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Yoga and Stretching Both Ease Chronic Back Pain

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Weekly yoga classes eased pain and improved functioning in some people with chronic lower back pain – but the yoga sessions weren't any better than regular stretching classes, according to a new study.

Researchers found that participants in both types of classes had better functioning and fewer symptoms after three months than back patients who were only given a book with advice on preventing and managing pain.

"We've known for a while... that exercise is good for back pain," said Dr. Timothy Carey, from the University of North Carolina, Chapel Hill, who wrote a commentary published with the study.
Yoga, he told Reuters Health, "seems to be a perfectly good option for people with back pain, but it is not a preferred option."

Finding that yoga and stretching had about equal effects means it was probably the stretching involved in yoga – and not the relaxation or breathing components of the practice that helped improve functioning and pain symptoms, researchers report today in Archives of Internal Medicine.

For the study, they divided 228 adults with long-lasting back pain into three groups. Patients in the first two groups went to either weekly yoga or stretching classes for 12 weeks and were asked to practice on their own between classes. Both types of classes focused on stretching and strengthening the lower back and legs.

Patients in the third group were given a book with back pain-related exercise and lifestyle advice and information on managing flare-ups.

After the 12-week program, people who had gone to the group classes reported significantly lower scores on a questionnaire measuring how much pain interferes with daily activities, compared to those given the book.

The questionnaire rated daily "disability" level on a scale of zero to 23, with 23 being the most severe. At the 12-week mark, the exercise groups had dropped from an initial average score of 10 in the yoga group or nine in the stretching group to between four and five in both groups. The people who received the book started with an average score of nine and at 12 weeks had dropped to about a seven.

More participants who did either yoga or stretching also said that their back pain had diminished or was gone. Sixty percent of people in the yoga group reported improvements in pain, compared to 46 percent in the stretching classes and just 16 percent of people who only got the books.

Three months after the end of classes, symptom improvements were similar in people who had done either stretching or yoga, and still better than in the third, non-exercise group.

And at both the end of class sessions and three months later, twice as many of the class participants reported cutting back on pain medications, such as non-steroidal anti-inflammatories (NSAIDs) about 40 percent versus 20 percent in the book group.

"Here is an option that is something worth trying," said Karen Sherman from the Group Health Research Institute in Seattle, who led the study.

With either stretching or yoga classes, she told Reuters Health, practice is a must for patients. "There is absolutely no treatment that works for everybody... (but) if they're willing to practice, they should go ahead and give it a try."

Carey said the findings suggest that the best type of exercise for people with back pain depends on their preferences and what's convenient.

"It's important that people do exercise they enjoy," he said that way, they're more likely to stick with it. And, "you don't need to drive 50 miles to the nearest yoga class if there's not one near you," Carey added.

He highlighted group exercise in general as a way to stay motivated that's also relatively inexpensive.

Sherman said attending a single yoga or stretching session costs about $20, but probably varies in different parts of the country. That would be cheaper than other options for managing lower back pain, such as acupuncture and massage or talk therapy.

And, she added, "Once a person learns how to do these in a way that's safe for them, they can do them on their own."

The study was funded by the National Center for Complementary and Alternative Medicine.
While it didn't include people with severe back pain, so the findings don't necessarily apply to them,  Carey said that "almost anyone with back pain can benefit from stretching exercises."