guardian.co.uk,
Nic Fleming, Monday 31 October 2011
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| Yoga sessions used in the study were designed to be safe and beneficial for people with lower back pain. Photograph: David Mcnew/Getty Images |
Doing yoga
is a more effective way for people with lower back pain to become more mobile
than the treatments currently offered by GPs, according to new research.
The study
found that back pain sufferers recorded greater improvements in everyday
physical tasks such as walking, bending down and getting dressed if they did
weekly yoga sessions.
Participants
who had practised yoga reported enhanced function compared with those receiving
standard care, even nine months after the yoga classes had finished.
Previous,
smaller studies have suggested yoga could be beneficial to back pain sufferers.
However, these have often involved just one teacher and have not included
long-term follow-up.
Back pain
is estimated to affect 80% of adults at some point in their lives, and one in
five people visits their GP in any given year because of it.
The
condition, defined as chronic if it lasts longer than six weeks, is the second
most common cause of long-term disability after arthritis and second only to
stress as a cause of absence from work. It costs the NHS around £1bn per year
and the annual cost to the economy has been estimated at £20bn.
Existing
treatment options include painkillers, spinal manipulation, acupuncture,
exercise classes and cognitive behavioural therapy.
"In
the past when you had back pain, you were told to lie down until it
passed," said Prof David Torgerson, director of the York Trial Unit at the
University of York, who led the study.
"These
days the main advice is to keep your back active. It seems yoga has more
beneficial effects than usual care including other forms of exercise, although
we have not carried out a direct comparison.
"We
are still carrying out the economic analysis but it is likely yoga could reduce
the costs of back pain both for patients and for the NHS."
Twenty
experienced yoga teachers from the British Wheel of Yoga and Iyengar Yoga were
trained to deliver a beginner level course of 12 yoga sessions specially designed to be safe and beneficial to those with lower back pain.
A group of
156 patients with chronic lower back pain were assigned to have the 75-minute
yoga classes in north and west London, Manchester, York and Truro, in addition
to normal GP care, while a control group of 157 just saw their GPs.
Participants
filled in a 24-point questionnaire on whether their condition prevented them
from doing everyday tasks. Lower scores equated to better function.
Those who
did the yoga scored on average 2.17 points lower than those who did not. Three
and nine months later, their scores were still 1.48 and 1.57 points lower
respectively.
Participants
also reported lower overall pain levels on average. However, this effect did
not reach statistical significance. Around 60% of those in the yoga group
continued with their practice after the classes.
The study
is published in the Annals of Internal Medicine.
Rates of
reported cases of back pain have doubled in the past 40 years in England, a
trend seen in other Western countries. Some believe this is a result of higher
levels of obesity, stress and depression, while others suggest people are more
willing to report the condition.
When the
UK's National Institute for Health and Clinical Excellence – which draws up
guidelines on the best treatments – last reviewed treatments for lower back
pain in May 2009, it ruled that exercise, spinal manipulation and acupuncture
were cost-effective treatments.
"Yoga
is one of a number of treatments that have now been shown to be effective for
back pain," said Martin Underwood, professor of primary care research at
Warwick Medical School.
"The
study shows it having a small to moderate average effect for patients, meaning
there will be some people who experience little or no effect and other people
for whom it has substantial benefit. Unfortunately we don't yet know which
patients respond to which treatments."
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