Yoga Can Ease Low Back Pain: A Review of the Literature

Low back pain is the single leading cause of disability globally, and the second most cited reason for doctor’s visits. Most back pain is idiopathic, or unrelated to fracture, cancer, infection or arthritis, making it difficult to understand and treat.

Whether due to illness, injury, stress, or muscle tension, low back pain can range from intermittent and uncomfortable to chronic and debilitating. Americans spend in excess of $50 billion per year on back-related pain, with many therapies such as anti-inflammatory and opioid medications providing only modest or temporary relief.

Back pain sufferers are increasingly seeking alternative approaches to pain relief and overall low back health. In response to this demand, doctors are increasingly recommending yoga for back pain, to both manage and prevent the pain.

Can yoga help ease low back pain? Individual studies so far have shown encouraging results, but how consistent are these? A recently published review analyzes the research available on yoga for back pain and suggests that indeed, yoga may consistently offer relief from back pain.

Comparing and Contrasting Multiple Studies

In a recent article in the Clinical Journal of Pain, authors conducted a meta-analysis on all of the published studies in which yoga was used as an intervention for low back pain. Meta-analyses systematically compare and contrast the results from different studies with the goal of drawing conclusions regarding what works and what doesn’t.

The authors reviewed all randomized controlled trials published before January 2012 in which adults (people less than 18 years of age) who received yoga therapy for back pain were compared with a group of matched controls. Ten trials with a total of 967 participants were identified.

There was a great deal of variability in the nature of the yoga therapy received, the type of control group used, as well as the dosage, or amount  of yoga therapy received. Programs ranged from daily yoga practice over the course of  one week, to twice-weekly interventions over 24 weeks. Control groups included usual care (two studies), education (seven studies), and exercise programs (three studies).

Overall effects of yoga compared to no treatment were computed for outcomes including “pain, back-specific disability, generic disability, health-related quality of life, and global improvement.”

Results of the meta-analysis suggested that individuals who participated in a yoga program experienced significantly reduced short-term (roughly 12 week) and long-term (approximately 12 month) pain and back-specific disability compared to controls. There were no differences between groups for health-related quality of life.  No adverse events were reported in any of the studies.

Increased Access, Increased Benefits

The Clinical Journal of Pain’s findings are consistent with earlier meta-analyses that provided evidence of the beneficial effects of yoga for low back pain (see P. Posadzki and E. Ernst, 2011).

Based on these findings the authors recommended yoga as an adjunctive therapy for individuals with chronic low back pain. It is important to note that these trials included predominantly Caucasian and Asian women. Consequently, it is impossible to assess whether or not yoga will be equally effective for men, or for individuals with other physical or psychological complications that may contribute to chronic back pain.

A promising study conducted at Boston Medical Center published in Evidence-Based Complementary and Alternative Medicine early this year examined whether participation in yoga classes once or twice per week would be related to reduced back pain for an ethnically diverse, low income sample of adults with moderate to severe chronic low back pain.

Researchers recruited adults from health care facilities that served an ethnically diverse, low income sample. Fewer than 20% of adult participants were white, one-third had a high school education or less, and over 75% of the sample had an annual household income of less than $40,000. Participants were assigned to receive either once-weekly or twice-weekly hatha yoga classes.

After 12 weeks, pain and back-related functioning improved for both groups suggesting

that yoga practice was similarly effective at reducing low back pain whether individuals practiced once or twice per week. This is particularly important given that participants in this study have restricted access to yoga classes for financial reasons.

It’s important to note that yoga can also be used to prevent back problems. Safe flexion, extension and rotation of the spine can help to reduce vertebral compression, and improve the strength and flexibility of the spine and the tissues that support it. Those with a healthy spine are less likely to develop chronic back problems.

So whether you’re one of the millions of those suffering from chronic back pain, or someone hoping to avoid the experience, these studies confirm that yoga may be just the ticket.

B Grace Bullock, PhD, E-RYT 500 is a psychologist, research scientist, educator, author, yoga and mindfulness expert and creator ofBREATHE: 7 Skills for Mindful Relationships. Her mission is to reduce stress, increase health and wellbeing and improve the quality of relationships. She offers classes, workshops, writing and research that combine the wisdom of applied neuroscience, psychophysiology, psychology and contemplative science and practice. Her goal is to empower individuals, groups, leaders and organizations to reduce chronic stress and increase awareness, attention, compassion, mindfulness and effective communication to strengthen relationships, release dysfunctional patterns and unlock new and healthy ways of being. Dr. Bullock is a Certified Viniyoga Therapist and Faculty at the Integrated Health Yoga Therapy (IHYT) Training program. She is the former Senior Research Scientist at the Mind & Life Institute and former Editor-in-Chief of the International Journal of Yoga Therapy. For more information see www.bgracebullock.com