Yoga and physical therapy show a promising result among people who are already taking pain medication to treat their condition and those who did not fear that exercise would make their back pain worse, according to a new study.
Led by researchers at Boston Medical Centre and published in Pain Medicine?, the findings also showed that individuals who expected to do well with yoga were more likely to have a meaningful improvement in their function if they received yoga compared to receiving physical therapy. Studying a population of predominately non-white and low-income patients, the results from this clinical trial show that overall, 39 per cent of participants responded to one of the three treatment options with a greater response to yoga-or-physical therapy (42 per cent) than the self-care group (23 per cent).
There was not a significant difference in proportion of people responding to yoga versus physical therapy both showed similar improvements in back-related physical function. Among the study participants that were also using pain medication to treat chronic lower back pain, a large effect was observed among more participants in yoga (42 per cent) or physical therapy (34 per cent) compared with self-care (11 per cent).
This study highlights the effect that fear can have on patient outcomes. Among the participants identified to have less fear around physical activity, 53 per cent were more likely to respond to yoga and 42 per cent were more likely to respond to physical therapy than self-care (13 per cent).
In contrast, among participants who started out with high fear avoidance around taking part in physical activity, the proportions of responders to the three treatment options showed no additional effect in response to treatment.
"Adults living with chronic low back pain could benefit from a multi-disciplinary approach to treatment including yoga or physical therapy, especially when they are already using pain medication,' said Eric Roseen, a chiropractic physician at Boston Medical Centre.
The yoga intervention consisted of 12 group-based weekly 75-minute hatha yoga classes incorporating poses, relaxation and meditation exercises, yoga breathing and yoga philosophy. Thirty minutes of daily home practice was encouraged and supported with at-home yoga supplies. The physical therapy intervention consisted of 15 one-on-one 60-minute appointments over 12 weeks.
During each appointment, the physical therapist utilised the Treatment-Based Classification Method and supervised aerobic exercise, while providing written instructions and supplies to continue exercises at home. The self-care intervention consisted of reading from a copy of The Back Pain Handbook?, a comprehensive resource describing evidence-based self-management strategies for chronic lower back pain including stretching, strengthening and the role of psychological and social factors. Participants received check-in calls regarding reading every three weeks.