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Yoga may have a medium-to-large effect on chronic lower back pain and functional disability, according to a new meta-analysis of eight randomised, controlled trials.
In conjunction with standard care, yoga is a promising treatment for non-specific lower back pain, said Thomas Beggs, a graduate student at the University of British Columbia, Okanagan, in Kelowna, Canada, who led the analysis.
"It is important that patients find a yoga teacher who has experience working with individuals with chronic low back pain," Beggs says.
On behalf of Beggs and his team, Dr Susan Holtzman presented the findings at the annual meeting of the American Pain Society in Honolulu, Hawaii.
Back pain difficult to treat
The eight trials included a total of 743 patients. Analysis showed that yoga had a medium to large effect on functional disability (Cohen's d = 0.645, 95% confidence interval = 0.496 - 0.795). Five of the eight trials measured pain intensity, and they found a similarly large effect (Cohen's d = 0.623, 95% CI 0.377 - 0.868).
To explain yoga's efficacy, Beggs suggests that the practice offers a holistic, multi-pronged treatment of pain. "Recent studies suggest that yoga can lead to improvements at a behavioural level, by reducing avoidance of activity, and even at a neurological level by changing how the brain processes pain," he said.
Chronic lower back pain is one of the most difficult conditions to treat, particularly among the elderly, said Dr Pao-feng Tsai, an associate professor of nursing science at the University of Arkansas for Medical Sciences in Little Rock, Arkansas, who was not involved in this research.
Yoga worth a try
"Given the fact that pharmacological interventions have severe side effects and show limited efficacy in reducing chronic lower back pain, it may be worth a try to use yoga as an adjunct for treating chronic back pain," she said.
Looking at targets for future study, Beggs points out that most of the trials in this analysis did not compare yoga to other movement-based therapies such as strength training or cardiovascular workouts.
"As such, we don't yet know whether improvements are uniquely due to yoga, or whether they are due to the general effects of physical activity and patient expectations that they are going to get better," he said.
(Rob Goodie, Reuters Health, May 2012)
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