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Yoga For Lower Back Pain (LBP)

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January 16, 2021

Effect of Yoga on Lower Back Pain

By now you know that yoga is a CAM practice that includes a number of disciplines such as asanas, pranayama, and meditation. According to 2018 report, yoga’s popularity has consistently grown over the last decade, with around 28% of adults in the U.S preferring yoga (U.S, 2018). [53] The number of modern yoga practitioners in the U. S. is estimated to be around 28.75 million people. According to published research, yoga helps ease back ache and minimize physical and functional disability caused by it. However, due to insufficient statistical power and variance in the outcome measures utilized between investigations, these studies have produced mixed results (Swain and McGwin 11). [54] The objective of this study was to investigate the impact of yoga on impairment associated with chronic LBP diseases using a robust meta-analysis and systematic review (Crow et al.3). [55]

Physical functionality

In a small scale study (controlled randomized experiment), the yoga group demonstrated advances in balance and flexibility, as well as decreased depression and functional disability (Mary Lou Galantino 49). [56] Similarly, in a 16-week controlled randomized experiment, patients with LBP treated with Iyengar yoga therapy were compared to a control group to validate the effectiveness of yoga. The findings provide evidence that the yoga practitioners reported less ache and functional impairment than the control group (K. A. Williams et al. 107). [48] Further, Williams et al. again attempted a 24-week research and proved significantly decreased functional impairment, pain severity, and depression in the yoga practitioners (K. Williams et al. 2066)]. [41]

An intense seven-day residential yoga programmed for patients with LBP was completed by 80 patients with LBP (Tekur, Chametcha, et al. 637). [57] Yoga’s impact on disability, quality of life and flexibility were investigated. The intervention group meditated, did yoga exercises, chanted, and attended lectures on a daily basis. The control group had a regular schedule that included exercise, educational lectures, non-yogic breathing exercises, and watching nature shows. This control differs from the standard controls utilized in previous studies. Between the two groups, there was a significant difference in disability, with the yoga group benefiting more than the control. The yoga members improved their flexibility and pain levels more than the control (Tekur, Singphow, et al. 10). [58]

Another study enrolled 53 persons who had previously participated in either physical therapy or a yoga intervention to treat LBP, outcome predictors were investigated. At 6 weeks, there were no substantial variations in disability. In both the groups, back pain was found to be the key indicators of health status, pain and disability. The back pain scale was used to examine a person’s belief in their ability to affect results by their individual activities. The criteria of self-selection unfairness in this study is a serious drawback, as the participants were previously enrolled into the physical therapy or yoga groups before the investigation (Evans et al.11). [59] Likewise, two large randomized trials have looked at the effects of yoga on physical functioning. The comparative study was carried out by Tilbrook et al. for 12-week comparing adults following yoga programmed (long-term effectiveness) versus a back pain instruction booklet. At 3, 6, and 12 months, the yoga members reported a significantly superior back function than the group following booklet (Tilbrook et al. 569; Cox et al.187). [60, 61] For individuals with LBP, Sherman et al. compared yoga routine to self-care instruction booklet method. With time, all of the cohorts’ function and symptoms improved. When compared to the self-care group, the yoga and stretching groups achieved equal outcomes (Sherman, Cherkin, Wellman, et al. 2019). [51] The authors concluded that the physical benefits of yoga outweigh the mental benefits.

Further, the 8-week pilot study was carried out with adult women suffering from musculoskeletal disorders such as osteoarthritis with LBP looked at the benefits of yoga on balance and gait. When compared to pre-study levels, the subjects’ balance and gait characteristics improved statistically. (Ülger and Yaĝllulger 13). [62]

Pain

Yoga has been shown to be useful in relieving pain related to chronic LBP in a number of studies. The pain-related anxieties of movement and pain beliefs were all assessed by Williams et al as the study compared the educational control group and the yoga intervention. The results found a two-fold reduction in pain and pain medication use (K. A. Williams et al.107). [48] There was no substantial difference in movement anxieties or pain attitudes, possibly because the study lacked statistical power to detect these differences. Williams et al. went on to show that a 24-week Iyengar yoga programme can help people with chronic LBP. Individuals in the yoga group improved their pain intensity more than those in the control group (K. Williams et al. 2066). [41]

The effect of yoga on back pain in low-income, racially diverse people was investigated by Saper et al. Following the 12-week treatment, respondents’ average LBP intensity for the preceding week was drastically reduced from 7 to 5 regardless of whether they attended once or multiple times yoga classes (Saper et al.). [63] Further, due to the complexities of pain, Sherman et al. noted pain “bothersomeness” rather than pain severity. Subjects reported their back pain on an 11-point scale ranging from “not at all” to “extremely” troublesome during the preceding week in accordance to a 3-month yoga, exercise, or book education intervention (Sherman, Cherkin, Wellman, et al. 2019). [64] All of the therapies were beneficial, but the exercise and yoga groups showed the most improvement.

The “bothersomeness” of back pain was investigated in people who had previously had either a physical therapy or a yoga intervention. Both interventions were effective, and after 6 weeks of treatment, there were no substantial differences between the physical therapy and yoga groups. However, the yoga group’s baseline structures were such that they had less back ache and functional disability to begin with. In participants with nonspecific chronic low back pain, a randomized controlled trial looked at the effects of Iyengar yoga on pain severity and overall health-related quality of life. The researchers assessed yoga therapy to traditional exercise therapy over a six-month period (GS et al. 48). [65] Both programs had a considerable impact, but the yoga intervention had the bigger influence.

Psychological effect

To date, the scientific literature on yoga’s influence on psychological health has not been fully described. In a study of veterans with back pain, Groessl et al. looked at the effects of yoga on psychological conditions like mental depression and effect on quality of life (Groessl, Weingart, Aschbacher, et al. 1123). [66] They discovered considerable reductions in depression, as well as a trend toward significant gains in the SF-12’s Mental Health Scale. The amount of home practice reported by the individuals tended to correlate with the improvement in depression. In participants with chronic LBP, the effects of Iyengar yoga on depression were evaluated. Subjects in the yoga group improved more than those in the control group in terms of depression. The yoga group was given substantial attention than the control group, which was one of the study’s limitations. The lack of controls for physical activity between the groups was another limitation (Groessl, Weingart, Johnson, et al. 832). [67] Further, Tekur et al. compared yoga group to the controls and discovered that the yoga group improved much more on the psychological state of their mind and the quality of life. This residential study, however, included more features than the standard Hatha or Iyengar yoga interventions (e.g., 8 hours of interactive talks, chanting, and meditation sessions per day (Tekur, Chametcha, et al. 637). [58] In addition, this was a one-week follow-up study. Similarly, with the mental health condition, one randomized controlled experiment (Tilbrook et al. 569) and an associated pilot research (Cox et al.187) compared yoga to “usual care.” [60, 61] The pilot study indicated no significant differences, however the sample size was small (n = 20). The power of their follow-up study was sufficient. At the 3-, 6-, and 12-month examinations, they found no substantial differences in psychological functions or mental health (although the 3 and 6 month assessments demonstrated a trend towards improvement). According to these reports, yoga is beneficial in lowering ache and functional disability, as well as increasing physical and psychological function.

Safety Data of Yoga for back pain

LBP is a physical disease that has a high recurrence rate and a high rate of partial recovery. As a result, it’s not uncommon to see some negative outcomes while investigating patients with back discomfort (Kamper et al. 9). [68] Yoga positions, on the other hand, do not appear to pose a significant risk to healthy persons or patients with back pain. In one study, one adverse event was documented among 30 patients who were randomly assigned to yoga. During the trial, a participant had symptoms of osteoarthritis and was diagnosed with a ruptured disc (K. A. Williams et al.107). [48] The Institutional Review Board decided that the adverse event was unrelated to the yoga postures after conducting a medical review. In the yoga versus exercise experiment, there were no significant adverse effects recorded among the 101 participants (Sherman, Cherkin, Erro, et al. 849). [69] One yoga student dropped out owing to migraine, and another exerciser hurt her back and received help from a chiropractor. Sherman et al. identified an equivalent incidence of moderate adverse effects (mainly briefly increased LBP) in both the yoga and the standard stretching interventions. A significant occurrence occurred once in the 87 yoga class participants, a herniated disc. One person in the control group with self-care treatment experienced severe pain. Despite all of these negative events, the stretching and yoga groups had reasonably better results overall. [64] Finally, safety data from the most latest and significant trials demonstrate a 10%–15% occurrence of substantially improved LBP discomfort, with two cases of herniated disc discovered. There appear to be certain concerns linked with yoga. However, the majority of individuals believe to gain large benefits due to yoga interventions with little or no negative effects (Sherman, Cherkin, Wellman, et al. 2019). [70] Overall, yoga appears to be a more well established intervention as the health sector transitions from treating acute illnesses to treating chronic diseases, and healthcare providers pursue to establish preventive measures to combat the enduring diseases that plague modern society. Since yoga is a reflective activity, it may be useful for military veterans who are dealing with the long-term effects of wartime stress.

Conclusion

Yoga appears to be just as helpful as other non-pharmacologic therapy at reducing back pain’s functional impairment. When compared to conventional treatments/therapies, it proves to be more successful in reducing the recurrence of LBP or dipping the pain severity. Yoga may help with depression and other psychological co-morbidities by maintaining serotonin or BDNF levels in the blood. Yoga demonstrates to be a safe way to treat persistent low back pain.

 

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