Yoga may work better for
lower back pain than conventional treatments
by Nic
Fleming – Monday, 31 October 2011, The Guardian
Patients
with lower back pain who did yoga showed bigger
improvements in their ability to perform everyday
physical tasks
Doing yoga
is a more effective way for people with lower
back pain to become more mobile than the treatments
currently offered by GPs, according to new research.
The study
found that back pain sufferers recorded greater
improvements in everyday physical tasks such as
walking, bending down and getting dressed if they
did weekly yoga sessions. Participants who had
practised yoga reported enhanced function compared
with those receiving standard care, even nine
months after the yoga classes had finished.
Previous,
smaller studies have suggested yoga could be beneficial
to back pain sufferers. However, these have often
involved just one teacher and have not included
long-term follow-up.
Back pain
is estimated to affect 80% of adults at some point
in their lives, and one in five people visits
their GP in any given year because of it.
The condition,
defined as chronic if it lasts longer than six
weeks, is the second most common cause of long-term
disability after arthritis and second only to
stress as a cause of absence from work. It costs
the NHS around £1bn per year and the annual
cost to the economy has been estimated at £20bn.
Existing treatment options include painkillers,
spinal manipulation, acupuncture, exercise classes
and cognitive behavioural therapy.
"In
the past when you had back pain, you were told
to lie down until it passed," said Prof
David Torgerson, director of the York
Trial Unit at the University of York, who led
the study. "These days the main advice is
to keep your back active. It seems yoga has more
beneficial effects than usual care including other
forms of exercise, although we have not carried
out a direct comparison.
"We
are still carrying out the economic analysis but
it is likely yoga could reduce the costs of back
pain both for patients and for the NHS."
Twenty experienced
yoga teachers from the British
Wheel of Yoga and Iyengar
Yoga were trained to deliver a beginner level
course of 12 yoga sessions specially
designed to be safe and beneficial to those with
lower back pain. A group of 156 patients with
chronic lower back pain were assigned to have
the 75-minute yoga classes in north and west London,
Manchester, York and Truro, in addition to normal
GP care, while a control group of 157 just saw
their GPs.
Participants
filled in a 24-point questionnaire on whether
their condition prevented them from doing everyday
tasks. Lower scores equated to better function.
Those who
did the yoga scored on average 2.17 points lower
than those who did not. Three and nine months
later, their scores were still 1.48 and 1.57 points
lower respectively. Participants also reported
lower overall pain levels on average. However,
this effect did not reach statistical significance.
Around 60% of those in the yoga group continued
with their practice after the classes.
The study
is published in the Annals
of Internal Medicine.
Rates of reported
cases of back pain have doubled in the past 40
years in England, a trend seen in other Western
countries. Some believe this is a result of higher
levels of obesity, stress and depression, while
others suggest people are more willing to report
the condition.
When the UK's
National Institute for Health and Clinical Excellence
– which draws up guidelines on the best
treatments – last
reviewed treatments for lower back pain in
May 2009, it ruled that exercise, spinal manipulation
and acupuncture were cost-effective treatments.
"Yoga
is one of a number of treatments that have now
been shown to be effective for back pain,"
said Martin Underwood, professor
of primary care research at Warwick Medical School.
"The study shows it having a small to moderate
average effect for patients, meaning there will
be some people who experience little or no effect
and other people for whom it has substantial benefit.
Unfortunately we don't yet know which patients
respond to which treatments."
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