Yoga May Help Patients With Chronic Nonspecific Low Back Pain

A review of several studies helps to answer the question, "Does yoga help relieve low back pain?"

Peer Reviewed

Yoga is commonly used to help treat low back pain, but do studies show that it works? A recent review of recent studies indicates yoga helps improve function compared with no exercise, and did not find any evidence for a difference between yoga and more traditional exercises.

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“We found that the practice of yoga was linked to pain relief and improvement in function,” said lead author, L. Susan Wieland, PhD, MPH, Assistant Professor of Family and Community Medicine at the University of Maryland School of Medicine in Baltimore. “For some patients suffering from chronic non-specific low back pain, yoga may be worth considering as a form of treatment.”

Dr. Wieland and her co-authors reviewed 12 studies involving more than 1,000 adults with low back pain lasting for at least 3 months with no known cause. The studies compared yoga to non-exercise programs, such as educational material given to a patient, or to exercise targeting the back, such as physical therapy. There are a variety of yoga types, and most of the trials in this study used Iyengar, Hatha, or Viniyoga forms of the practice.

Yoga Found Beneficial Over No Exercise
The researchers found low to moderate certainty evidence that patients using yoga had small to moderate improvements in back-related function at three and six months, as well as small improvements in pain, compared to patients in the non-exercise group.

Yoga performed about the same as non-yoga exercise in terms of improving back function at three and six months, although the researchers found few studies comparing yoga to other exercise and therefore considered the evidence to be of “very low certainty.”

Because all study participants knew whether or not they were practicing yoga, and their reporting of changes in pain and functioning could have been affected by this knowledge, the study outcomes could only be graded with “moderate” certainty at best.

The study also found that patients using yoga had more adverse effects—mostly increases in back pain—than patients who did not use exercise, but had similar rates of adverse effects as patients who used non-yoga exercise. Yoga was not associated with serious adverse events.

Importantly, people with low back pain should talk to their doctors for advice on how to exercise safely, Dr. Wieland said. In addition, she noted that the yoga treatments in the study were specially designed for people with low-back pain, and that experienced instructors supervised the yoga classes.

Consistency Is Key to Exercise for Low Back Pain
“I spend a lot of time encouraging my patients to initiate or enhance an exercise program for multiple benefits,” commented Isador H. Lieberman, MD, MBA, FRCSC, Director of the Scoliosis & Spine Tumor Center, Texas Back Institute, Texas Health Presbyterian Hospital Plano, Plano, Texas. “I firmly believe a regular exercise program is good for my patients’ mental, social, and physical health.

Dr. Lieberman recommends yoga and Pilates to build muscle stamina without overwhelming the joints. “I recommend low resistance, high repetition exercise programs, and encourage consistency. You must be religious and dedicated to the exercise program, as an irregular exercise is not helpful,” said Dr. Lieberman, who is a member of the SpineUniverse Editorial Board.

“Back pain affects us all; the best treatment is avoidance, the best way to avoid is with an active healthy lifestyle,” Dr. Lieberman concluded.

Updated on: 03/03/17
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Isador H. Lieberman, MD, MBA, FRCSC
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