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Yoga Eases Low-Grade Back Pain

It proved more effective than exercise or self-help book, study finds

TUESDAY, Dec. 20, 2005 (HealthDay News) -- The next time your balky back acts up, maybe you should give the Warrior a try. Or the Cobra. Or perhaps the Supine Butterfly.

A new study of 101 adults with chronic lower back pain compared the benefits of yoga, conventional therapeutic exercise, and the information contained in a popular back pain book. The result: Those who took weekly yoga classes for 12 weeks experienced the most increase in function and the biggest decrease in the need for pain medication.

"The study suggests that for people who are looking to do something for themselves, you could clearly say that yoga is the best," said Karen Sherman, an epidemiologist and researcher with Group Health Cooperative in Seattle, and the lead author of the study.

The results of the study, which was sponsored by the National Institutes of Health, appear in the Dec. 20 issue of the Annals of Internal Medicine.

For the study, Sherman and her colleagues chose participants between 20 and 64 years of age who suffered from chronic but not serious back pain -- people who "see their primary care doctor because their back is bothering them, and they're not feeling good," she said.

The researchers divided the participants, mostly women in their 40s, into three groups. One group took classes in viniyoga, a therapeutically oriented style of yoga that's relatively easy to learn and also emphasizes safety. The second group attended specifically designed therapeutic exercise classes taught by a physical therapist, which included strength and stretching exercises. The third group was given a copy of The Back Pain Helpbook and asked to read it.

The participants were interviewed four times during the 26-week study, including prior to the start the study and a follow-up at 26 weeks, to assess their ability to do daily tasks, pain level and how much pain medication they took.

All three groups reported improved function. But those who took the yoga class experienced the most improvement, with 78 percent of the group improving by at least two points on a standardized measure called the Roland Disability Scale, which assesses how people can perform daily tasks, such as walking up stairs without pain or bending over to tie shoelaces. Sixty-three percent who took the exercise class reported at least a two-point improvement, while 47 percent of those who read the book reported a similar benefit, Sherman said.

The yoga participants also reduced their use of pain medicine more than those in the other two groups. By the end of the 26 weeks, only 21 percent in the yoga class were taking medication for their back pain; 58 percent had been doing so before starting the yoga class. The use of pain medicine for the exercise group dropped to 50 percent from 57 percent, while those who read the book increased their use of pain medication -- from 50 percent to 59 percent, the researchers said.

Sherman said yoga may be more effective in helping with back pain because many people are unaware how they move their bodies. And the breathing that is a component of yoga makes people more conscious of their bodies and of ways they move that might contribute to their back problems, she said.

Sherman said this is the largest study done so far comparing different therapies for chronic, low back pain. But larger studies would be helpful in further teasing out the benefits of yoga compared to other forms of exercise or reading a self-help book.

She also emphasized that it's important to choose the right yoga instructor if you're struggling with back pain.

Dr. Andrew Sherman, head of medical rehabilitation at the Spine Institute at the University of Miami Miller School of Medicine, said that while yoga was shown in this study to be helpful, the best rehabilitation is tailored to each patient. Someone under stress and with tight muscles might be a good candidate for yoga, but another person with back pain who has very weak muscles might do better with a strength-building exercise program, he said.

Because there were only about 35 people in each group in this study, a larger study is needed before yoga can be shown to be definitively better than other therapies, he said.

"You can't throw other therapies under the bus based on 35 patients," Sherman said.

Kate Lorig, one of the co-authors of The Back Pain Helpbook and the director of the Stanford Patient Education Research Center, said she wasn't surprised by the study's findings.

"We have long known that in most cases giving people information alone is not enough to change either health behaviors or health status," she said. "I would never expect a book alone to make much difference."

She also agreed that the best way to achieve the desired results is with a good yoga instructor.

"My real question is if the findings from this study can be replicated with other instructors," Lorig said.

More information

For more on back pain, visit the National Library of Medicine.

SOURCES: Karen Sherman, Ph.D., MPH, epidemiologist and researcher, Group Health Cooperative, Seattle; Andrew Sherman, M.D., assistant professor and head of medical rehabilitation at the Spine Institute, University of Miami Miller School of Medicine, Fla.; Kate Lorig, R.N., Dr.PH, director of the Stanford Patient Education Research Center, Stanford University School of Medicine, Stanford, Calif., and co-author, The Back Pain Helpbook; Dec. 20, 2005, Annals of Internal Medicine
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