Yoga may help with chronic low back pain

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Yoga may help with chronic low back pain

Recent systematic review results have shown that yoga vs. non-exercise controls displayed small to moderate betterment in back-related function at 3 and 6 months. As per the current guidelines, exercise may be advantageous for chronic low back pain (cLBP).

It is believed that yoga, a mind-body exercise may help deal with non-specific LBP. A group of researchers distinguished the effects of yoga for chronic non-specific LBP vs. no treatment, minimal intervention (e.g, education), or active treatment assessing pain, function and adverse events.

L. Susan Wieland and the team explored different databases and trial registries till March 11, 2016 for randomized controlled trials of yoga treatment in patients suffering from chronic non-specific LBP. The studies that compared yoga vs. any intervention or no intervention plus studies comparing yoga as the adjunct to other therapies vs. the other therapies were considered. The GRADE approach was used to categorize the overall certainty of evidence. Overall, 12 trails (n=1,080) were included in the review.

The most common forms of yoga used were the lyengar, hatha or Viniyoga. The trials compared yoga to no intervention or a non-exercise intervention like education (7 trials), an exercise intervention (3 trials) or both exercise and non-exercise interventions (2 trials). All study results were demoted as "moderate certainty" because of the risk of bias and further demoted if the further serious risk of bias, unexplained heterogeneity between studies or imprecise analyses were present. There was a low-certainty evidence that yoga caused small to moderate improvements in back-related function at 3–4 months (standardized mean difference [SMD], –0.4, 95% CI: –0.66 to –0.14) for yoga vs. non-exercise controls. At 6 months, moderate-certainty evidence was observed for small to moderate improvements (SMD –0.44, 95% CI: –0.66 to –0.22). At 12 months, a low-certainty evidence was observed for small improvements (SMD –0.26, 95% CI: –0.46 to –0.05).

The investigators revealed a very low- to moderate-certainty evidence that yoga was slightly better for pain at 3–4 months (MD –4.55, 95% CI: –7.04 to –2.06), 6 months (MD –7.81, 95% CI: –13.37 to –2.25) and 12 months (MD –5.4, 95% CI: –14.50 to –3.70). Although the pre-defined clinically significant change in pain (≥15 points) was not met. Higher risk of adverse pain (escalated back pain) was observed in patients in the yoga cohort vs. those in the non-exercise controls (risk difference [RD] 5%, 95% CI: 2%–8%).

For yoga vs. non-yoga exercise controls, they observed a very low-certainty evidence for little or no difference in back-related function at 3 months (SMD –0.22, 95% CI: -0.65 to 0.20) and 6 months (SMD –0.20, 95% CI: –0.59, 0.19). On a 0–100 scale, they noticed a very low-certainty evidence for lower pain at 7 months (MD –20.40, 95% CI: –25.48 to –15.32) and no information on pain at 3 months or after 7 months. Therefore, it can be concluded that there is a low-certainty evidence for no difference in the risk of adverse events when distinguishing yoga vs. non-yoga exercise controls. Altogether, yoga led to small to moderate improvements in back-related function at 3 and 6 months as compared to non-exercise controls as per the low- to moderate-certainty evidence. At months 3 and 6, yoga may also impart slightly more pain relief though the effect size did not meet clinical importance. According to the authors, more high-quality research is required to examine the long-term outcomes.



Link to the source:

The original title of the article:

Yoga for Chronic Low Back Pain: Is it Effective?


Yannick Palmowski et al.

Therapeutic, Yoga, Low back pain (LBP), Pain, Spine, Chronic, Systematic Review, GRADE
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