From Padasana to Pain Relief: Iyengar Yoga for Chronic Low Back Pain

Selfridge, Nancy
January 2010
Alternative Medicine Alert;Jan2010, Vol. 13 Issue 1, p9
BASED ON A FEW STUDIES SHOWING THAT YOGA THERAPY is helpful for treating chronic low back pain, including a 2005 randomized controlled trial of shorter duration by the same lead study author, Williams et al hypothesized that a 24-week program of Iyengar yoga would result in improvements in pain, functional disability, and depression, and in reductions in pain medication usage. Ninety participants were identified and allocated randomly to an intervention group (n = 43) or a control group (n = 47). The intervention group participated twice-weekly in 90-minute Iyengar yoga classes and were directed to practice 30 minutes of yoga daily at home on nonclass days after being supplied with props, a DVD, and an Iyengar yoga instruction manual. Their compliance was measured by documenting class attendance and by participants submitting weekly reports on the duration and frequency of their home practice. The control group continued self-directed standard medical care without any attempt to regulate treatment received and monthly phone calls were conducted to both groups to collect information about medical care and the use of pain medicine. The control group participants who were adherent to the study requirements were "wait-listed" and offered the yoga classes 6 months after the conclusion of the study. Four primary outcomes were determined: pain using a visual analogue scale, functional disability using the Oswestry Disability Index, depression using the Beck Depression Inventory, and self-reported medication use. Data were obtained at baseline, 12, 24, and 48 weeks and results for the treatment and control groups were compared in both intention-to-treat and per-protocol analyses for each primary outcome. The yoga treatment group had statistically significant reductions in functional disability, pain intensity, and depression in both intention-to-treat and per-protocol analyses compared to the control group. A total of 16 study participants did not complete the 24-week protocol. This included 12 from the yoga group, the majority reporting reasons unrelated to the yoga therapy. There was a nonsignificant reduction in pain medication use by both the yoga and control groups over the course of the study, though the yoga group showed a trend for a higher success rate in decreasing pain medication over time. One adverse event was reported during the 6-month post-treatment follow-up period that was not associated with the yoga intervention but with physical therapy.


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