As a physician, chronic back pain is one of the most common complaints I hear from my patients, and also one of the hardest to treat. Western medicine is often ineffective in managing this type of pain.
In its latest guidelines on the management of low back pain , the American College of Physicians recommends that “clinicians should consider the addition of nonpharmacologic therapy with proven benefits […]; for chronic or subacute low back pain, intensive interdisciplinary rehabilitation, exercise therapy, acupuncture, massage therapy, spinal manipulation, yoga, cognitive-behavioral therapy, or progressive relaxation.”
But what is the evidence that yoga can be effective in relieving back pain?
First of all, it is important to realize that back pain is often a symptom of something more serious. Thus, anyone experiencing unexplained weight loss, fever, urinary retention, incontinence, as well as pain, weakness or numbness in the legs should consult with a physician to rule out a serious medical condition.
The best evidence that yoga can be used as part of a management strategy for low back pain comes from a recent review by Holger Cramer et al which appeared in the Clinical Journal of Pain in May 2013. By combining the results of eight studies on the effects of yoga on chronic back pain, the authors conclude that there is “strong evidence for short-term and moderate evidence for long-term reduction of low back pain and back-specific disability after yoga interventions.”
An earlier 2005 study by Karen Sherman compared a 12-week program of hatha yoga to a program of aerobic strengthening exercises and found that the yoga group scored slightly better on a pain and disability questionnaire at the end of the program compared to the exercise group.
There is a growing belief that emotional, psychological and social factors may be important in the experience of pain, and yoga, which originated as a holistic series of both mental and physical practices may hold an advantage over other forms of exercise in these areas.
Evidence that yoga may provide relief for chronic back pain is growing. As with anything, though, it is important to find a qualified teacher who can guide you through the process safely.
In the group’s next article, we will share with you what are some postures that are recommended and not recommended.
Dr. Michael Cheung, MD
- Chou R, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478-91.