Yoga as good for low back pain as physiotherapy: study

Chronic lower back pain is equally likely to improve withyoga classes as with physical therapy, according to a new study.

The research, published Tuesday in the Annals of Internal Medicine, found that 12weeks of yoga lessened pain and improved function in people with low back pain (LBP) as much as physical therapy sessions over the same period.

Both yoga and physical therapy are excellent non-drug approaches for low back pain.- Dr. RobertSaper,Boston Medical Center

"Both yoga and physical therapy are excellent non-drug approaches for low back pain," said lead author Dr. Robert Saper, of Boston Medical Center.

Physical therapy is the most common non-drug treatment for low back painprescribed by doctors, according to Saper and colleagues. Yoga is also backed by some guidelines and studies as a treatment option.

TheCollege of Family Physicians Canada includes certain types of yoga in itsrecommendationsfor managing chronic low back pain, but said it'simportant to find an instructor who has experienceworking with people who have LBP.

Until now, no research hascompared the two.

Noticeable results from 12-week yoga program

For the new study, the researchers recruited 320 adults with chronic lowback pain. The participants were racially diverse and tended to have lowincomes.

The participants were randomly assigned to one of three groups. One grouptook part in a 12-week yoga program designed for people with low back pain. Another took part in a physical therapy program over the same amount of time.

People in the third group received a book with comprehensive information aboutlow back pain and follow-up information every few weeks.

At the start of the study, participants reported, on average, moderate tosevere functional impairment and pain. More than two-thirds were using painmedications.

To track participants function and pain during the study, the researcherssurveyed them at six, 12, 26, 40 and 52 weeks using the Roland Morris DisabilityQuestionnaire (RMDQ).

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Scores on the RMDQ measure for function declined meaning function wasimproving by 3.8 points over the 12 weeks in the yoga group, compared to 3.5points in the physical therapy group. Participants who received education had anaverage RMDQ score decline of 2.5.

Statistically, participants ended up with similar functional improvementswhether they underwent yoga, physical therapy or education.

More people in the yoga and physical therapy groups ended up with noticeableimprovements in function, however.

Improvements lasted through the year

People would feel a noticeable improvement with a four- to five-point drop onthe RMDQ, wrote Dr. Douglas Chang, of the University of California, San Diego, and Dr. Stefan Kertesz of the University of Alabama at Birmingham, in an accompanying editorial.

They wrote that 48 per cent of yoga participants and 37 per cent of physicaltherapy participants reached that goal, compared to 23 per cent of people whowere in the education group.

For achieving noticeable differences in pain, physical therapy was again nobetter or worse than yoga. After 12 weeks, people in the yoga group were 21percentage points less likely to usepain medications than those in theeducation group. That difference was 22 percentage points for physical therapyversus education.

The improvements among the people in yoga and physical therapy groups lastedthroughout the year, the researchers found.

"If they remain the same after one year, it's a good bet that theirimprovement will continue on," Saper told Reuters Health.

One treatment method won't help all or even most patients, wrote Chang andKertesz in their editorial.

"Nevertheless, as Saper and colleagues have shown, yoga offers some personstangible benefit without much risk," they write. "In the end, however, itrepresents one tool among many."