Suffering from Low Back Pain?
In her book, Strong Women, Strong Backs,
Maybe You Should Try Yoga
T
wo new studies offer a glimmer of
hope for sufferers of chronic low
back pain, from an unexpected
source—yoga. The ancient physical,
mental and spiritual discipline, which
originated in ancient India and came
to America in the 1890s, outperformed
self-care for back pain in both stud-
ies. While yoga’s stretching activities
seemed to be the primary factor in
patients’ improvement, one of the stud-
ies also cited its mental discipline as
possibly helpful for back-pain sufferers.
“Sixty to ninety percent of all adults
experience back pain at some point in
their lives,” notes Miriam E. Nelson,
PhD, director of Tufts’ John Hancock
Research Center on Physical Activ-
ity, Nutrition and Obesity Prevention
and author of Strong Women, Strong
Backs. “It’s no wonder when you look
at what our backs have to do—twist,
lift, shove, heave, etc. Our backs
are made up of a series of vertebrae,
ligaments, tendons and nerves. The
vertebrae come together at 20 small,
intricate joints.”
Yoga, Nelson adds, is “a terrific
exercise that reduces stress and increas-
es both flexibility and coordination,
improving your health and fitness.”
C
an it also alleviate back pain? Two
studies, published within days of
each other in Archives of Internal
Medicine and Annals of
Internal Medicine, set
out to test that pos-
sibility. The first study
compared weekly
yoga classes to self-
care or conventional
stretching exercises
among 228 sufferers
of chronic low back
pain. Both the yoga
and the stretching ac-
tivity improved function
at 12 and 26 weeks.
At no point,
however, was yoga
superior to con-
ventional stretching
exercises. Lead author Karen Sherman,
PhD, MPH, of Group Health Research
Institute in Seattle, concluded, “Physi-
cal activity involving stretching, regard-
less of whether it is achieved using yoga
or more conventional exercises, has
moderate benefits in individuals with
moderately impairing low back pain.
“We expected back pain to ease
more with yoga than with stretching,
so our findings surprised us,” Sherman
added. “The most straightforward
interpretation of our findings would be
that yoga’s benefits on back function
and symptoms were largely physical,
due to the stretching and strengthening
of muscles.”
Both the yoga and stretching
classes were 75 minutes long, but the
stretching class spent more time—52
minutes—actually performing stretch-
ing exercises. The yoga class also spent
time with breathing and deep relax-
ation exercises.
Sherman said, “It’s important to
emphasize that both yoga and stretch-
ing had clinically important benefits.”
I
n the second study, yoga also proved
more effective than self-care, and
researchers partly credited the disci-
pline’s focus on mindfulness. Helen Til-
brook, MSc, of the University of York,
and colleagues randomly assigned 313
back-pain patients to yoga training or
usual care with no active intervention.
All participants received a back-pain
educational booklet. The yoga group
participated in 12 classes over a three-
month span.
The yoga group reported superior
back function at three, six and 12
months, as measured by a standard
test of disability, along with greater
confidence in performing normal
activities. There was no difference
between the
yoga and
control
groups,
however, in
scores of back
pain or general health.
February 2012 : TUFTS UNIVERSITY HEALTH & NUTRITION LETTER 3
What Causes Back Pain?
Tufts’ Miriam E. Nelson, PhD, lists some
of the numerous causes of back pain:
• Lack of strength and flexibility
• Excess body weight
• Poor posture
• Degenerative disks
• Scoliosis
• Osteoporosis
• Trauma
• Herniated disc
• Arthritis
• Spinal stenosis
Tilbrook and colleagues suggested
that some of yoga’s apparent benefits
could be due to its mental discipline,
as well as its focus on posture. They
noted, though, that those benefits
diminished over time, after the yoga
classes were completed; continuing
classes may be needed to keep enjoying
yoga’s functional benefits.
“Yoga seems to be a safe and ef-
fective activity that clinicians could
consider recommending for patients
with a history of low back pain,” the
researchers concluded.
N
ot all yoga activities are equally
beneficial, Tufts’ Nelson cautions.
If you’re looking for a strength-
ening benefit, she says, “you can tell
by how your muscles feel whether
it’s effective. If the pose is challenging
enough so that you can hold it only for
a minute before you need to rest, and
if you feel the burn of muscle fatigue,
then probably you’re getting some
strengthening effect.”
If you have osteoporosis and are
tempted to try yoga, Nelson adds, keep
in mind that forward flexation can be
dangerous to your spine. Before you
tackle any new fitness regimen, it’s
smart to check with your healthcare
professional.
TO LEARN MORE: Archives of Internal Medicine, online
first; abstract at <archinte.ama-assn.org/cgi/content/
short/archinternmed.2011.524>. Annals of Internal
Medicine, Nov. 1, 2011; abstract at <www.annals.org/
content/155/9/569.abstract?aimhp>. u
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