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Summaries for Patients |18 July 2017

Yoga, Physical Therapy, or Education for Chronic Low Back Pain Free

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Author, Article, and Disclosure Information
This article was published at Annals.org on 20 June 2017.

  • The full report is titled “Yoga, Physical Therapy, or Education for Chronic Low Back Pain. A Randomized Noninferiority Trial.” The authors are R.B. Saper, C. Lemaster, A. Delitto, K.J. Sherman, P.M. Herman, E. Sadikova, J. Stevans, J.E. Keosaian, C.J. Cerrada, A.L. Femia, E.J. Roseen, P. Gardiner, K. Gergen Barnett, C. Faulkner, and J. Weinberg.


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    • Why did the researchers do this particular study?
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What is the problem and what is known about it so far?

Low back pain is a common problem that affects adults. Although most patients with low back pain get better quickly, some patients have symptoms that last a long time (also called chronic low back pain). Physical therapy is an effective treatment that is often used for chronic low back pain. Yoga is a practice that involves physical poses, controlled breathing, and meditation. Although studies show that yoga is effective for treating low back pain, it is not clear how it compares with standard treatments for chronic low back pain that are covered by health insurance, such as physical therapy.

Why did the researchers do this particular study?

To see if yoga is as effective as physical therapy for treating chronic low back pain.

Who was studied?

320 adults with chronic low back pain. These adults were seen at a university hospital and 7 community health centers that care for low-income people of different racial backgrounds.

How was the study done?

Study participants were randomly assigned to 1 of 3 groups: yoga classes every week for 3 months, 15 visits with a physical therapist over 3 months, or education (which involved getting a back pain self-help book and mailed newsletters). After 3 months, the yoga group attended more yoga sessions or practiced at home for another 9 months and the physical therapy group had sessions with the physical therapist every 2 months or did physical therapy exercises at home for another 9 months. The study participants answered questions about their level of back pain and activity limitations at baseline and 12 weeks. The researchers also monitored the participants' use of pain medications during the study, satisfaction with treatment, and quality of life.

What did the researchers find?

The yoga and physical therapy groups showed almost the same amount of improvement in pain and activity limitation over time. The improvements in pain and activity limitation in the yoga and physical therapy groups were also found at 1 year and were similar to each other. Yoga did not perform better than education in terms of improvement in pain and activity limitation at 3 months. However, participants in both the yoga and physical therapy groups were less likely to use pain medications at 3 months compared with the education group. Other measurements (satisfaction and quality of life) were similar between the physical therapy and yoga groups. A similar number of participants in the yoga and physical therapy groups reported mild joint and back pain as side effects of the treatment.

What were the limitations of the study?

The study participants knew what treatments they were receiving. The participants attended a low number of yoga and physical therapy sessions.

What are the implications of the study?

Participants in the yoga and physical therapy groups showed similar improvements in levels of pain and activity limitations. Yoga may be another reasonable option for treating chronic low back pain.

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Yoga, Physical Therapy, or Education for Chronic Low Back Pain. Ann Intern Med. 2017;167:I–20. [Epub ahead of print 20 June 2017]. doi: https://doi.org/10.7326/P17-9039

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Published: Ann Intern Med. 2017;167(2):I-20.

DOI: 10.7326/P17-9039

Published at www.annals.org on 20 June 2017

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2017 American College of Physicians
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