Yoga may have health benefits for patients with chronic non-specific lower back pain, though the evidence is limited, according to a Cochrane review.
The systematic review suggests that yoga may lead to a reduction in pain and boost functional ability in those with chronic non-specific lower back pain in the short term, compared with no exercise.
“At the moment, we only have low to moderate quality evidence”
However, the researchers behind the review, which included UK patients, advised that larger and longer studies were needed to provide information on long-term effects.
They noted that current US guidelines – published by the American College of Physicians and the American Pain Society – stated that exercise therapy may be beneficial, particularly yoga.
The technique has gained popularity as a form of mind-body exercise, with general life-style benefits, and studies have investigated the potential of yoga to relieve the symptoms of lower back related problems.
The new Cochrane Review summarised the results of 12 randomised trials, involving 1,080 men and women with an average age between 34 and 48 years old.
The trials were conducted in India, the UK, and the US. All participants had chronic non-specific lower back pain.
“Yoga may also be slightly more effective for pain at three and six months”
The Cochrane researchers included studies that compared practising yoga in a class to not doing any back-focused exercise, or to other forms of exercise. Most trials used Iyengar, Hatha, or Viniyoga forms of yoga.
Seven studies compared yoga with no exercise, three studies compared it with back-focused exercise, or added yoga for a back-focused exercise programme. Two studies compared yoga with two other forms of control group – no exercise or a self-care book.
All yoga interventions used were specifically designed for treatment of lower back pain, and were provided by experienced and qualified teachers, noted the researchers.
The review found that, compared to no exercise, practising yoga might improve back-related function and also reduce symptoms of back pain by a small amount in the first six to 12 months.
However, they acknowledged that the effect was consistently less than that judged to be clinically important.
They also highlighted that yoga may actually cause an increase in back pain in some people, though this may be to a similar level as other back-focused exercise.
The study authors concluded there was “low- to moderate-certainty evidence that yoga compared to non-exercise controls results in small to moderate improvements in back-related function at three and six months”.
Young man back pain
“Yoga may also be slightly more effective for pain at three and six months, however the effect size did not meet predefined levels of minimum clinical importance,” they said in the Cochrane Database of Systematic Reviews.
They added: “It is uncertain whether there is any difference between yoga and other exercise for back-related function or pain, or whether yoga added to exercise is more effective than exercise alone.”
Lead study author Susan Wieland, from the University of Maryland School of Medicine in the US, said: “Our findings suggest that yoga exercise may lead to reducing the symptoms of lower back pain by a small amount, but the results have come from studies with a short follow up.
“At the moment, we only have low to moderate quality evidence for the effects of yoga before six months as a type of exercise for helping people with chronic lower back pain,” she said.
“The yoga exercises practised in the studies were developed for low back pain and people should also remember that in each of the studies we reviewed, the yoga classes were led by experienced practitioners,” she added.