Yoga as good for low back pain as physiotherapy: study

Chronic lower back pain is equally likely to improve with yoga classes as with physical therapy, according to a new study published Tuesday in the Annals of Internal Medicine.

Improvement lasted throughout an entire year of measurement

In a study of non-drug treatment for chronic low back pain, nearly half of participants who did a 12-week yoga program found noticeable improvement, and they were equally less likely to use pain medication as those who received physiotherapy. (Mark Metcalfe/Getty Images)

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

The research, published Tuesday in the Annals of Internal Medicine, found that 12 weeks 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. Robert Saper, 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 pain prescribed by doctors, according to Saper and colleagues. Yoga is also backed by some guidelines and studies as a treatment option.

The College of Family Physicians Canada includes certain types of yoga in its recommendations for managing chronic low back pain, but said it's important to find an instructor who has experience working with people who have LBP. 

Until now, no research has compared the two.

Noticeable results from 12-week yoga program

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

The participants were randomly assigned to one of three groups. One group took 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 about low back pain and follow-up information every few weeks.

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

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

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

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

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

Improvements lasted through the year

People would feel a noticeable improvement with a four- to five-point drop on the 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 physical therapy participants reached that goal, compared to 23 per cent of people who were in the education group.

There is some evidence that Viniyoga and Iyengar types of yoga can be helpful in the treatment of chronic low back pain, says the College of Family Physicians Canada. The mass yoga session pictured here took place at Peking University in China on Tuesday, to mark the first International Day of Yoga. (VCG/Getty Images)

For achieving noticeable differences in pain, physical therapy was again no better or worse than yoga. After 12 weeks, people in the yoga group were 21 percentage points less likely to use pain medications than those in the education group. That difference was 22 percentage points for physical therapy versus education.

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

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

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

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