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Yoga improves back function but not pain in patients with chronic low back pain

November 3, 2011

By Webmaster

A group of scientists from the University of York and the University of Manchester at UK conducted a randomized trial from April 2007 to March 2010 to compare the effectiveness of yoga and usual care for chronic or recurrent low back pain.

The trial recruited 313 adults with chronic or recurrent low back pain at 13 non–National Health Service premises in theUnited Kingdom. Each participant was randomly assigned into one of two parallel groups: Yoga (n =156) or usual care (n =157).  All participants received a back pain education booklet. The Yoga group was offered a 12-class, gradually progressing yoga program delivered by 12 teachers over 3 months.

Outcomes were measured before randomization; at baseline; and at 3, 6, and 12 months. The pre-specified primary outcome was back function at 3 months, immediately after the yoga intervention. Back function was measured by using the RMDQ (Roland–Morris Disability Questionnaire), a 24-item questionnaire with scores ranging from 0 (best) to 24 (worst). Secondary outcomes included 1) 6- and 12-month measures of the primary outcome; 2) physical and mental health Short Form-12 (SF-12) Health Survey component summary scores; 3) back pain scores on the Aberdeen Back Pain Scale (ABPS); 4) self-efficacy scores on the Pain Self-Efficacy Questionnaire (PSEQ); 5) EuroQol-5D health index.

The yoga group had better back function at 3, 6, and 12 months than the usual care group. The improvements in back function were observed across the 12-month follow-up period but were more pronounced at 3 months, immediately after the intervention. The adjusted mean RMDQ score was 2.17 points (95%CI, 1.03 to 3.31 points) lower in the yoga group at 3 months, 1.48 points (95%CI, 0.33 to 2.62 points) lower at 6 months, and 1.57 points (95%CI, 0.42 to 2.71 points) lower at 12 months. Although there is no consensus, a change of 1.1 to 2.5 on the RMDQ has been recommended as clinically important.

The yoga and usual care groups had similar back pain and general health scores at 3, 6, and 12 months, and the yoga group had higher pain self-efficacy scores at 3 and 6 months but not at 12 months. Two of the 157 usual care participants and 12 of the 156 yoga participants reported adverse events, mostly increased pain.

The study concluded that offering a 12-week yoga program to adults with chronic or recurrent low back pain led to greater improvements in back function than did usual care. Although there was no evidence of pain reduction at 12 months, confidence in performing normal activities despite pain improved more in the yoga group than usual care group at 3 and 6 months. Yoga seems to be a safe and effective activity that clinicians could consider recommending for patients with a history of low back pain.

For more details please refer to Ann Intern Med. 2011;155:569-578.


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