Physical therapy is a mainstay in the treatment of low back pain, but could yoga be just as effective? A recently published study suggests that it might be. And you don’t necessarily need to get on the floor to do it!
In a study recently published online in the Annals of Internal Medicine, 320 people with chronic low back pain were put into 3 groups to compare yoga, physical therapy, and education using newsletters and The Back Pain Handbook. The study looked at primarily at the reduction of pain and improvement of function, but also measured medication use, overall improvement, and quality of life. No surprise to yoga practitioners, yoga was “non-inferior” to physical therapy, and both were generally more effective than education alone.
Many other studies have suggested that yoga is effective at helping to manage low back pain, and possibly lots of other types of pain. There are many styles of yoga, but there has not been much research done to determine the “best” style for back pain. It may have a lot to do with what type of personality you have, whether you are able to do a strenuous workout, and how physically fit you are. Some of the basic styles that seem to be best for beginners are Hatha, Yinyoga, and Restorative yoga. All focus on holding poses and include some meditation. A beginner level Iyengar yoga class may also be helpful. Vinyasa is more quickly paced and focuses on moving from pose to pose. There are even classes that have adapted poses so they can be done in a chair, for people who are unable to stand for a long time or get down on the floor.
Science doesn’t really understand why yoga is effective at helping manage pain. Some theories are that yoga helps improve posture and body mechanics, or helps reduce the physical and emotional response to stress. Both are probably true. Yoga may be better than just stretching at home because there is more social interaction, and more motivation to continue. Compared to physical therapy, yoga may be less expensive, and insurance providers are starting to recognize that and may start covering the cost of yoga classes.
I usually recommend starting with a class and working with an experienced instructor. Most poses can be adapted to accommodate a variety of physical limitations, or to focus on a person’s specific needs, and a good instructor will be able to help you with those adaptations. There are dozens of yoga studios in our area, and many fitness clubs offer classes, as well as YMCAs, senior centers, and community centers. A quick Internet search will pull up a long list. Call them up or email, and ask questions. Be honest about your current capabilities, and ask if they have instructors who are experienced in working with people with physical limitations. Once you are in a class, you’ll get the most benefit if you also practice at home, at least a few minutes a day, unless you can go to a few classes a week.
Don’t try yoga without talking to your healthcare provider if you have a sudden onset of severe pain after an injury or associated with fevers. Pain associated with weight loss or in a person with a history of cancer, long-term steroid use, or IV drug use should be checked out before you start yoga. You should also get the OK from your health care provider to start yoga if you have pain at night or pain at rest. These are all signs that something MIGHT be seriously wrong, and should be evaluated before you start any exercise program.
By the way, I really dislike the images that people usually think of when they think of yoga – you know, the thin, physically-fit, radiant young woman in some impossible pretzel shape. Yoga is great for larger people, stiff people, older people, tense people … all kinds of people. How about you?
At North Shore Pain Management we provide advanced, evidence-based, multidisciplinary and cost-effective pain management. Our goal is to improve your ability to return to the activities you have been missing as well as provide a meaningful reduction in pain.