When I started having low back problems, I thought of swimming and other low impact exercise. However, yoga was not something I considered.
This was partially because of my ignorance of yoga and my admitted prejudice about a discipline that includes postures called Downward Facing Dog, Half Moon, Fetus, Cow Face and others.
However, a study published recently in the Annals of Internal Medicine journal has suggested that yoga is more effective at decreasing lower back pain than conventional medical treatment.
The study assigned 156 patients to yoga classes and a control group of 157 patients to standard care. The control group received a range of interventions, including mild pain relief medication, physical therapy and advice to remain active and avoid heavy lifting.
On average, members of the yoga group were able to undertake 30 percent more activities compared with those in the usual care group after three months.
On the other hand, yoga did not yield greater reductions in pain or improvements in overall health compared with usual care.
In terms of yoga studies for low back pain, this study is the largest so far, with over 300 participants, and it has the longest follow-up of any yoga trial.
The participants were followed for nine months after they had finished the yoga classes and found that the benefit of yoga was sustained for this length of time, probably because many of the participants continued to practice yoga after they had completed their formal course.
The study participants were offered Iyengar yoga classes (12 classes total, once weekly). The yoga classes were given by 12 yoga teachers who had extra training in back care. Each class lasted 75 minutes.
Part of the idea behind this study is that yoga aims to treat the whole person rather than just the physical aspects of back pain. According to one of the investigators, the yoga program included poses for pain-relief and mental calming; mobilizing, stretching, strengthening and relaxat ion; imp roving awareness of posture; education about how a healthy back functions; and positive mental focus.
If you think the yoga effect sounds too good to be true, you might be correct in some cases. Eight percent of yoga participants reported adverse events that were mostly nonserious and generally related to increased pain. Adverse events were reported in only one percent of the usual care group.
Other interventions for low back pain that have been previously evaluated in randomized controlled trials include exercise and manipulation, the Alexander technique, and cognitive behavioral therapy.
Compared with these other techniques, yoga may improve back function more than exercise and manipulation, cognitive behavioral treatment, and 6 sessions of 1-on-1 Alexander technique but not as much as 24 sessions of Alexander technique.
From my point of view, I believe that this study reinforces the idea that back pain is best treated with activity and gentle stretching, rather than rest, except for a short time after an acute injury.
If you are a back pain sufferer, do include yoga as you consider physical therapy, low impact exercise and stretching, and other treatments.
Most of all, try to keep moving as much as you can. As I explained to my mother (usually during church) when I was a child, God does not want us to just sit still.
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