Low Back pain is the most common pain problem in United States. Traditionally, Physical Therapy (PT) has been considered non-pharmacologic conventional therapy with about 22% of low backache patients getting referred for the same.
In a diverse group double blind study presented at the American Academy of Pain Management (AAPM) 2016, Robert B. Saper, MD, Director of Integrative Medicine, Boston Medical Center, Massachusetts has reported that the effect of yoga was found to be better or non inferior to physical therapy group with other benefits like cost effectiveness.
The selected patients had high pain scores (average of 7 out of 10 on a pain scale) and were quite disabled in terms of their back pain with almost three quarters using pain medication and about 20% taking opioids.
A structured yoga protocol of 75-minute weekly class with a very low student-to-teacher ratio was designed. Participants were provided mats and CD for practice at home.
Yoga proved to be safe, with only mild, usually transient exacerbations of back pain. The researchers found that for some patients, quality yoga was superior to PT in relieving back pain, especially among those who were more dedicated to practicing it.
The study showed that for function (score on the Roland-Morris Disability Questionnaire), yoga was found superior and for every two patients who go for yoga, about 50% of them are going to have a clinical response.
In pain medication usage 20% of both the yoga and the PT groups had reduced their usage of pain medicines.
Complex activity of exercise, breath control and meditation prevent age related decrease in gray matter of brain leading to a robust relationship between how long a person has done yoga and positive brain changes. Yoga influences areas of the brain that are important for pain modulation and its practitioners have a higher pain tolerance than other people.
And finally, it seems that yoga may be just as good, if not better, than physical therapy (PT) for relief from back pain.
Dr Shamsher Singh
American Academy of Pain Management (AAPM) 2016 Annual Meeting. Presented September 23, 24, 2016.