A study published this week by the Annals of Internal Medicine indicates that yoga classes designed for alleviating chronic low back pain (CLBP) may work just as well as physical therapy.
The NIH funded study, aptly named Back to Health, was conducted over the course of a year in the Boston area and recruited 320 participants with chronic low back pain. They targeted people of predominantly low-income minority backgrounds since these populations have higher incidences of CLBP due to disparities in access and treatment.
Participants were split into 3 groups:
- One spent 12 weeks attending a weekly yoga class designed specifically to remedy back pain
- The second group went to 15 physical therapy (PT) visits.
- The third group received an educational book and newsletters with evidence based self-care options for alleviating CLBP.
At the end of 12 weeks, the yoga group was tasked with attending drop-in classes or home practice and the PT group was assigned to “booster sessions” or home practice.
A questionnaire was used to monitor changes in participant’s pain and ability to function.
At the beginning of the study, close to 70% of the study participants were taking some form of pain medication.
Both the yoga and the PT groups displayed a similar improvement in pain and function over the length of the study.
At the end of the initial 3 months of classes or PT sessions, the percentage for both those groups dropped to 50%. There was no improvement in use of pain medication for the educational group.
The study author Rob Saper, Director of Integrative Medicine at Boston Medical Center is quick to point out: “I’m not recommending that people just go to any yoga class,” as told to NPR in this article.
The point of the research was to identify poses and relaxation techniques that were both effective and safe.
The NPR article goes further to say:
Saper says he chose to compare the effects of yoga with physical therapy because “PT is the most common referral that physicians make for patients with back pain. It’s accepted, it’s reimbursed, and it’s offered in most hospitals.”
Saper says if research shows that yoga can be as effective, “maybe yoga should be considered as a potential therapy that can be more widely disseminated and covered [by insurance].”
We think this study makes another great point that should be noted:
It’s not enough to read about wellness and educate yourself on health.
You must act on it.
Knowing that cat-cow pose will improve your spinal flexion will not alleviate your back pain. You have to get your body onto a mat or to physical therapy and actually DO the exercises or rehab.
Treating back pain can be a complicated endeavor and if your back pain is the result of an injury or other diagnosed issue, yoga (or possibly even PT) may not be for you.
However, if you’re reasonably healthy, without injury or disease and your decision point is popping more Advil or getting on the floor and doing some spinal rocks, yoga is a good, low risk alternative.
Since heavy or long term use of analgesics (pain killers like aspirin, acetaminophen and ibuprofen) can cause chronic kidney disease, if your kidneys have a choice, they would pick poses.
Your brain and nervous system would chime in with a resounding “yes!” to yoga as well due to the other benefits gleaned from a mindfulness practice like improved mood and a reduction in stress levels.
As long as you remain gentle in your approach, there is little peril in giving yoga a try.
For information on the poses used in the Back to Health study and how to set up a home practice from the team that conducted the study, you can find a pdf of the Participant Guidebook here.
You can find additional articles and resources for alleviating back pain from Yoga Journal online.