Back pain Anna Ashby and Paulina Novak by YogaClicks


About

As the common causes of back pain are poor posture and alignment, muscle tightness or weakness (especially around the core), over-flexibility and stress, yoga can be an effective back pain treatment.

The stretching, relaxing and balancing movements can improve flexibility in a controlled way, breathing fresh oxygen and nutrients to constricted areas, reducing pain, improving quality of life and increasing vitality.

You don't always need to get on a mat. Meditation can be a great way to reduce the psychological distress of backache and simple activities such as so-called Chair Yoga are a good start. You can sit at your desk at work, or in the comfort of your favourite armchair, and work through a series of exercises that should bring some relief.

For more serious ailments such as a slipped disc, always consult a doctor first.

Also see Sciatica & Neck pain


What the clinical studies say

Yoga
  • Alleviates depression
  • Fosters relaxation
  • Improves balance
  • Improves quality of life
  • Improves vitality
  • Increases flexibility
  • Reduces functional disability
  • Reduces pain
Meditation
  • Alleviates anger
  • Pain acceptance
  • Reduces psychological distress
Mindfulness
  • Pain acceptance

The clinical studies

Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

The objectives of this pilot study were to assess the feasibility of recruitment and adherence to an eight-session mindfulness meditation program for community-dwelling older adults with chronic low back pain (CLBP) and to develop initial estimates of treatment effects. It was designed as a randomized, controlled clinical trial.

Participants were 37 community-dwelling older adults aged 65 years and older with CLBP of moderate intensity occurring daily or almost every day. Participants were randomized to an 8-week mindfulness-based meditation program or to a wait-list control group. Baseline, 8-week and 3-month follow-up measures of pain, physical function, and quality of life were assessed. Eighty-nine older adults were screened and 37 found to be eligible and randomized within a 6-month period. The mean age of the sample was 74.9 years, 21/37 (57%) of participants were female and 33/37 (89%) were white.

At the end of the intervention 30/37 (81%) participants completed 8-week assessments. Average class attendance of the intervention arm was 6.7 out of 8. They meditated an average of 4.3 days a week and the average minutes per day was 31.6. Compared to the control group, the intervention group displayed significant improvement in the Chronic Pain Acceptance Questionnaire Total Score and Activities Engagement subscale (P = .008,P = .004) and SF-36 Physical Function (P = .03).

An 8-week mindfulness-based meditation program is feasible for older adults with CLBP. The program may lead to improvement in pain acceptance and physical function.
Citations

277
Authors

Natalia E Morone | Carol M Greco | Debra K Weiner
Published

2007
Journal

Pain journal
Volume / Issue

34:3
Author's primary institution

Department of Medicine, Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
The impact of modified Hatha yoga on chronic low back pain: a pilot study.
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Purpose:

The purpose of this randomized pilot study was to evaluate a possible design for a 6-week modified hatha yoga protocol to study the effects on participants with chronic low back pain.

Participants:

Twenty-two participants (M = 4; F = 17), between the ages of 30 and 65, with chronic low back pain (CLBP) were randomized to either an immediate yoga based intervention, or to a control group with no treatment during the observation period but received later yoga training.

Methods:

A specific CLBP yoga protocol designed and modified for this population by a certified yoga instructor was administered for one hour, twice a week for 6 weeks. Primary functional outcome measures included the forward reach (FR) and sit and reach (SR) tests. All participants completed Oswestry Disability Index (ODI) and Beck Depression Inventory (BDI) questionnaires. Guiding questions were used for qualitative data analysis to ascertain how yoga participants perceived the instructor, group dynamics, and the impact of yoga on their life.

Analysis:

To account for drop outs, the data were divided into better or not categories, and analyzed using chi-square to examine differences between the groups. Qualitative data were analyzed through frequency of positive responses.

RESULTS:

Potentially important trends in the functional measurement scores showed improved balance and flexibility and decreased disability and depression for the yoga group but this pilot was not powered to reach statistical significance. Significant limitations included a high dropout rate in the control group and large baseline differences in the secondary measures. In addition, analysis of the qualitative data revealed the following frequency of responses (1) group intervention motivated the participants and (2) yoga fostered relaxation and new awareness/learning.

CONCLUSION:

A modified yoga-based intervention may benefit individuals with CLB, but a larger study is necessary to provide definitive evidence. Also, the impact on depression and disability could be considered as important outcomes for further study. Additional functional outcome measures should be explored. This pilot study supports the need for more research investigating the effect of yoga for this population.
Citations

189
Authors

ML Galantino | TM Bzdewka | JL Eissler-Russo | ML Holbrook | EP Mogck | P Geigle | JT Farrar
Published

2004
Journal

Alternative Therapies in Health and Medicine
Volume / Issue

10:
Author's primary institution

Program in Physical Therapy, Richard Stockton College of New Jersey, USA
Effect of Iyengar yoga therapy for chronic low back pain
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Low back pain is a significant public health problem and one of the most commonly reported reasons for the use of Complementary Alternative Medicine.

A randomized control trial was conducted in subjects with non-specific chronic low back pain comparing Iyengar yoga therapy to an educational control group. Both programs were 16 weeks long. Subjects were primarily self-referred and screened by primary care physicians for study of inclusion/exclusion criteria.

The primary outcome for the study was functional disability. Secondary outcomes including present pain intensity, pain medication usage, pain-related attitudes and behaviors, and spinal range of motion were measured before and after the interventions. Subjects had low back pain for 11.2±1.54 years and 48% used pain medication.

Overall, subjects presented with less pain and lower functional disability than subjects in other published intervention studies for chronic low back pain. Of the 60 subjects enrolled, 42 (70%) completed the study. Multivariate analyses of outcomes in the categories of medical, functional, psychological and behavioral factors indicated that significant differences between groups existed in functional and medical outcomes but not for the psychological or behavioral outcomes. Univariate analyses of medical and functional outcomes revealed significant reductions in pain intensity (64%), functional disability (77%) and pain medication usage (88%) in the yoga group at the post and 3-month follow-up assessments.

These preliminary data indicate that the majority of self-referred persons with mild chronic low back pain will comply to and report improvement on medical and functional pain-related outcomes from Iyengar yoga therapy.
Citations

257
Authors

Kimberly Anne Williams | John Petronis | David Smith | David Goodrich | Juan Wu | Neelima Ravi | Edward J. Doyle | R. Gregory Juckett | Maria Munoz Kolar | Richard Gross | Lois Steinberg
Published

2005
Journal

Pain journal
Volume / Issue

115:2
Author's primary institution

West Virgina University School of Medicine, Morgantown, USA
Evaluation of the Effectiveness and Efficacy of Iyengar Yoga Therapy on Chronic Low Back Pain
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Study Design:

The effectiveness and efficacy of Iyengar yoga for chronic low back pain (CLBP) were assessed with intention-to-treat and per-protocol analysis. Ninety subjects were randomized to a yoga (n = 43) or control group (n = 47) receiving standard medical care. Participants were followed 6 months after completion of the intervention.

Objective:

This study aimed to evaluate Iyengar yoga therapy on chronic low back pain. Yoga subjects were hypothesized to report greater reductions in functional disability, pain intensity, depression, and pain medication usage than controls.

Summary of Background Data:

CLBP is a musculoskeletal disorder with public health and economic impact. Pilot studies of yoga and back pain have reported significant changes in clinically important outcomes.

Methods:

Subjects were recruited through self-referral and health professional referrals according to explicit inclusion/exclusion criteria. Yoga subjects participated in 24 weeks of biweekly yoga classes designed for CLBP. Outcomes were assessed at 12 (midway), 24 (immediately after), and 48 weeks (6-month follow-up) after the start of the intervention using the Oswestry Disability Questionnaire, a Visual Analog Scale, the Beck Depression Inventory, and a pain medication-usage questionnaire.

Results:

Using intention-to-treat analysis with repeated measures ANOVA (group × time), significantly greater reductions in functional disability and pain intensity were observed in the yoga group when compared to the control group at 24 weeks. A significantly greater proportion of yoga subjects also reported clinical improvements at both 12 and 24 weeks. In addition, depression was significantly lower in yoga subjects. Furthermore, while a reduction in pain medication occurred, this was comparable in both groups. When results were analyzed using per-protocol analysis, improvements were observed for all outcomes in the yoga group, including a greater trend for reduced pain medication usage. Although slightly less than at 24 weeks, the yoga group had statistically significant reductions in functional disability, pain intensity, and depression compared to standard medical care 6-months post intervention.

Conclusion:

Yoga improves functional disability, pain intensity, and depression in adults with CLBP. There was also a clinically important trend for the yoga group to reduce their pain medication usage compared to the control group.
Citations

142
Authors

Kimberly Williams | Christiaan Abildso | Lois Steinberg | Edward Doyle | Beverly Epstein | David Smith | Gerry Hobs | Richard Gross | George Kelley | Linda Cooper
Published

2009
Journal

Spine journal
Volume / Issue

34:19
Author's primary institution

Department of Community Medicine, West Virginia University, Morgantown, USA
Effect of Short-Term Intensive Yoga Program on Pain, Functional Disability and Spinal Flexibility in Chronic Low Back Pain: A Randomized Control Study
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Objective:

The aim of this study was to compare the effect of a short-term intensive residential yoga program with physical exercise (control) on pain and spinal flexibility in subjects with chronic low-back pain (CLBP).

Design:

This was a wait-list, randomized controlled study.

Setting:

The study was conducted at a residential integrative health center in Bangalore, South India.

Subjects:

Eighty (80) subjects (females, n = 37) with CLBP, who consented were randomly assigned to receive yoga or physical exercise if they satisfied the selection criteria.

Intervention:

The intervention consisted of a 1-week intensive residential yoga program comprised of asanas (physical postures) designed for back pain, pranayamas (breathing practices), meditation, and didactic and interactive sessions on philosophical concepts of yoga. The control group practiced physical exercises under a trained physiatrist and also had didactic and interactive sessions on lifestyle change. Both of the groups were matched for time on intervention and attention.

Outcome measures:

Pain-related outcomes were assessed by the Oswestry Disability Index (ODI) and by spinal flexibility, which was assessed using goniometer at pre and post intervention. Data were analyzed using repeated measures analysis of variance (RMANOVA).

Results:

Data conformed to a Gaussian distribution. There was a significant reduction in ODI scores in the yoga group compared to the control group (p = 0.01; effect size 1.264). Spinal flexibility measures improved significantly in both groups but the yoga group had greater improvement as compared to controls on spinal flexion (p = 0.008; effect size 0.146), spinal extension (p = 0.002; effect size 0.251), right lateral flexion (p = 0.059; effect size 0.006); and left lateral flexion (p = 0.006; effect size 0.171).

Conclusions:

Seven (7) days of a residential intensive yoga-based lifestyle program reduced pain-related disability and improved spinal flexibility in patients with CLBP better than a physical exercise regimen.
Citations

174
Authors

Padmini Tekur | Chametcha Singphow | Hongasandra Ramarao Nagendra | and Nagarathna Raghuram
Published

2008
Journal

The Journal of Alternative and Complementary Medicine
Volume / Issue

14:
Author's primary institution

Division of Yoga and Life Sciences, Swami Vivekanada Yoga Research Foundation
Loving-Kindness Meditation for Chronic Low Back Pain
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Purpose:

Loving-kindness meditation has been used for centuries in the Buddhist tradition to develop love and transform anger into compassion. This pilot study tested an 8-week loving-kindness program for chronic low back pain patients.

Method:

Patients (N = 43) were randomly assigned to the intervention or standard care. Standardized measures assessed patients’ pain, anger, and psychological distress.

Findings:

Post and follow-up analyses showed significant improvements in pain and psychological distress in the loving-kindness group, but no changes in the usual care group. Multilevel analyses of daily data showed that more loving-kindness practice on a given day was related to lower pain that day and lower anger the next day.

Conclusions:

Preliminary results suggest that the loving-kindness program can be beneficial in reducing pain, anger, and psychological distress in patients with persistent low back pain.

Implications:

Clinicians may find loving-kindness meditation helpful in the treatment of patients with persistent pain.
Citations

140
Authors

James W. Carson | Francis J. Keefe | Thomas R. Lynch | Kimberly M. Carson | Veeraindar Goli | Anne Marie Fras | Steven R. Thorp
Published

2013
Journal

Journal of Holistic Nursing
Volume / Issue

23:
Author's primary institution

Duke University Medical Center
A Randomized Trial Comparing Yoga, Stretching, and a Self-care Book for Chronic Low Back Pain 
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Background:

Chronic low back pain is a common problem lacking highly effective treatment options. Small trials suggest that yoga may have benefits for this condition. This trial was designed to determine whether yoga is more effective than conventional stretching exercises or a self-care book for primary care patients with chronic low back pain.

Methods:

A total of 228 adults with chronic low back pain were randomized to 12 weekly classes of yoga (92 patients) or conventional stretching exercises (91 patients) or a self-care book (45 patients). Back-related functional status (modified Roland Disability Questionnaire, a 23-point scale) and bothersomeness of pain (an 11-point numerical scale) at 12 weeks were the primary outcomes. Outcomes were assessed at baseline, 6, 12, and 26 weeks by interviewers unaware of treatment group.

Results:

After adjustment for baseline values, 12-week outcomes for the yoga group were superior to those for the self-care group (mean difference for function, −2.5 [95% CI, −3.7 to −1.3]; P < .001; mean difference for symptoms, −1.1 [95% CI, −1.7 to −0.4]; P < .001). At 26 weeks, function for the yoga group remained superior (mean difference, −1.8 [95% CI, −3.1 to −0.5]; P < .001). Yoga was not superior to conventional stretching exercises at any time point.

Conclusion:

Yoga classes were more effective than a self-care book, but not more effective than stretching classes, in improving function and reducing symptoms due to chronic low back pain, with benefits lasting at least several months.
Citations

119
Authors

Karen J. Sherman | Daniel C Cherkin | Robert D. Wellman | Andrea J. Cook | Rene J. Hawkes | Kristin Delaney | Richard A. Deyo
Published

2011
Journal

Archives of International Medicine
Volume / Issue

171
Author's primary institution

University of Washington, Seattle
Yoga for chronic low back pain in a predominantly minority population: A pilot randomized controlled trial.
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Background:

Several studies suggest yoga may be effective for chronic low back pain; however, trials targeting minorities have not been conducted.

Primary Study Objectives:

Assess the feasibility of studying yoga in a predominantly minority population with chronic low back pain. Collect preliminary data to plan a larger powered study.

Study Design:

Pilot randomized controlled trial. Setting: Two community health centers in a racially diverse neighborhood of Boston, Massachusetts.

Participants:

Thirty English-speaking adults (mean age 44 years, 83% female, 83% racial/ethnic minorities; 48% with incomes ≤$30000) with moderate-to-severe chronic low back pain.

Interventions:

Standardized series of weekly hatha yoga classes for 12 weeks compared to a waitlist usual care control.

Outcome Measures:

Feasibility measured by time to complete enrollment, proportion of racial/ethnic minorities enrolled, retention rates, and adverse events. Primary efficacy outcomes were changes from baseline to 12 weeks in pain score (0=no pain to 10=worst possible pain) and back-related function using the modified Roland-Morris Disability Questionnaire (0–23 point scale, higher scores reflect poorer function). Secondary efficacy outcomes were analgesic use, global improvement, and quality of life (SF-36).

Results:

Recruitment took 2 months. Retention rates were 97% at 12 weeks and 77% at 26 weeks. Mean pain scores for yoga decreased from baseline to 12 weeks (6.7 to 4.4) compared to usual care, which decreased from 7.5 to 7.1 (P=.02). Mean Roland scores for yoga decreased from 14.5 to 8.2 compared to usual care, which decreased from 16.1 to 12.5 (P=.28). At 12 weeks, yoga compared to usual care participants reported less analgesic use (13% vs 73%, P=.003), less opiate use (0% vs 33%, P=.04), and greater overall improvement (73% vs 27%, P=.03). There were no differences in SF-36 scores and no serious adverse events.

Conclusion:

A yoga study intervention in a predominantly minority population with chronic low back pain was moderately feasible and may be more effective than usual care for reducing pain and pain medication use.
Citations

90
Authors

Robert B. Saper | Karen J. Sherman | Diana Cullum0Dugan | Roger B Davis | Russell S. Phillips | Larry Culpepper
Published

2009
Journal

Alternative Therapies in Health and Medicine
Volume / Issue

15:
Author's primary institution

Department of Family Medicine, Boston University School of Medicine, Massachusetts, USA
A Systematic Review and Meta-analysis of Yoga for Low Back Pain
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Objectives:

To systematically review and meta-analyze the effectiveness of yoga for low back pain.

Methods:

MEDLINE, the Cochrane Library, EMBASE, CAMBASE, and PsycINFO, were screened through January 2012. Randomized controlled trials comparing yoga to control conditions in patients with low back pain were included. Two authors independently assessed risk of bias using the risk of bias tool recommended by the Cochrane Back Review Group. Main outcome measures were pain, back-specific disability, generic disability, health-related quality of life, and global improvement. For each outcome, standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated.

Results:

Ten randomized controlled trials with a total of 967 chronic low back pain patients were included. Eight studies had low risk of bias. There was strong evidence for short-term effects on pain (SMD=−0.48; 95% CI, −0.65 to −0.31; P<0.01), back-specific disability (SMD=−0.59; 95% CI, −0.87 to −0.30; P<0.01), and global improvement (risk ratio=3.27; 95% CI, 1.89-5.66; P<0.01). There was strong evidence for a long-term effect on pain (SMD=−0.33; 95% CI, −0.59 to −0.07; P=0.01) and moderate evidence for a long-term effect on back-specific disability (SMD=−0.35; 95% CI, −0.55 to −0.15; P<0.01). There was no evidence for either short-term or long-term effects on health-related quality of life. Yoga was not associated with serious adverse events.

Discussion:

This systematic review found strong evidence for short-term effectiveness and moderate evidence for long-term effectiveness of yoga for chronic low back pain in the most important patient-centered outcomes. Yoga can be recommended as an additional therapy to chronic low back pain patients.
Citations

61
Authors

Holger Cramer | Romy Lauche | Heidemaire Haller | Gustav Dobos
Published

2013
Journal

Clinical Journal of Pain
Volume / Issue

29:5
Author's primary institution

Department of Complementary and Integrative Medicine, University of Duisburg-Essen, Essen, Germany
Yoga for Veterans with Chronic Low-Back Pain
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Objectives:

Chronic back pain affects a large proportion of both the general population and of military veterans. Although numerous therapies exist for treating chronic back pain, they can be costly and tend to have limited effectiveness. Thus, demonstrating the efficacy and cost-effectiveness of additional treatment alternatives is important. The purpose of our study was to examine the benefits of a yoga intervention for Veterans Administration (VA) patients. Subjects/intervention: VA patients with chronic back pain were referred by their primary care providers to a yoga program as part of clinical care. Before starting yoga, a VA physician trained in yoga evaluated each patient to ensure that they could participate safely.

Design:

The research study consisted of completing a short battery of questionnaires at baseline and again 10 weeks later.

Outcome measures:

Questionnaires included measures of pain, depression, energy/fatigue, health-related quality of life, and program satisfaction. Paired t-tests were used to compare baseline scores to those at the 10-week follow-up for the single group, pre–post design. Correlations were used to examine whether yoga attendance and home practice were associated with better outcomes.

Results:

Baseline and follow-up data were available for 33 participants. Participants were VA patients with a mean age of 55 years. They were 21% female, 70% white, 52% married, 68% college graduates, and 44% were retired. Significant improvements were found for pain, depression, energy/fatigue, and the Short Form-12 Mental Health Scale. The number of yoga sessions attended and the frequency of home practice were associated with improved outcomes. Participants appeared highly satisfied with the yoga instructor and moderately satisfied with the ease of participation and health benefits of the yoga program.

Conclusions:

Preliminary data suggest that a yoga intervention for VA patients with chronic back pain may improve the health of veterans. However, the limitations of a pre–post study design make conclusions tentative. A larger randomized, controlled trial of the yoga program is planned.
Citations

50
Authors

Erik J. Groessl | Kimberly R. Weingart. Kirstin Aschbacher | Laureen Pada. Sunita Baxi
Published

2008
Journal

Journal of Alternative and Complementary Medicine
Volume / Issue

14:9
Author's primary institution

Department of Psychiatry, University of California San Diego
Yoga for Chronic Low Back Pain: A Randomized Trial
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Background:

Previous studies indicate that yoga may be an effective treatment for chronic or recurrent low back pain.

Objective:

To compare the effectiveness of yoga and usual care for chronic or recurrent low back pain.

Design:

Parallel-group, randomized, controlled trial using computer-generated randomization conducted from April 2007 to March 2010. Outcomes were assessed by postal questionnaire. (International Standard Randomised Controlled Trial Number Register: ISRCTN 81079604)

Setting:

13 non–National Health Service premises in the United Kingdom.

Patients:

313 adults with chronic or recurrent low back pain.

Intervention:

Yoga (n = 156) or usual care (n = 157). All participants received a back pain education booklet. The intervention group was offered a 12-class, gradually progressing yoga program delivered by 12 teachers over 3 months.

Measurements:

Scores on the Roland–Morris Disability Questionnaire (RMDQ) at 3 (primary outcome), 6, and 12 (secondary outcomes) months; pain, pain self-efficacy, and general health measures at 3, 6, and 12 months (secondary outcomes).

Results:

93 (60%) patients offered yoga attended at least 3 of the first 6 sessions and at least 3 other sessions. The yoga group had better back function at 3, 6, and 12 months than the usual care group. The adjusted mean RMDQ score was 2.17 points (95% CI, 1.03 to 3.31 points) lower in the yoga group at 3 months, 1.48 points (CI, 0.33 to 2.62 points) lower at 6 months, and 1.57 points (CI, 0.42 to 2.71 points) lower at 12 months. The yoga and usual care groups had similar back pain and general health scores at 3, 6, and 12 months, and the yoga group had higher pain self-efficacy scores at 3 and 6 months but not at 12 months. Two of the 157 usual care participants and 12 of the 156 yoga participants reported adverse events, mostly increased pain.

Limitation:

There were missing data for the primary outcome (yoga group, n = 21; usual care group, n = 18) and differential missing data (more in the yoga group) for secondary outcomes.

Conclusion:

Offering a 12-week yoga program to adults with chronic or recurrent low back pain led to greater improvements in back function than did usual care.
Citations

120
Authors

Helen E. Tilbrook | Helen Cox | Catherine E. Hewitt | Arthur Ricky Kang'ombe | Ling-Hsiang Chuang | Shalmini Jayakody | John D. Aplin | Anna Semlyen | Alison Trewhela | Ian Watt | David J. Torgerson
Published

2011
Journal

Annals of Internal Medicine
Volume / Issue

155:9
Author's primary institution

University of York, Heslington, York YO10 5DD, United Kingdom.
Yoga for low back pain: a systematic review of randomized clinical trials
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

It has been suggested that yoga has a positive effect on low back pain and function. The objective of this systematic review was to assess the effectiveness of yoga as a treatment option for low back pain.

Seven databases were searched from their inception to March 2011. Randomized clinical trials were considered if they investigated yoga in patients with low back pain and if they assessed pain as an outcome measure. The selection of studies, data extraction and validation were performed independently by two reviewers.

Seven randomized controlled clinical trials (RCTs) met the inclusion criteria. Their methodological quality ranged between 2 and 4 on the Jadad scale. Five RCTs suggested that yoga leads to a significantly greater reduction in low back pain than usual care, education or conventional therapeutic exercises. Two RCTs showed no between-group differences.

It is concluded that yoga has the potential to alleviate low back pain. However, any definitive claims should be treated with caution.
Citations

50
Authors

Paul Posadzki | Edzard Ernst
Published

2011
Journal

Clinical Rheumatology
Volume / Issue

30:9
Author's primary institution

Complementary Medicine, Peninsula Medical School, 25 Victoria Park Road, Exeter, Devon, EX2 4NT, UK
Asana-Based Exercises for the Management of Low-Back Pain
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

The present study evaluates a number of simple asanas which may be used as rehabilitative techniques on the basis of biomechanical principles. This study also suggests a set of asanas which work on the back with increasing intensity.

A series of tests are presented for assessing the physiological debility of a patient. The assessment results form the basis for the selection of asanas to be prescribed to the patient. A chart is provided to enable the yoga therapist to increase the intensity of asanas so that the muscles of the low-back may be strengthened systematically and progressively
Citations

13
Authors

T.V Ananthanarayanan & Srinivasan
Published

1993
Journal

International Journal of Yoga Therapy
Volume / Issue

4:1
Author's primary institution

International Association of Yoga Therapists
Effects of yoga interventions on pain and pain-associated disability: a meta-analysis
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

We searched databases for controlled clinical studies, and performed a meta-analysis on the effectiveness of yoga interventions on pain and associated disability.
Five randomized studies reported single-blinding and had a higher methodological quality; 7 studies were randomized but not blinded and had moderate quality; and 4 nonrandomized studies had low quality. In 6 studies, yoga was used to treat patients with back pain; in 2 studies to treat rheumatoid arthritis; in 2 studies to treat patients with headache/migraine; and 6 studies enrolled individuals for other indications.

All studies reported positive effects in favor of the yoga interventions. With respect to pain, a random effect meta-analysis estimated the overall treatment effect at SMD = −.74 (CI: −.97; −.52, P < .0001), and an overall treatment effect at SMD = −.79 (CI: −1.02; −.56, P < .0001) for pain-related disability.

Despite some limitations, there is evidence that yoga may be useful for several pain-associated disorders.

Moreover, there are hints that even short-term interventions might be effective. Nevertheless, large-scale further studies have to identify which patients may benefit from the respective interventions.
Citations

91
Authors

Arndt Büssing
Published

2011
Journal

The Journal of pain
Volume / Issue

13 : 1
Author's primary institution

Center for Integrative Medicine, Faculty of Medicine, University of Witten/Herdecke, Herdecke, Germany
A pragmatic multicentered randomized controlled trial of yoga for chronic low back pain: economic evaluation
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract



Study Design

Multicentered randomized controlled trial with quality of life and resource use data collected.

Objective

The objective of this study was to evaluate the cost-effectiveness of yoga intervention plus usual care compared with usual care alone for chronic or recurrent low back pain.

Summary of Background Data

Yoga has been shown as an effective intervention for treating chronic or recurrent low back pain. However, there is little evidence on its cost-effectiveness. The data are extracted from a pragmatic, multicentered, randomized controlled trial that has been conducted to evaluate the effectiveness and cost-effectiveness of a 12-week progressive program of yoga plus usual care in patients with chronic or recurrent low back pain.

Methods

With this trial data, a cost-effectiveness analysis during the time period of 12 months from both perspectives of the UK National Health Service and the societal is presented. Main outcome measure is an incremental cost per quality-adjusted life-year (QALY).

Results

From the perspective of the UK National Health Service, yoga intervention yields an incremental cost-effectiveness ratio of £13,606 per QALY. Given a willingness to pay for an additional QALY of £20,000, the probability of yoga intervention being cost-effective is 72%. From the perspective of the society, yoga intervention is a dominant treatment compared with usual care alone. This result is surrounded by fewer uncertainties—the probability of yoga being cost-effective reaches 95% at a willingness to pay for an additional QALY of £20,000. Sensitive analyses suggest the same results that yoga intervention is likely to be cost-effective in both perspectives.

Conclusion

On the basis of this trial, 12 weekly group classes of specialized yoga are likely to be a cost-effective intervention for treating patients with chronic or recurrent low back pain.
Citations

18
Authors

Ling Hsiang, Marta Soares, Helen Tilbrook, Helen Cox, Catherine E. Hewitt, John Aplin, Anna Semlyen, Alison Trewhela, Ian Watt, David J. Torgerson
Published

2012
Journal

Spine
Volume / Issue

37 : 18
Author's primary institution

A comprehensive yoga programs improves pain, anxiety and depression in chronic low back pain patients more than exercise: an RCT
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Introduction

Previously, outpatient Yoga programs for patients with chronic low back pain (CLBP) lasting several months have been found to reduce pain, analgesic requirement and disability, and improve spinal mobility. This study evaluated changes in pain, anxiety, depression and spinal mobility for CLBP patients on short-term, residential Yoga and physical exercise programs, including comprehensive yoga lifestyle modifications.

Methods

A seven day randomized control single blind active study in an residential Holistic Health Centre in Bangalore, India, assigned 80 patients (37 female, 43 male) with CLBP to yoga and physical exercise groups. The Yoga program consisted of specific asanas and pranayamas for back pain, meditation, yogic counselling, and lectures on yoga philosophy. The control group program included physical therapy exercises for back pain, and matching counselling and education sessions.

Results

Group × time interactions (p < 0.05) and between group differences (p < 0.05) were significant in all variables. Both groups’ scores on the numerical rating scale for pain reduced significantly, 49% in Yoga (p < 0.001, ES = 1.62), 17.5% in controls (p = 0.005, ES = 0.67). State anxiety (STAI) reduced 20.4% (p < 0.001, ES = 0.72) and trait anxiety 16% (p < 0.001, ES = 1.09) in the yoga group. Depression (BDI) decreased in both groups, 47% in yoga (p < 0.001, ES = 0.96,) and 19.9% in controls (p < 0.001, ES = 0.59). Spinal mobility (‘Sit and Reach’ instrument) improved in both groups, 50%, in yoga (p < 0.001, ES = 2.99) and 34.6% in controls (p < 0.001, ES = 0.81).

Conclusion

Seven days intensive residential Yoga program reduces pain, anxiety, and depression, and improves spinal mobility in patients with CLBP more effectively than physiotherapy exercises.
Citations

50
Authors

P. Tekur, R. Nagarathna, S. Chametcha, Alex Hankey, H.R. Nagendra
Published

2012
Journal

Division of Yoga & Life Sciences, Swami Vivekananda Yoga Research Foundation (SVYASA), Bengaluru, India
Volume / Issue

20 : 3
Author's primary institution

Complementary Therapies in Medicine
A pragmatic multi-centred randomised controlled trial of yoga for chronic low back pain: Trial protocol
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

A systematic review revealed three small randomised controlled trials of yoga for low back pain, all of which showed effects on back pain that favoured the yoga group. To build on these studies a larger trial, with longer term follow-up, and a number of different yoga teachers delivering the intervention is required. This study protocol describes the details of a randomised controlled trial (RCT) to determine the effectiveness and cost-effectiveness of Yoga for chronic Low Back Pain, which is funded by Arthritis Research Campaign (arc) and is being conducted by the University of York. 262 patients will be recruited from GP practices in 5 centres in England. Patients will be randomised to receive usual care or 12 weekly classes of yoga. A yoga programme will be devised that can be delivered by yoga teachers of the two main national yoga organisations in the UK (British Wheel of Yoga and Iyengar Yoga Association (UK)).
Citations

16
Authors

Helen Cox, Helen Tilbrook, John Aplin, Ling-Hsiang Chuang, Catherine Hewitt, Shalmini Jayakody, Anna Semlyen, Marta O. Soares, David Torgerson, Alison Trewhela, Ian Watt, and Gill Worthy
Published

May 2010
Journal

Complementary Therapies in Clinical Practice
Volume / Issue

16(2): 76-80
Author's primary institution

York Trials Unit, Department of Health Sciences, The University of York, Heslington, York YO10 5DD, United Kingdom.
Compliance effects in a randomised controlled trial of yoga for chronic low back pain: a methodological study
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Methodological study nested within a multicentre randomised controlled trial (RCT) of yoga plus usual general practitioner (GP) care vs usual GP care for chronic low back pain. Objective: To explore the treatment effects of non-compliance using three approaches in an RCT evaluating yoga for low back pain.
Citations

5
Authors

H.E. Tilbrook, C.E. Hewitt, J.D. Aplin, A. Semlyen, A. Trewhela, I. Watt, D.J. Torgerson
Published

September 2014
Journal

Tilbrook HE
Volume / Issue

100(3) 256-262
Author's primary institution

York Trials Unit, Department of Health Sciences, University of York, York, UK
Effectiveness of Iyengar yoga in treating spinal (back and neck) pain: A systematic review
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Considerable amount of money spent in health care is used for treatments of lifestyle related, chronic health conditions, which come from behaviors that contribute to morbidity and mortality of the population. Back and neck pain are two of the most common musculoskeletal problems in modern society that have signifi cant cost in health care. Yoga, as a branch of complementary alternative medicine, has emerged and is showing to be an effective treatment against nonspecifi c spinal pain. Recent studies have shown positive outcome of yoga in general on reducing pain and functional disability of the spine. The objective of this study is to conduct a systematic review of the existing research within Iyengar yoga method and its effectiveness on relieving back and neck pain (defi ned as spinal pain). Database research form the following sources (Cochrane library, NCBI PubMed, the Clinical Trial Registry of the Indian Council of Medical Research, Google Scholar, EMBASE, CINAHL, and PsychINFO) demonstrated inclusion and exclusion criteria that selected only Iyengar yoga interventions, which in turn, identifi ed six randomized control trials dedicated to compare the effectiveness of yoga for back and neck pain versus other care. The difference between the groups on the postintervention pain or functional disability intensity assessment was, in all six studies, favoring the yoga group, which projected a decrease in back and neck pain. Overall six studies with 570 patients showed, that Iyengar yoga is an effective means for both back and neck pain in comparison to control groups. This systematic review found strong evidence for short-term effectiveness, but little evidence for long-term effectiveness of yoga for chronic spine pain in the patient-centered outcomes.
Citations

3
Authors

Edith Meszaros Crow, Emilien Jeannot, Alison Trewhela
Published

January-June 2015
Journal

International Journal of Yoga
Volume / Issue

8(1): 3-14
Author's primary institution

Institute of Global Health, Faculty of Medicine, University of Geneva, Switzerland
A randomised controlled trial of yoga for the treatment of chronic low back pain: Results of a pilot study
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Objective: To conduct a pilot trial of yoga for the treatment of chronic low back pain (LBP) to inform the feasibility and practicality of conducting a full-scale trial in the UK; and to assess the efficacy of yoga for the treatment of chronic low back pain. Design: A pragmatic randomised controlled trial was undertaken comparing yoga to usual care. Participants: Twenty participants who had presented to their GP with chronic low back pain in the previous 18 months were recruited via GP records from one practice in York, UK. Interventions: Twenty patients were randomised to either 12 weekly 75-min sessions of specialised yoga plus written advice, or usual care plus written advice. Allocation was 50/50. Main outcome measures: Recruitment rate, levels of intervention attendance, and loss to follow-up were the main non-clinical outcomes. Change as measured by the Roland and Morris disability questionnaire was the primary clinical outcome. Changes in the Aberdeen back pain scale, SF-12, EQ-5D, and pain self-efficacy were secondary clinical outcomes. Data were collected via postal questionnaire at baseline, 4 weeks, and 12 weeks follow-up. Results: Of the 286 patients identified from the GP database, 52 (18%) consented and returned the eligibility questionnaire, out of these 20 (6.9%) were eligible and randomised. The total percentage of patients randomised from the GP practice population was 0.28%. Ten patients were randomised to yoga, receiving an average of 1.7 sessions (range 0e5), and 10 were randomised to usual care. At 12 weeks follow-up data was received from 60% of patients in the yoga group and 90% of patients in the usual care group (75% overall). No significant differences were seen between groups in clinical outcomes apart from on the Aberdeen back pain scale at four weeks follow-up where the yoga group reported significantly less pain. Conclusion: This pilot study provided useful data and information to inform the design and development of a full-scale trial of yoga for CLBP in the UK. A key finding is the calculation of GP practice total list size required for patient recruitment in a full-scale trial, and the need to implement methods to increase class attendance.
Citations

36
Authors

Helen Cox , Helen Tilbrook, John Aplin, Anna Semlyen, David Torgerson, Alison Trewhela, Ian Watt
Published

November 2010
Journal

Complementary Therapies in Clinical Practice
Volume / Issue

Volume 16, Issue 4
Author's primary institution

York Trials Unit, Department of Health Sciences, University of York


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