Yoga and Physical Therapy Yield Similar Results in Treating Chronic Low Back Pain
(Boston) - June 19, 2017 - While many people with chronic low back pain see a physical therapist to help improve their symptoms, a new study suggests that yoga may be just as effective. Published in the Annals of Internal Medicine, Boston Medical Center (BMC) researchers found that yoga classes designed for chronic low back pain produced similar outcomes compared to physical therapy for reducing pain, improving function and lowering the need for pain medication among the study participants. This demonstrates that yoga should be considered as a treatment option for patients depending on their preferences and availability.
Chronic low back pain (CLBP) affects approximately 10 percent of American adults and is one of the main reasons why people seek health care services and take sick leave from work. While there are treatments available, overall patient satisfaction with their back pain treatment is low, and insurance copayments are out of reach for some individuals. In addition, the impact of CLBP is greater in racial or ethnic minorities and in people of lower socioeconomic status.
Yoga is a practice that involves physical poses, controlled breathing and meditation that combines both physical and mental fitness. While studies have indicated that yoga is effective in treating CLBP, it wasn’t yet known how it would compare to practices, such as physical therapy, that are covered by health insurance.
Patients in this study were from an academic safety-net hospital and its affiliated community health centers and were predominantly low-income. The 320 racially diverse patients all had CLBP and were randomly assigned into three groups for the study period (12 weeks) and the maintenance period (40 weeks). Group one took a weekly yoga class for three months; group two had 15 visits with a physical therapist over three months; and group three received a back pain self-help book and were mailed educational newsletters. After three months, the yoga group attended drop-in sessions or practiced at home for another nine months, and the PT group had booster sessions with a physical therapist or did physical therapy exercises at home for nine months. All participants answered a survey at the beginning of the study and then again at 12 weeks and 12 months about their level of back pain, activity limits and pain medication usage. Patient’s satisfaction with the treatment and quality of life were also monitored during that time.
The physical therapy and yoga groups reported almost the same amount of improvement in pain and activity limitations at both the three and 12-month marks. The physical therapy and yoga group members also were less likely to take pain medications at three months compared to the education group. Additionally, treatment satisfaction was similar among both the physical therapy and yoga groups. Both yoga and physical therapy were similarly safe.
“The large impact of chronic low back pain on suffering, disability, and cost means we need to explore other treatment models that can offer relief, and our study indicates that yoga classes tailored to back pain patients may be a safe and effective option,” said Robert Saper, MD, MPH, a family physician and director of integrative medicine at BMC who serves as the study’s first author. “As a health care community, we should collaborate with patients with chronic low back pain to determine their best options given their individual condition and preferences, and both physical therapy and yoga should be part of the discussion.”
The researchers state that higher attendance to the yoga and physical therapy sessions was associated with greater improvements for their chronic low back pain and less pain medication use, further indicating the importance of offering these treatments to patients as effective nonpharmacologic approaches to treating this type of pain.
The researchers plan to do a cost analysis using the data for this study that will focus on work productivity outcomes from the interventions.
Funding for this study was provided by the National Center for Complementary and Integrative Health of the National Institutes of Health. Saper also is associate professor at both the BU School of Medicine and BU School of Public Health.
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