Improve Low Back Pain and Its Effects with Yoga Practice
By John M. de Castro, Ph.D.
“If you’re dealing with back pain, yoga may be just what the doctor ordered. Yoga is a mind-body therapy that’s often recommended to treat not only back pain but the stress that accompanies it. The appropriate poses can relax and strengthen your body.” – Emily Cronkleton
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 combines mindfulness practice with exercise and has been shown to have a myriad of health benefits. 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. Indeed, yoga has been shown to relieve chronic pain. Yoga practice has also been shown to be effective for the relief of chronic low-back pain. The research has been accumulating and it is useful to summarize what has been learned.
In today’s Research News article “Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low 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/PMC7462307/ ) Zhu and colleagues review, summarize, and perform a meta-analysis of the effectiveness of yoga practice in comparison to other exercises for low back pain. They identified 18 randomized controlled trials.
They report that the published research found that yoga practice, in comparison to baseline and no-exercise controls, produced significant reductions in pain and functional disability that was still present 6 months after the completion of training. At 12 months, there was still a significant difference in functional disability but not pain. In comparison to physical therapy, yoga produced significantly greater pain reduction but not functional disability immediately after treatment but this difference disappeared at 4 weeks after the completion of training. Yoga practice did not produce significant improvements in the patients’ quality of life.
These results suggest that yoga practice is effective in improving pain and functional disability in patients with low back pain. Yoga practice appears to be as effective but not superior to physical therapy. Hence, the published research to date suggests that low back pain can be successfully treated with either yoga practice or physical therapy.
So, improve low back pain and its effects with yoga practice.
“Achy back? Give yoga a go. Numerous studies have shown the power of the ancient practice, which emphasizes stretching, strength, and flexibility, to relieve back soreness and improve function.” – Annie Houser
CMCS – Center for Mindfulness and Contemplative Studies
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Feilong Zhu, Ming Zhang, Dan Wang, Qianqin Hong, Cheng Zeng, Wei Che. Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. PLoS One. 2020; 15(9): e0238544. Published online 2020 Sep 1. doi: 10.1371/journal.pone.0238544
Chronic low back pain (CLBP) is a common and often disabling musculoskeletal condition. Yoga has been proven to be an effective therapy for chronic low back pain. However, there are still controversies about the effects of yoga at different follow-up periods and compared with other physical therapy exercises.
To critically compare the effects of yoga for patients with chronic low back pain on pain, disability, quality of life with non-exercise (e.g. usual care, education), physical therapy exercise.
This study was registered in PROSPERO, and the registration number was CRD42020159865. Randomized controlled trials (RCTs) of online databases included PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase which evaluated effects of yoga for patients with chronic low back pain on pain, disability, and quality of life were searched from inception time to November 1, 2019. Studies were eligible if they assessed at least one important outcome, namely pain, back-specific disability, quality of life. The Cochrane risk of bias tool was used to assess the methodological quality of included randomized controlled trials. The continuous outcomes were analyzed by calculating the mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI) according to whether combining outcomes measured on different scales or not.
A total of 18 randomized controlled trials were included in this meta-analysis. Yoga could significantly reduce pain at 4 to 8 weeks (MD = -0.83, 95% CI = -1.19 to -0.48, p<0.00001, I2 = 0%), 3 months (MD = -0.43, 95% CI = -0.64 to -0.23, p<0.0001, I2 = 0%), 6 to 7 months (MD = -0.56, 95% CI = -1.02 to -0.11, p = 0.02, I2 = 50%), and was not significant in 12 months (MD = -0.52, 95% CI = -1.64 to 0.59, p = 0.36, I2 = 87%) compared with non-exercise. Yoga was better than non-exercise on disability at 4 to 8 weeks (SMD = -0.30, 95% CI = -0.51 to -0.10, p = 0.003, I2 = 0%), 3 months (SMD = -0.31, 95% CI = -0.45 to -0.18, p<0.00001, I2 = 30%), 6 months (SMD = -0.38, 95% CI = -0.53 to -0.23, p<0.00001, I2 = 0%), 12 months (SMD = -0.33, 95% CI = -0.54 to -0.12, p = 0.002, I2 = 9%). There was no significant difference on pain, disability compared with physical therapy exercise group. Furthermore, it suggested that there was a non-significant difference on physical and mental quality of life between yoga and any other interventions.
This meta-analysis provided evidence from very low to moderate investigating the effectiveness of yoga for chronic low back pain patients at different time points. Yoga might decrease pain from short term to intermediate term and improve functional disability status from short term to long term compared with non-exercise (e.g. usual care, education). Yoga had the same effect on pain and disability as any other exercise or physical therapy. Yoga might not improve the physical and mental quality of life based on the result of a merging.