-income participants who received twice-weekly group yoga for 12 weeks, following 6–12 weeks of no intervention. Outcome measures were taken at baseline, preintervention (6–12 weeks following baseline), and then postintervention. Outcome measures included pain, disability, core strength, flexibility, and plasma tumor necrosis factor (TNF)-α protein levels. Outcomes measures were analyzed by one-way ANOVA and paired one-tailed t-tests.

Results:

Eight patients completed the intervention. Significant improvements in pain scores measured over time were supported by the significant improvement in pre- and post-yoga session pain scores. Significant improvements were also seen in the Oswestry Disability Questionnaire scores, spinal and hip flexor flexibility, and strength of core muscles following yoga. Six participants saw a 28.6%–100% reduction of TNF-α plasma protein levels after yoga, while one showed an 82.4% increase. Two participants had no detectable levels to begin with. Brain imaging analysis shows interesting increases in N-acetylaspartate in the dorsolateral prefrontal cortex and thalamus.

Conclusion:

Yoga appears effective in reducing pain and disability in a low-income CLBP population and in part works by increasing flexibility and core strength. Changes in TNF-α protein levels should be further investigated for its influence on pain pathways.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746048/

 

Improve Fibromyalgia Symptoms with Mindfulness

Improve Fibromyalgia Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness training is a low-cost, side-effect-free addition to fibromyalgia treatment that almost anyone can try — research suggests it helps you improve negative emotions surrounding fibromyalgia pain and, over time, change the way you respond to and think about your fibromyalgia symptoms.” – Madeline Vann

 

Fibromyalgia is a mysterious disorder whose causes are unknown. It is very common affecting over 5 million people in the U.S., about 2% of the population with about 7 times more women affected than men. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. Fibromyalgia may also have morning stiffness, tingling or numbness in hands and feet, headaches, including migraines, irritable bowel syndrome, sleep disturbances, thinking and memory problems, and painful menstrual periods. The symptoms are so severe and debilitating that about half the patients are unable to perform routine daily functions and about a third have to stop work. Although it is not itself fatal, suicide rates are higher in fibromyalgia sufferers.

 

There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia. Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. The studies are accumulating, so, it would make sense to pause and summarize what has been learned.

 

In today’s Research News article “Mindfulness- and acceptance-based interventions for patients with fibromyalgia – A systematic review and meta-analyses.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719827/), Haugmark and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials exploring the effectiveness of mindfulness- and acceptance-based interventions in the treatment of fibromyalgia. They found 9 published randomized controlled trials employing Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), or Acceptance and Commitment Therapy (ACT).

 

They found that the published research studies report that the mindfulness- and acceptance-based interventions produced small to moderate but significant improvements in the fibromyalgia patients’ levels of pain, depression, anxiety, sleep quality, health-related quality of life, and mindfulness. These benefits were sustained at follow-up but were diminished in magnitude. Hence, these interventions were safe and effective treatments for the suffering and psychological well-being of patients with fibromyalgia.

 

Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), and Acceptance and Commitment Therapy (ACT) are quite different therapies with some vastly different therapeutic techniques. But they all have in common, mindfulness training. So, it would appear that mindfulness training was the critical component responsible for the benefits. This should not be surprising as mindfulness has been shown in many studies of various healthy and distressed groups to improve pain, depression, anxiety, sleep quality, and health-related quality of life. But fibromyalgia has no cure and causes great suffering in its victims. It is very comforting to see that mindfulness training can, at least, mitigate the suffering.

 

So, improve fibromyalgia symptoms with mindfulness.

 

people with fibromyalgia may have what’s called an “attentional bias” toward negative information that appeared to be linked to pain severity. Researchers suggested that mindfulness training may help manage this trait and therefore reduce pain.” – Adrienne Dellwo

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Haugmark, T., Hagen, K. B., Smedslund, G., & Zangi, H. A. (2019). Mindfulness- and acceptance-based interventions for patients with fibromyalgia – A systematic review and meta-analyses. PloS one, 14(9), e0221897. doi:10.1371/journal.pone.0221897

 

Abstract

Objectives

To analyze health effects of mindfulness- and acceptance-based interventions, including mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT) and acceptance and commitment therapy (ACT). Additionally, we aimed to explore content and delivery components in terms of procedure, instructors, mode, length, fidelity and adherence in the included interventions.

Methods

We performed a systematic literature search in the databases MEDLINE, PsychINFO, CINAHL, EMBASE, Cochrane Central and AMED from 1990 to January 2019. We included randomized and quasi-randomized controlled trials analyzing health effects of mindfulness- and acceptance-based interventions for patients with fibromyalgia compared to no intervention, wait-list control, treatment as usual, or active interventions. MBSR combined with other treatments were included. Predefined outcomes were pain, fatigue, sleep quality, psychological distress, depression, anxiety, mindfulness, health-related quality of life and work ability. The Template for Intervention Description and Replication (TIDieR) checklist and guide was used to explore content and delivery components in the interventions. Meta-analyses were performed, and GRADE was used to assess the certainty in the evidence.

Results

The search identified 4430 records, of which nine original trials were included. The vast majority of the participants were women. The analyses showed small to moderate effects in favor of mindfulness- and acceptance-based interventions compared to controls in pain (SMD -0.46 [95% CI -0.75, -0.17]), depression (SMD -0.49 [95% CI -0.85, -0.12]), anxiety (SMD -0.37 [95% CI -0.71, -0.02]), mindfulness (SMD -0.40 [-0.69, -0.11]), sleep quality (SMD -0.33 [-0.70, 0.04]) and health-related quality of life (SMD -0.74 [95% CI -2.02, 0.54]) at end of treatment. The effects are uncertain due to individual study limitations, inconsistent results and imprecision.

Conclusion

Health effects of mindfulness- and acceptance-based interventions for patients with fibromyalgia are promising but uncertain. Future trials should consider investigating whether strategies to improve adherence and fidelity of mindfulness- and acceptance-based interventions can improve health outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719827/

 

Improve Coping with Chronic Pain with Yoga

Improve Coping with Chronic Pain with Yoga

 

By John M. de Castro, Ph.D.

 

“By first understanding chronic pain as a mind-body experience and then using yoga’s toolbox of healing practices—including breathing exercises and restorative poses—you can find true relief from pain and begin to reclaim your life.” – Kelly McGonigal

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. There is an accumulating volume of research findings to demonstrate that mind-body therapies have highly beneficial effects on the health and well-being of humans. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices, in general, are effective in treating pain and specific practices such as yoga can be effective for the relief of chronic pain.

 

In today’s Research News article “Yoga for People With Chronic Pain in a Community-Based Setting: A Feasibility and Pilot RCT.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6689911/), Schmid and colleagues recruited adult pain patients from a pain clinic who had chronic pain for at least 6 months. They received treatment as usual but half were randomly assigned to receive an additional program of yoga practice for 60 minutes, twice a week, for 8 weeks, including both seated and standing poses. They were measured before and after training for pain severity, pain interference with daily activities, mental and physical quality of life, self-efficacy, and body responsiveness.

 

They found that after treatment the yoga group had significant improvements in pain interference with daily activities, self-efficacy surrounding pain management, physical function, and coping with symptoms, confidence to address pain and chronic disease, and body responsiveness. Hence, it appears that yoga practice, while not altering pain severity itself, does improve the patients’ ability to manage the pain and prevent it from interfering with their daily activities and thereby improve their quality of life. Chronic pain produces suffering, which interferes with the conduct of the patients’ lives. Relief is critical. Yoga practice appears to produce a modicum of that relief.

 

So, improve coping with chronic pain with yoga.

 

“Yoga can be helpful in pain management with both physical and mental benefits, but yoga is not a quick fix solution. Yoga has many of the same benefits as mindfulness practice, due to the common focus on breath, body and present moment awareness. Because yoga is also a physical practice many people find yoga more accessible than traditional meditation practices, which are undertaken in stillness.” – PainHealth

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Schmid, A. A., Fruhauf, C. A., Sharp, J. L., Van Puymbroeck, M., Bair, M. J., & Portz, J. D. (2019). Yoga for People With Chronic Pain in a Community-Based Setting: A Feasibility and Pilot RCT. Journal of evidence-based integrative medicine, 24, 2515690X19863763. doi:10.1177/2515690X19863763

 

Abstract

The purpose of this feasibility pilot study was to assess benefits of 8 weeks of yoga in people with chronic pain. Participants completed baseline assessments and were randomized to yoga or usual care. Yoga was offered twice a week for 8 weeks. We assessed feasibility and the Brief Pain Inventory (BPI) was the primary outcome, assessing pain-severity and pain interference on daily activities. Eighty-three people were recruited; 67 people completed the study and were included in the analyses. Average age of participants was 50.78 ± 10.43 years and most participants had pain >10 years. The intervention appeared feasible and there were significant improvements (P < .05) in multiple measures for the yoga group, including a decrease in BPI interference scores from 7.15 ± 1.70 to 6.14 ± 2.21 (P = .007). There was a significant difference in body responsiveness and pain management scores between groups at 8 weeks. It appears that yoga was feasible and positively influenced multiple outcome measures for people with chronic pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6689911/

 

Improve Chronic Low Back Pain with Yoga

Improve Chronic Low Back Pain with Yoga

 

By John M. de Castro, Ph.D.

 

Yoga is great for working on flexibility and core stability, correcting posture, and breathing—all of which are necessary for a healthy back.” – Sasha Cyrelson

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses. Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects.

 

Mindfulness practices have been found to be effective in treating pain and have been shown to be safe and effective in the management of low back painYoga practice has been shown to have a myriad of health benefits. These include relief of chronic painYoga practice has also been shown to be effective for the relief of chronic low-back pain.  Many forms of yoga focus on the proper alignment of the spine, which could directly address the source of back and neck pain for many individuals. So, it makes sense to further explore the effectiveness of yoga practice for chronic low back pain.

 

In today’s Research News article “Yoga, Physical Therapy, or Education for Chronic Low Back Pain: A Randomized Noninferiority Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392183/), Saper and colleagues recruited adult patients with low back pain lasting at least 12 weeks and randomly assigned them to receive yoga, physical therapy, or education. Yoga training consisted of 12 weekly, 75 minute classes with 30 minutes of daily practice at home including relaxation, breathing exercises, meditation, and poses. Drop-in yoga classes were available during the subsequent 40 weeks. Physical therapy occurred in 15 60-minute session of graded exercise over 12 weeks. Booster classes were offered during the subsequent 40 weeks. Education included information on chronic low back pain self-management, stretching, strengthening, and the role of emotions and fear avoidance. They were measured before and after training and at 14, 28, and 40 weeks later for back-related function, pain intensity, global improvement, patient satisfaction, and health related quality of life.

 

They found that in comparison to baseline both the yoga and physical therapy groups had improvements in back-related function and pain intensity and were less likely to use pain medication at the end of training. These improvements were maintained 40 weeks later. Hence, both yoga practice and physical therapy were equivalently safe and effective treatments for low back pain and the improvements produced were enduring.

 

So, improve chronic low back pain with yoga.

 

Yoga is one of the more effective tools for helping soothe low back pain. The practice helps to stretch and strengthen muscles that support the back and spine, such as the paraspinal muscles that help you bend your spine, the multifidus muscles that stabilize your vertebrae, and the transverse abdominis in the abdomen, which also helps stabilize your spine.” – Matthew Solan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Saper, R. B., Lemaster, C., Delitto, A., Sherman, K. J., Herman, P. M., Sadikova, E., … Weinberg, J. (2017). Yoga, Physical Therapy, or Education for Chronic Low Back Pain: A Randomized Noninferiority Trial. Annals of internal medicine, 167(2), 85–94. doi:10.7326/M16-2579

 

Abstract

Background:

Yoga is effective for mild to moderate chronic low back pain (cLBP), but its comparative effectiveness with physical therapy (PT) is unknown. Moreover, little is known about yoga’s effectiveness in underserved patients with more severe functional disability and pain.

Objective:

To determine whether yoga is noninferior to PT for cLBP.

Design:

12-week, single-blind, 3-group randomized noninferiority trial and subsequent 40-week maintenance phase. (ClinicalTrials.govNCT01343927)

Setting:

Academic safety-net hospital and 7 affiliated community health centers.

Participants:

320 predominantly low-income, racially diverse adults with nonspecific cLBP.

Intervention:

Participants received 12 weekly yoga classes, 15 PT visits, or an educational book and newsletters. The maintenance phase compared yoga drop-in classes versus home practice and PT booster sessions versus home practice.

Measurements:

Primary outcomes were back-related function, measured by the Roland Morris Disability Questionnaire (RMDQ), and pain, measured by an 11-point scale, at 12 weeks. Prespecified noninferiority margins were 1.5 (RMDQ) and 1.0 (pain). Secondary outcomes included pain medication use, global improvement, satisfaction with intervention, and health-related quality of life.

Results:

One-sided 95% lower confidence limits were 0.83 (RMDQ) and 0.97 (pain), demonstrating noninferiority of yoga to PT. However, yoga was not superior to education for either outcome. Yoga and PT were similar for most secondary outcomes. Yoga and PT participants were 21 and 22 percentage points less likely, respectively, than education participants to use pain medication at 12 weeks. Improvements in yoga and PT groups were maintained at 1 year with no differences between maintenance strategies. Frequency of adverse events, mostly mild self-limited joint and back pain, did not differ between yoga and PT.

Limitations:

Participants were not blinded to treatment assignment. The PT group had disproportionate loss to follow-up.

Conclusion:

A manualized yoga program for nonspecific cLBP was noninferior to PT for function and pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392183/

 

Relieve Chronic Low Back Pain with Tai Chi

Relieve Chronic Low Back Pain with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai Chi has demonstrated usefulness in the prevention and treatment of certain problems such as back pain. Importantly, Tai Chi is non-invasive, relatively inexpensive, and gentle on the spine, so many people with back pain are starting to try it as an adjunct to (or sometimes instead of) traditional medical approaches to manage back pain. Furthermore, Tai Chi does not require any expensive equipment and can be practiced anywhere.” – Robert Humphreys

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses.

 

Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back painTai Chi is a mindfulness practice that is safe and gentle and has been shown to improve spinal health and reduce pain. So, it would seem reasonable to examine the ability of Tai Chi practice to treat chronic low back pain.

 

In today’s Research News article “Chen-Style Tai Chi for Individuals (Aged 50 Years Old or Above) with Chronic Non-Specific Low Back Pain: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388249/), Liu and colleagues recruited older adults (aged 50 and over) who were diagnosed with chronic low back pain and randomly assigned them to receive Chen Style Tai Chi training, deep core stabilization exercise, or a no-treatment control condition. Tai Chi and core stabilization exercise practice occurred for 60 minutes three times per week for 12 weeks. They were measured before and after training for lower back pain intensity and for knee and ankle joint position matching ability (proprioception).

 

They found that in comparison to baseline and the control group both Tai Chi training and core stabilization exercise produced a significant decrease in lower back pain, with Tai Chi training producing the greatest relief of the pain. There were, however, no significant effects of training on knee and ankle joint proprioception.

 

The study is significant in that it demonstrates that Tai Chi practice is a safe and effective treatment to relieve chronic low back pain in older adults. This pain is a major problem decreasing their ability to fully engage in daily and work activities. So the relief of the pain by Tai Chi practice should contribute to a marked increase in their quality of life.

 

Tai Chi is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent means to treat with chronic low back pain.

 

So, relieve chronic low back pain with Tai Chi.

 

Some solid research shows that tai chi can benefit people with osteoarthritis, rheumatoid arthritis, fibromyalgia, tension headache, and other ongoing, painful conditions.”  – Harvard Health

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Liu, J., Yeung, A., Xiao, T., Tian, X., Kong, Z., Zou, L., & Wang, X. (2019). Chen-Style Tai Chi for Individuals (Aged 50 Years Old or Above) with Chronic Non-Specific Low Back Pain: A Randomized Controlled Trial. International journal of environmental research and public health, 16(3), 517. doi:10.3390/ijerph16030517

 

Abstract

Tai Chi (TC) can be considered safe and effective intervention to improve pain and pain-related functional disability. However, it is unclear that whether aging individuals with Chronic Non-Specific Low Back Pain (CNS-LBP) can achieve positive results. This study, therefore, attempted to explore the effects of TC on pain and functional disability in CNS-LBP patients aged 50 years old or above. Forty-three individuals (aged 50 years old or above) with CNS-LBP were randomly assigned into three groups: Chen-Style TC group (n = 15), Core Stabilization training (CST) group (n = 15), and control group (n = 13). Participants in the TC group participated in Chen-style TC training program (three 60-min sessions per week for 12 weeks), individuals in CST group received 12-week Core Stabilization exercise on the Swiss ball, whereas individuals in the control group maintained their unaltered lifestyle. Pain intensity as primary outcome was measured using the Visual Analogue Scale (VAS), A BiodexSystem 3 isokinetic dynamometer was used to measure knee and ankle joint position sense (JPS) as secondary outcomes at baseline and after the 12-week intervention. TC and CST have significant effects in VAS for CNS-LBP patients (p< 0.01, TC group OR CST group versus control group in mean of the post-minus-pre assessment). However, the feature of joint position sense (JPS) of ankle inversion, ankle eversion and knee flexion did not occur, it showed no significant effects with TC and CST. TC was found to reduce pain, but not improve lower limb proprioception in patients with CNS-LBP. Future research with larger sample sizes will be needed to achieve more definitive findings on the effects of TC on both pain and lower limb proprioception in this population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388249/

 

Improve Psychopathology with Meditation

Improve Psychopathology with Meditation

 

By John M. de Castro, Ph.D.

 

“The research is strong for mindfulness’ positive impact in certain areas of mental health, including stress reduction, emotion and attention regulation, reduced rumination, for reducing mild to moderate depression and anxiety, and preventing depressive relapse.” – Kelle Walsh

 

There are vast numbers of people who suffer with mental illnesses; psychopathology. In the United states it has been estimated that in any given year 1 in 5 people will experience a mental illness. Many are treated with drugs. But drug treatment can produce unwanted side effects, don’t work for many patients, and often can lose effectiveness over time. Mindfulness practices provide a safe alternative treatment. They have been found to be helpful with coping with these illnesses and in many cases reducing the symptoms of the diseases. Hence, it appears that mindfulness practices are safe and effective treatments for a variety of psychiatric conditions including anxietydepressionpsychosesaddictions, etc.. Since there has accumulated a large amount of research, it makes sense to step back and summarize what has been discovered.

 

In today’s Research News article “Mindfulness Meditation and Psychopathology.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597263/), Wielgosz and colleagues review and summarize the published research studies investigating the efficacy of mindfulness meditation practices for the treatment of a variety of psychopathologies.

 

They report that mindfulness meditation produces significant improvements in depression and in anxiety disorders in comparison to inactive and active control conditions. Efficacy is equivalent to that of other evidence-based treatments. The research suggests that meditation reduces depression by decreasing rumination and anxiety by reducing repetitive negative thinking. Hence, meditation training is an excellent safe and effective treatment for these prevalent mental illnesses.

 

They also report that mindfulness meditation produces significant improvements in chronic pain intensity and unpleasantness in comparison to inactive but not active control conditions. Efficacy is equivalent to that of other evidence-based treatments. This is true for chronic low back pain fibromyalgia, migraine, and chronic pelvic pain. Meditation also appears to improve the quality of life of chronic pain patients. The research suggests that meditation reduces chronic pain by decreasing negative emotional reactivity. Such reactivity appears to intensify pain and meditation reduces this reactivity and thereby reduces pain.

 

They report that mindfulness meditation produces significant improvements in substance abuse disorders in comparison to inactive and active control conditions and even in comparison to other evidence-based treatments. It appears to reduce substance use frequency, use-related problems, and craving. This is important as addictions are very difficult to treat and frequently relapse.

 

There is evidence that mindfulness meditation is effective in the treatment of attention deficit hyperactivity disorder (ADHD) both in children and adults and also post-traumatic stress disorder (PTSD). But there are currently no comparisons to the effects of other active or evidence-based treatments. It will be important to have randomized controlled trials with active controls to better assess the efficacy of meditation for the treatment of ADHD and PTSD.

 

There is emerging evidence that mindfulness meditation may be effective for eating disorders, and major mental illnesses such as bipolar disorder, major depression, and psychosis. But there is a need for more, better controlled research.

 

Hence, this comprehensive review suggests that mindfulness meditation is a useful treatment for a variety of types of psychopathology. It is amazing that such a simple practice as meditation can have such wide-ranging benefits for such diverse mental illnesses. Meditation appears to act indirectly by strengthening cognitive, emotional, and stress related process that in turn have beneficial effects on the psychopathologies. Hence, it is clear that mindfulness meditation is a safe and effective treatment for psychopathologies that can be used alone or in combination with other treatments.

 

So, improve psychopathology with meditation.

 

“When they’re depressed, people are locked in the past. They’re ruminating about something that happened that they can’t let go of. When they’re anxious, they’re ruminating about the future — it’s that anticipation of what they can’t control. In contrast, when we are mindful, we are focused on the here and now. Mindfulness trains individuals to turn their attention to what is happening in the present moment.” – Carolyn Gregoire

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Wielgosz, J., Goldberg, S. B., Kral, T., Dunne, J. D., & Davidson, R. J. (2019). Mindfulness Meditation and Psychopathology. Annual review of clinical psychology, 15, 285–316. doi:10.1146/annurev-clinpsy-021815-093423

 

Abstract

Mindfulness meditation is increasingly incorporated into mental health interventions, and theoretical concepts associated with it have influenced basic research on psychopathology. Here, we review the current understanding of mindfulness meditation through the lens of clinical neuroscience, outlining the core capacities targeted by mindfulness meditation and mapping them onto cognitive and affective constructs of the Research Domain Criteria matrix proposed by the National Institute of Mental Health. We review efficacious applications of mindfulness meditation to specific domains of psychopathology including depression, anxiety, chronic pain, and substance abuse, as well as emerging efforts related to attention disorders, traumatic stress, dysregulated eating, and serious mental illness. Priorities for future research include pinpointing mechanisms, refining methodology, and improving implementation. Mindfulness meditation is a promising basis for interventions, with particular potential relevance to psychiatric comorbidity. The successes and challenges of mindfulness meditation research are instructive for broader interactions between contemplative traditions and clinical psychological science.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597263/

Improve Chronic Low Back Pain with Mindful Movement Practices

Improve Chronic Low Back Pain with Mindful Movement Practices

 

By John M. de Castro, Ph.D.

 

Tai chi helps with back pain in several ways. It strengthens the muscles in your abdomen and pelvic area that are crucial to supporting the lower back; it improves your balance and flexibility; and it makes you more aware of your posture when you sit, stand, and walk.” – Benjamin Kligler

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. The pain interferes with daily living and with work, interfering with productivity and creating absences. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses. Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects.

 

Pain involves both physical and psychological issues. Physically, exercise can be helpful in strengthening the back to prevent or relieve pain. Psychologically, the stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Tai Chi, Qigong, and yoga  are both exercises and mindfulness practices that have been found to be effective for back pain. There is accumulating evidence. So, it is useful to take a step back and summarize what has been found.

 

In today’s Research News article “Are Mindful Exercises Safe and Beneficial for Treating Chronic Lower Back Pain? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571780/), Zou and colleagues review, summarize, and perform a meta-analysis of the effects of the mindful movement practices of Tai Chi, Qigong, and yoga on chronic low back pain. The identified 17 randomized controlled trials that included a total of 2022 participants.

 

They report that the published research found that both Tai Chi and yoga practices produced significant reductions in pain intensity and back specific disability in patients with chronic low back pain. There were no reported adverse events with Tai Chi practice but there were a few adverse events reported with yoga practice. So, although both are effective in treating chronic low back pain, more care must be taken with yoga practice to protect against injury.

 

The results of the published research strongly suggests that Tai Chi  practice should be prescribed for chronic low back pain, reducing pain and disability. In addition, Tai Chi is a gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice would appear to be an excellent gentle practice to chronic low back pain.

 

So, improve chronic low back pain with mindful movement practices.

 

“On the physical side, tai chi supports or improves balance, coordination, flexibility, muscle strength, and stamina. On the mental side, tai chi helps relieve stress, improves body awareness and, when done in a group setting, reduces social isolation.” – Harvard Health

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Zou, L., Zhang, Y., Yang, L., Loprinzi, P. D., Yeung, A. S., Kong, J., … Li, H. (2019). Are Mindful Exercises Safe and Beneficial for Treating Chronic Lower Back Pain? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of clinical medicine, 8(5), 628. doi:10.3390/jcm8050628

 

Abstract

Background: Chronic low back pain (CLBP) is a common health issue worldwide. Tai Chi, Qigong, and Yoga, as the most widely practiced mindful exercises, have promising effects for CLBP-specific symptoms. Objective: We therefore conducted a comprehensive review investigating the effects of mindful exercises versus active and/or non-active controls while evaluating the safety and pain-related effects of mindful exercises in adults with CLBP. Methods: We searched five databases (MEDLINE, EMBASE, SCOPUS, Web of Science, and Cochrane Library) from inception to February 2019. Two investigators independently selected 17 eligible randomized controlled trials (RCT) against inclusion and exclusion criteria, followed by data extraction and study quality assessment. Standardized mean difference (SMD) was used to determine the magnitude of mindful exercises versus controls on pain- and disease-specific outcome measures. Results: As compared to control groups, we observed significantly favorable effects of mindful exercises on reducing pain intensity (SMD = −0.37, 95% CI −0.5 to −0.23, p < 0.001, I2 = 45.9 %) and disability (SMD = −0.39, 95% CI −0.49 to −0.28, p < 0.001, I2 = 0 %). When compared with active control alone, mindful exercises showed significantly reduced pain intensity (SMD = −0.40, p < 0.001). Furthermore, of the three mindful exercises, Tai Chi has a significantly superior effect on pain management (SMD= −0.75, 95% CI −1.05 to −0.46, p < 0.001), whereas Yoga-related adverse events were reported in five studies. Conclusion: Findings of our systematic review suggest that mindful exercises (Tai Chi and Qigong) may be beneficial for CLBP symptomatic management. In particular, Tai Chi appears to have a superior effect in reducing pain intensity irrespective of non-control comparison or active control comparison (conventional exercises, core training, and physical therapy programs). Importantly, training in these mindful exercises should be implemented with certified instructors to ensure quality of movement and injury prevention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571780/

 

Improve Mobility and Quality of Life in Patients with Chemotherapy-Induced Peripheral Neuropathy with Yoga

Improve Mobility and Quality of Life in Patients with Chemotherapy-Induced Peripheral Neuropathy with Yoga

 

By John M. de Castro, Ph.D.

 

“Exercise can increase blood flow to the hands and feet and may offer temporary relief from pain. People should discuss the exercises that are best for them with their doctor. Low-impact activities, such as swimming, low-impact aerobics, or yoga, are the safest options.” – Zawn Villines

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But, surviving cancer carries with it a number of problems. Painful Chemotherapy-induced peripheral neuropathy is a frequent side effect of cancer treatment. This Neuropathy is characterized by damage to the nervous system resulting from chemotherapy. Between 30-100% of patients can experience this neuropathy.  It can affect patients motor abilities including walking, and balance. But it can also affect driving, relationships, work, writing, exercise, sleep and sexual activity.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that has been shown to help relieve chronic pain and be beneficial for cancer patients.  So, it makes sense to examine the ability of yoga practice to help relieve the symptoms of chemotherapy-induced peripheral neuropathy.

 

In today’s Research News article “Impact of Somatic Yoga and Meditation on Fall Risk, Function, and Quality of Life for Chemotherapy-Induced Peripheral Neuropathy Syndrome in Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537287/), Galantino and colleagues recruited cancer survivors who had completed all treatments but who had some degree of peripheral neuropathy. They participated in a 90 minute, twice a week for 8-weeks, Hatha yoga program including postures, breathwork, and meditation. They were also asked to practice at home. They were measured before and after treatment for motor functions, balance, lower extremity flexibility, pain, neurotoxicity, perceived stress, sleep quality, spiritual efficacy, fear of falling, vibration sense, and salivary cortisol. The participants were asked to record their reflections on their yoga practice in a diary.

 

They found that at the completion of the yoga training the patients had significantly improved mobility, flexibility, balance, risk of falling, perceived pain, pain interference with life activities, sensory systems, muscular weakness, foot vibration sensitivity, and perceived stress. They did not find any adverse effects of the yoga practice on the patients. Qualitative analysis of the patient diaries revealed that the patients noted improvements in enhanced sensations in the extremities, that the yoga practice helped them in managing their symptoms, that the improvement in physical function allowed return to work and re-engagement in hobbies, greater ability to relax, and enjoyment of the social aspects of the yoga practice.

 

It should be noted that this was a small pilot study and there wasn’t a control condition so the results need to be interpreted with caution. But the results are very encouraging and suggest that a large randomized controlled trial is justified and needed to verify the efficacy of the yoga program. But prior to the program there was no improvement over time, so participation in the program likely produced the benefits. The benefits obtained in this study are significant and important contributing to the daily functions, mental and physical health of the patients.

 

Chemotherapy-induced peripheral neuropathy is painful, persistent, disruptive, and debilitating. The degree of improvement seen in the patients after yoga practice markedly improved their symptoms and greatly reduced their suffering. Importantly, after yoga practice the symptoms of peripheral neuropathy were greatly reduced allowing the patients to better function and to enjoy their lives.

 

So, improve mobility and quality of life in patients with chemotherapy-induced peripheral neuropathy with yoga.

 

“They may also benefit from exercise programs such as water exercise, a strength & balance class, Tai Chi, and yoga.  Although patients survived their cancer, giving them their quality of life back should be a priority for those that are suffering from CIPN.” – Pam McMillan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Galantino, M. L., Tiger, R., Brooks, J., Jang, S., & Wilson, K. (). Impact of Somatic Yoga and Meditation on Fall Risk, Function, and Quality of Life for Chemotherapy-Induced Peripheral Neuropathy Syndrome in Cancer Survivors. Integrative cancer therapies, 18, 1534735419850627. doi:10.1177/1534735419850627

 

Abstract

Objective. Chemotherapy-induced peripheral neuropathy (CIPN) syndrome causes significant pain as an adverse effect of treatment, with few nonpharmacological interventions tested. A somatic yoga and meditation (SYM) intervention on functional outcomes and quality of life (QOL) was investigated. Design and methods. Individuals diagnosed with CIPN were enrolled in an open-label, single-arm, mixed-methods feasibility trial. Participants and Setting. In an outpatient rehabilitation center, ten participants with median age 64.4 years (47-81) attended 61% of the sessions with no adverse events. Intervention. SYM twice a week for 8 weeks for 1.5 hours, with home program and journaling. Main outcome measures. Primary functional outcomes included Sit and Reach (SR), Functional Reach (FR), and Timed Up and Go (TUG). Self-reported Patient Neurotoxicity Questionnaire (PNQ) and Functional Assessment of Cancer Therapy—Neurotoxicity (FACT-GOG-NTX) were secondary CIPN outcomes. Biomarkers included salivary cortisol (stress) and bioesthesiometer (vibration). Results: Quantitative findings. Significant improvements were found in flexibility (SR; P = .006); balance (FR; P = .001) and fall risk (TUG; P = .004). PNQ improved significantly (P = .003) with other measures improving non-significantly. Qualitative findings. Five themes emerged: (1) vacillation of CIPN pain perception over time; (2) transferability of skills to daily activities; (3) improvement in physical function; (4) perceived relaxation as an effect of SYM; and (5) group engagement provided a social context for not feeling isolated with CIPN. Conclusion. Preliminary data suggest SYM may improve QOL, flexibility, and balance in cancer survivors with CIPN, with a fully powered randomized controlled trial indicated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537287/

 

Relieve Low Back Pain with Yoga

Relieve Low Back Pain with Yoga

 

By John M. de Castro, Ph.D.

 

“reductions in disability and pain intensity were found despite the reductions in opioid use and other medical and self-help pain treatments at six months. The trial confirms the findings of two prior randomized controlled trials with non-veterans showing that yoga is safe and can reduce pain and disability among adults with chronic low back pain.” – National Pain

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. But active military and veterans have a higher rate than the general population. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses. Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects.

 

Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back painYoga practice has been shown to have a myriad of health benefits. These include relief of chronic painYoga practice has also been shown to be effective for the relief of chronic low-back pain.  Many forms of yoga focus on the proper alignment of the spine, which could directly address the source of back and neck pain for many individuals. So, it makes sense to further explore the effectiveness of yoga practice for chronic low back pain in military veterans.

 

In today’s Research News article “Yoga for Military Veterans with Chronic Low Back Pain: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399016/), Groessl and colleagues recruited military veterans with chronic low back pain and randomly assigned them to receive either 12 weeks, twice a week, 60-minutes of hatha yoga practice or to a wait-list control condition. Yoga practice consisted of postures, breathing practice, and focused meditation. They were measured for back-specific functional limitations, pain intensity, and medication use before and after treatment and 3 months later.

 

They found that the veterans who practiced yoga had decreases in functional limitations due to back pain and pain intensity that were significant 3 months after the end of formal yoga practice. Opiate use declined over the trial period, but this was true for both yoga and control groups. Hence, yoga practice was found to be a safe, effective, and lasting treatment for back pain and disability in military veterans who have high rates of chronic low back pain. These results are similar to those seen in other groups of patients suffering from chronic low-back pain. It would be interesting in future research to compare yoga practice to other forms of exercise in relieving back-related disability and pain in a similar group.

 

So, relieve low back pain with yoga.

 

By demonstrating that yoga is an evidence-based treatment for cLBP in military veterans, complementary and integrative health researchers and [Veterans Affairs] administrators are in a position to begin implementing yoga programs more formally,” – Erik Groessl

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Groessl, E. J., Liu, L., Chang, D. G., Wetherell, J. L., Bormann, J. E., Atkinson, J. H., … Schmalzl, L. (2017). Yoga for Military Veterans with Chronic Low Back Pain: A Randomized Clinical Trial. American journal of preventive medicine, 53(5), 599–608. doi:10.1016/j.amepre.2017.05.019

 

Abstract

Introduction:

Chronic low back pain (cLBP) is prevalent, especially among military veterans. Many cLBP treatment options have limited benefits and are accompanied by side effects. Major efforts to reduce opioid use and embrace nonpharmacological pain treatments have resulted. Research with community cLBP patients indicates that yoga can improve health outcomes and has few side effects. The benefits of yoga among military veterans were examined.

Design:

Participants were randomized to either yoga or delayed yoga treatment in 2013–2015. Outcomes were assessed at baseline, 6 weeks, 12 weeks, and 6 months. Intention-to-treat analyses occurred in 2016.

Setting/Participants:

One hundred and fifty military veterans with cLBP were recruited from a major Veterans Affairs Medical Center in California.

Intervention:

Yoga classes (with home practice) were led by a certified instructor twice weekly for 12 weeks, and consisted primarily of physical postures, movement, and breathing techniques.

Main outcome measures:

The primary outcome was Roland–Morris Disability Questionnaire scores after 12 weeks. Pain intensity was identified as an important secondary outcome.

Results:

Participant characteristics were mean age 53 years, 26% were female, 35% were unemployed or disabled, and mean back pain duration was 15 years. Improvements in Roland–Morris Disability Questionnaire scores did not differ between the two groups at 12 weeks, but yoga participants had greater reductions in Roland–Morris Disability Questionnaire scores than delayed treatment participants at 6 months −2.48 (95% CI= −4.08, −0.87). Yoga participants improved more on pain intensity at 12 weeks and at 6 months. Opioid medication use declined among all participants, but group differences were not found.

Conclusions:

Yoga improved health outcomes among veterans despite evidence they had fewer resources, worse health, and more challenges attending yoga sessions than community samples studied previously. The magnitude of pain intensity decline was small, but occurred in the context of reduced opioid use. The findings support wider implementation of yoga programs for veterans.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399016/