Can Yoga Improve Back-Related Function in Chronic Low Back Pain?
Additional high-quality studies are necessary to evaluate the effects of yoga on back-related function
A study by an international team of researchers sought to determine whether yoga could effectively alleviate chronic, nonspecific low back pain (LBP). Results from this systematic review appear in the Cochrane Database of Systematic Reviews.1
For this study, scientists consulted 8 online databases (including PubMed Central and Medline) and 4 trial registers, and included 12 trials (n = 1080 participants) from 3 countries (United States, India, United Kingdom), in which yoga for LBP was compared with education (7 trials), exercise (3 trials), or a combination of exercise and no exercise interventions (2 trials).
As neither study participants nor providers were blinded to treatment option, and as treatment efficacy was determined on the basis of reports by patients (using the Roland-Morris Disability Questionnaire to measure LBP) vs clinical testing, thus introducing risks for bias, the authors categorized the certainty of evidence as "low" or "moderate." In addition, resulting improvements in back-related function were categorized as "small" or "small-to-moderate." Results were assessed at 3 to 4, 6, 7, and 12 months.
Yoga was found to only lead to small to moderate improvements with low-certainty evidence when compared with no exercise controls at 3 to 4 months (n = 810 from 9 trials; mean difference in Roland-Morris Disability Questionnaire score, −2.18; 95% confidence interval [CI], −3.60 to −0.76), and to small to moderate improvements with moderate certainty evidence at 6 months (mean difference in Roland-Morris Disability Questionnaire score, −2.15; 95% CI, −3.23 to −1.08). Similar results (ie, from small to small to moderate improvements with evidence of low to moderate certainty) were obtained when yoga was compared with nonyoga exercises.
The authors conclude, "It is uncertain whether there is any difference between yoga and other exercise for back-related function or pain, or whether yoga added to exercise is more effective than exercise alone."
They estimate that high-quality studies that would provide results with higher levels of certainty than those included in this review would allow more adequate determination of whether yoga provides clinical benefits for LBP.
- Wieland LS, Skoetz N, Pilkington K, Vempati R, D'Adamo CR, Berman BM. Yoga treatment for chronic non-specific low back pain. Cochrane Database Syst Rev. 2017;1:CD010671.