Yoga for lower back pain
Chronic lower back pain is often referred to medically as non-specific low back pain, in that the cause of the pain or stiffness is unclear. It does not appear to be associated with any disease, fractures, inflammatory condition, compression or infection. There is a high burden on health service and a high level of persistence among sufferers leading to reduced capacity to work and a reduced quality of life. The benefits of remaining active to those that suffer low back pain are well established.
In a randomised controlled trial of 313 participants, funded by Arthritis Research UK, researchers at the Universities of Manchester and York and yoga clinics in York and Cornwall have found that those with back pain may see significant improvements in physical tasks if they completed weekly yoga sessions.
The participants were mainly female with an average age of 46, half were assigned a yoga intervention (156 participants) and the other half were assigned an undisclosed method of usual care (157). The yoga intervention consisted of a progressive 12 class programme delivered by experienced yoga teachers over 3 months.
Yoga participants were given guided weekly classes in addition to study materials and encouragement to practice for 30 minutes twice a week at home. Classes consisted of teaching pranayama (breathing techniques), relaxation, guided meditation and philosophy were included. Classes followed a weekly theme encouraging body awareness and control to the yoga control group.
Those that were in the yoga control group and those undergoing ordinary care completed questionnaires on the level of disability associated with their lower back pain before embarking on the study. Follow up questionnaires at 3, 6 and 12 months were carried out to determine the effect of each cohort. The study showed that those in the ordinary care group showed no change, those in the yoga control group reported a lower disability score on all subsequent questionnaires.
87% of both groups completed the follow-up at 12 months and 60% of the yoga group attended at least half of the first 3 sessions and at least 3 subsequent sessions. At all 3 follow ups the yoga control group reported lower disability scores than the usual intervention group. Although 8% of yoga participants reported adverse events, such as increased pain, compared to 1% of usual care participants, this is still a relatively low proportion of the sample. While there was no reduction in the reporting of low back pain from either group after 12 months, those that practiced yoga had increased score of pain-efficacy, meaning that they were more able to undertake tasks than before the intervention.
It is worth bearing in mind that there are limitations to every scientific study and participants were aware that yoga may be beneficial to their symptoms therefor this could have had a positive bias on the participants perceived outcome. The study promotes the current medical treatment for chronic lower back pain where sufferers should remain active followed by a referral to a physiotherapist for a targeted exercise program if there are no improvements.Yoga may not be suitable for all those who suffer from chronic lower back pain as 8% of the yoga group discovered. Guidance should be sought from a GP or physiotherapist before starting any exercise regime.
More information on the York Trials Unit’s randomized controlled trial is
available at www.yogatrial.co.uk. Lower back pain sufferers, yoga teachers
and health professionals can also learn more about the ‘Yoga for Healthy
Lower Backs’ programme at www.yogaforbacks.co.uk, a website created by the
yoga teachers involved.