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Yoga found to be as good as physical therapy for chronic low back pain

By Bianca Nogrady 
Yoga may be as effective as physical therapy in helping people with chronic low back pain, a new US study published in the Annals of Internal Medicine has concluded. 

In the 12-week noninferiority trial, researchers randomised 320 low-income adults with low back pain that had persisted for at least 12 weeks to receive 12 weekly yoga classes, 15 physical therapy visits or an educational book about back pain and newsletters. 

The trial was followed by a 40-week maintenance phase of yoga drop-in classes or physical therapy booster sessions versus home practice. 

Participants in the yoga and physical therapy arms of the study showed similar improvements in their Roland Morris Disability Questionnaire scores and in pain scores. They were also significantly more likely than participants in the education arm of the study to achieve a greater than 30% reduction in Roland Morris Disability Questionnaire score. These improvements in the yoga and physical therapy groups were maintained at one year. 

‘These findings suggest that a manualised yoga intervention designed specifically for cLBP [chronic low back pain] is similarly effective to PT [physical therapy] for improving physical function and reducing pain in a diverse underserved population with high levels of impairment,’ the researchers wrote. 

At 12 weeks, yoga and physical therapy were both associated with significantly lower use of pain medications, such as paracetamol, NSAIDs or opioids, in the previous week, compared with education. 

Researchers saw no significant differences in the frequency or severity of adverse events between the yoga and physical therapy arms, and the events that were reported were mostly mild, self-limited joint or back pain. However, fewer than half the participants in any group met the adherence criteria: 44% in the yoga and education groups, and 36% adherence in the physical therapy group. 

Commenting on the study, Associate Professor Anne Tiedemann said the findings suggested that yoga was not harmful for this group and could even be beneficial, which opened up another treatment option for patients with chronic low back pain. 

‘We know that if people can select a program that is of interest and they enjoy, they are more likely to adhere to it,’ said Associate Professor Tiedemann, from the School of Public Health at The University of Sydney.

Associate Professor Tiedemann told Pain Management Today that because yoga could be a group-based activity, it could potentially be delivered at lower cost than physical therapy. 
Ann Intern Med 2017; 167; doi: 10.7326/M16-2579. 

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