Research on Yoga for Back Pain Continues

Robert Saper and colleagues at Boston Medical Center are conducting research to assess the likelihood that yoga may be as effective as physical therapy in reducing low back pain. If shown effective, yoga classes are more likely to be reimbursed by insurance as an alternative to more costly physical therapy.  

Saper’s research is notable for its inclusion of a broader sociodemographic sampling than the predominantly white, educated, affluent populations that have been used in previous published studies. Chronic low-back pain does not discriminate, affecting 5-10% of the population across all income levels, so including a wider range of incomes in this study further validates its findings.

Saper notes that yoga’s potential to alleviate other conditions that commonly present with back pain (e.g., depression, anxiety, hypertension) may prove particularly important in low-income patient populations.

Saper and colleagues’ 2009 pilot randomized controlled trial compared weekly hatha yoga classes to a standard of care control group. The yoga classes included postures, deep breathing, and meditation. Participants were given a CD and materials for 30 minutes of home practice. Following 12 weeks, the control group reported minimal improvement, while yoga group participants showed 80% reduced usage of pain medications and one-third less pain.

Building on this study, Saper and colleagues received a $2.7 million grant to conduct two additional studies. The first, currently underway, explores “dose” (investigating how much yoga is the optimum amount for symptom reduction) among 96 participants receiving one or two weekly yoga classes for 12 weeks. The second, a 3-armed RCT slated to launch in 2012, is to follow 320 participants over 12 weeks, comparing the effects of yoga treatment to physical therapy and a control group. Half the participants will receive a maintenance program following completion of the treatment to determine whether this improves outcomes.

A recently-published randomized controlled trial by Tilbrook and colleagues replicated Saper et al’s 2009 findings, as did Sherman et al’s investigation of a 3-armed trial comparing yoga to an educational pamphlet and conventional stretching. Conventional stretching did not, however, outperform yoga in this study. It will thus be interesting to see whether yoga boasts equivalent benefit to physical therapy following Saper’s 2012 trial.

Importantly, yoga may not be appropriate for everyone. For those who aren’t drawn to the practice, the same benefits may not be experienced. And yoga may actually exacerbate back pain for a small minority of practitioners; one of the participants in Saper et al’s 2009 study experienced an increase in symptoms during yoga participation which improved upon cessation, a trend reported across studies in a small number of participants.

Do you think yoga is as effective or more effective as physical therapy in reducing low back pain?

Comments 4

  1. The value of yoga for back pain, or anything else depends on the knowledge of the practitioner and the commitment of the patient/student. Just like physical therapy. However, there are more poorly educated yoga teachers than physical therapists since the later must school intensely and finish a supervised internship to 1) graduate and 2) sit for a national exam just to use their credential. We don’t have that kind of consumer protection in the yoga community. I think yoga has many additional benefits that P.T. usually doesn’t offer. I believe in it as a health treatment and practice. I caution the yoga community against encourage anyone who has the zeal to teach to believe they can intervene in physical disease without being very, very careful. I’ve certainly experienced teachers who throw caution to the wind in encouraging students to try poses that are wildly out of their league.

  2. I think that each person’s experience is unique to himself/herself. However, I came to yoga after a series of ruptured/herniated discs in the L5/S1 range of my lower back. After a full series of cortisone injections I completed a the PT with the clinics DC and PT specialists; followed by a regimen of yoga exercises which I have followed religiously. Then, my personal trainer at my fitness center worked with me and my DC on continued excersises and back care incorporating the use of a roller yoga bolster in a series of lower back and extremity exercises, plus the standard hatha yoga poses that I learned from the PT. I have been pain free without any medication for over two years. I routinely do water aerobics, cardio and my yoga routines severak times a week. I am developing a new and revitalized lifestyle with the help of yoga and a healthier diet.

  3. Yoga for back pain also depends on the reason for the pain. If the pain is muscular (as most back pain is) yoga practiced correctly and frequently can relieve symptoms, help strengthen the back and end the cycle of pain. But if the back pain is a symptom of a deeper problem, yoga, like any exercise, can make it worse. Anyone experiencing back pain or sciatic (down the leg) pain, should see a medical doctor before trying to self medicate through yoga or any other practice.

  4. I agree with Nbock above. See a doctor first. That said I had surgery for stenosis a few years ago but still had pain. Recently it became severe. A trip back to my surgeon showed a vertibrae shifted. He suggested yoga 3x a week for six weeks with a physical therapist, but my insurance dose’nt cover this very well so I went ahead and purchased a yoga DVD for complete back care–magic or maybe magic! I’m hooked forever.

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