Yoga As Medicine

Yoga Vs. Physical Therapy For Chronic Low Back Pain: Which Is More Effective?


FORBES Contributer, by Robert Glatter, MD

Excerpts from full article published June 2017

Now, a study published in the Annals of Internal Medicine finds that yoga was just as good as physical therapy for reducing pain and increasing mobility .

The study followed 320 mainly low-income, racially diverse adults with chronic low back pain. The study also found that patients who practiced yoga or physical therapy were also less inclined to require pain medications at 12 weeks.

The statistics are impressive, as chronic low back pain affects nearly 10 percent of adults living in the U.S., with a greater impact often seen on racial or ethnic minorities and those of lower socioeconomic status.

However, it’s curious that physical therapy still remains the most common reimbursable, evidence-based, non-pharmacologic therapy prescribed by doctors.

Researchers from Boston Medical Center randomized participants to the following regimen:  12 weekly yoga classes, 15 physical therapy visits, or reading materials  and newsletters about ways to deal with chronic low back pain.

After an “intervention phase”, participants transitioned to a maintenance phase and were followed for 1 year. Designed as a noninferiority trial, the aim was to understand if yoga was as effective as physical therapy for treating chronic low back pain.

What the investigators found was that found that yoga was as effective as physical therapy for alleviating pain, improving function, and reducing the use of pain medication.

Researchers noted that improvements in pain and function in yoga and physical therapy groups extended to 1 year, with similar maintenance strategies in both groups.

The researchers concluded that yoga may be a good alternative to physical therapy, based on patient preferences, cost and availability. But the power of yoga also lies in its ability to alleviate chronic pain, the subject of many critical reviews and medical trials over the past decade.

“Yoga is something a person can do using their own resources of mind, breath and body to directly confront the dragons of pain and suffering,” said Sol Soloncha, a yoga therapist and registered nurse at Lenox Hill Hospital, Northwell Health. “An effective program of yoga therapy can be tailored for the individual to suit specific goals, interests and medical conditions.  The gentle movement coordinated with conscious breathing that yoga offers helps the mind modulate the nervous system to dampen the pain response and promotes improved circulation and mobility.  It can be tremendously empowering and transformative to realize that one can do something to cope with pain besides taking a pill.

This change is approach comes on the heels of a newly released guideline issued earlier this year by the American College of Physicians (ACP) emphasizing consideration of “non-pharmacological options like yoga and mindfulness meditation before prescribing opioids for patients with chronic lower back pain,” according to Soloncha.

As the death toll from overprescribing of opioids continue to mount, embracing alternative therapies such as yoga and acupuncture, which harness the powerful mind-body connection, may help break the powerful grip of opioids in our culture.

 

 

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