Yoga: Can it help with low back pain?

It may not be a surprise that the most common condition a physiotherapist will see in people suffering with low back pain. The majority of these people are suffering from mechanical low back pain or muscle stiffness or tension. The advice and treatment for such cases is gentle stretches, encouraging normal movement and increasing activity levels. People have tended to adopt walking, cycling, swimming and Pilates as their chosen for of increased activity.

But is Yoga of any benefit in the management of low back pain?

Whilst I have partaken first hand in swimming, cycling, walking, running and Pilates, I can therefore talk to clients about them when asking about which exercises are beneficial for certain pathologies. I, however cannot say the same for yoga. it is well documented that exercise in general is beneficial for the management of low back pain, including Pilates. With a working knowledge of Pilates, I am able to build this into my treatment repertoire for low back pain. I however, am unable to with Yoga. I therefore felt it beneficial to look into the efficiency of Yoga.

A recent Cochrane Systematic Review by conducted by Wielend et al (2017) into the efficiency of Yoga and low back pain. (Herein known as "The Researchers")

1. Yoga compared to no exercise

The researchers identified a small clinical benefit in performing yoga as opposed to no exercise for the management of low back pain. The evidence reduced furthermore when viewing as a longitudinal study. The researchers stated there was no significant difference in pain reduction. The evidence was "quite sparse" when it came to quality of life and mental well-being

2. Yoga compared to exercise

The researchers suggested there was little to no difference between yoga and non-yoga exercise for the management of low back pain! The researchers added there was an increased risk of bias in the evidence reviewed, and the evidence itself was sparse. When it came to pain outcome measures, the researchers were unsuccessful in their search!

3. Yoga as an adjunct to exercise

The researchers identified that the evidence into this was extremely limited and the evidence they could identify had a high risk of bias and method imprecision. Therefore the researchers were unable to state whether yoga as an odd-on to exercise was beneficial.

Therefore the authors are unable to state whether yoga is effective in the management of low back pain. However, the authors have recommended that yoga is a better form of exercise than no exercise at all. In consideration, this review has not compared Pilates, swimming, running, walking or cycling in a similar way and can therefore pose the question into the reliability in the same 3 categories. I do feel from this research that I have enough treatment modalities in my treatment toolbox and will not be looking further into Yoga. I have seen good results from the Pilates, running, walking and cycling. I have blogged before about certain swimming strokes and should be considered when considering low back pain.

The original article is available on request. Wieland, et al (2017) "Yoga treatment for chronic non-specific low back pain (Review)". Wiley Online Library. pp;1-142