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Yoga or Stretching Eases Low Back Pain

A new study reports that weekly classes of yoga or intensive stretching are equally effective at reducing low back pain and improving back movement. Both proved better than a self-care book, and their benefits lasted several months after the classes ended.

Each year, Americans spend over $50 billion on low back pain. It is the most common cause of job-related disability and a leading reason for missed work. A variety of treatments are available, but none have proved to be highly effective for chronic back pain. In addition, little is known about the comparative effectiveness of these therapies.

Several small studies have found that yoga may ease back pain. Based on ancient Indian philosophy, yoga has been practiced for more than 2,000 years. It typically combines physical postures, breathing techniques, and meditation or relaxation. Because it integrates both mind and body, some people suspect that yoga might be more beneficial than other exercise techniques in improving back pain. However, no studies have conclusively shown that yoga has this advantage.

To investigate, a team of researchers led by Dr. Karen J. Sherman of the Group Health Research Institute in Seattle launched a clinical trial that enrolled 228 adults. All had moderate low back pain that had lasted for at least 3 months. The study was funded by NIH's National Center for Complementary and Alternative Medicine (NCCAM).

Participants were randomly assigned to 1 of 3 groups. Two groups received 12 weekly 75-minute classes of either yoga (92 participants) or stretching exercises led by a licensed physical therapist (91 participants). Those taking yoga or stretching were asked to practice at home each non-class day for at least 20 minutes. The remaining 45 volunteers received a self-care book that described the causes of back pain and suggested exercise and lifestyle changes to reduce pain. The study results were reported in the October 24, 2011, advance online edition of the Archives of Internal Medicine.

The researchers found that after 3 months, the outcomes for the yoga group were better than those in the self-care group and continued to be better even at 6 months. The effectiveness of stretching was similar to yoga at 6 weeks, 3 months and 6 months. Compared to the self-care group, more yoga and stretching participants reduced their medication use for back pain. Those taking yoga or stretching classes also had better back functioning and were significantly more likely to rate their back pain as better or completely gone at all follow-up times.

“We expected back pain to ease more with yoga than with stretching, so our findings surprised us,” says Sherman. The similar effectiveness of the 2 exercise-based approaches suggests that the benefits of yoga for back pain may have less to do with the mental component than with the physical aspects of muscle stretching and strengthening.

“Our results suggest that both yoga and stretching can be good, safe options for people who are willing to try physical activity to relieve their moderate low back pain” Sherman says. She adds that it's important for classes to be taught by instructors who can tailor the difficulty and adjust stretches and postures to accommodate participants' physical limitations.

— by Vicki Contie