Yoga and physiotherapy to treat back pain?
People with chronic lower back pain benefit more from yoga and physiotherapy than from other evidence-based tips for treating their pain. In addition, yoga is even more likely to achieve a significant improvement in their function in open-minded users than physiotherapy.
In the current study involving the Boston University School of Medicine, yoga and physiotherapy were found to fight back pain more effectively than guidance from written evidence-based self-help materials. In addition, the open-mindedness towards yoga and the fear of exercise seem to have a big impact on the treatment. The results were published in the English language journal "Pain Medicine".
The study had almost 300 participants
A total of 299 people with chronic back pain participated in the study. The duration of treatment through yoga, physiotherapy and self-treatment was twelve weeks each. At the same time, factors were determined which predicted major improvements in physical function and / or modified the effectiveness of yoga, physiotherapy or self-care.
Socioeconomic status influenced treatment
The study mostly included people whose income was below average income. Such people often suffer from undersupply. The results are in line with existing research and show that lower socioeconomic status, multiple comorbidities, depression and smoking are associated with a poor response to pain treatment, the researchers report.
How did a yoga treatment go?
The yoga treatment consisted of twelve group-based weekly 75-minute Hatha yoga classes. These hours included various poses, relaxation and meditation exercises, yoga breathing and yoga philosophy. The participants were asked to do their exercises at home for thirty minutes each day and were provided with the necessary material.
Participants took part in 15 physiotherapy sessions
The physiotherapy intervention consisted of 15 individual appointments of 60 minutes each over a period of twelve weeks. In physiotherapy, a treatment-based classification method was used during each appointment and the exercises performed were monitored. In addition, there were written instructions and materials to continue the exercises at home.
What did the self-help intervention include?
The self-help intervention consisted of reading a copy of the Handbook for Back Pain, which describes comprehensive evidence-based self-management strategies for chronic low back pain. These strategies include, for example, stretching, strengthening and influencing psychological and social factors. The participants were called every three weeks and asked about their success.
Improved treatment through yoga or physiotherapy
Participants responded better to their treatment approach when doing yoga or physical therapy than was the case with the support group. Yoga and physiotherapy showed similar improvements in back functions.
Pain relievers improved the treatment
If the participants also took painkillers to treat chronic lower back pain, yoga or physiotherapy also showed a better effect compared to people from the self-help group.
Anxiety had a negative effect on the treatment
The results of the study also illustrate the effect that fear can have on the treatment results of the participants. People who were less afraid of physical activity responded much better to yoga and physiotherapy than to self-help, the researchers report
Multidisciplinary treatment approach for back pain
The research group summarizes that adults who suffer from chronic low back pain in the lower back could benefit from a multidisciplinary treatment approach with yoga or physiotherapy, especially if they are already taking painkillers.
Positive thinking has a big impact on treatment
Chronic back pain can be effectively treated with the help of yoga or physiotherapy. The success of such treatments seems to improve if the person concerned also takes pain medication. In particular, people who are not worried that exercise may worsen their back pain seem to benefit more from yoga and physiotherapy. The researchers also report that the expectation that they will get on well with yoga can have a positive effect on treatment and even offer advantages over physiotherapy. (as)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Eric J Roseen, Hanna Gerlovin, David T Felson, Anthony Delitto, Karen J Sherman, Robert B Saper: Which Chronic Low Back Pain Patients Respond Favorably to Yoga, Physical Therapy, and a Self-care Book? Responder Analyzes from a Randomized Controlled Trial, in Pain Medicine (published 14.07.2020), Pain Medicine