November 30, 2017
Yoga may be an effective alternative treatment for patients with nonspecific chronic back pain, according to a recent noninferiority trial.
The trial included 320 predominately low-income and racially diverse adults with nonspecific chronic low back pain who were randomly assigned to receive an educational book and newsletters, or participate in 12 weeks of yoga classes or 15 physical therapy sessions. The 12-week intervention was followed by a 40-week maintenance phase, in which participants were randomly assigned to additional yoga classes or home practice, or additional physical therapy sessions or home practice.
At 12 weeks, the researchers assessed back-related function and pain, as well as pain medication use, global improvement, satisfaction with intervention, and health-related quality of life.
Yoga was found to be noninferior to physical therapy in assessments of pain and back-related function, but was not superior to education. However, both yoga and physical therapy lowered the amount of pain medication used by patients at 12 weeks compared with educational material.
After 1 year, participants assigned to either yoga or physical therapy maintained improvements in pain and back-related function, as well as medication use, which was unaffected by allocation to home practice or additional classes.
“A manualized yoga program for nonspecific [chronic low back pain] was noninferior to [physical therapy] for function and pain,” the researchers wrote.
Saper RB, Lemaster C, Delitto A, et al. Yoga, physical therapy, or education for chronic low back pain: a randomized noninferiority trial [published online June 20, 2017]. Ann Intern Med. doi: 10.7326/M16-2579.