Yoga for low back pain: A systematic review of randomized clinical trials

Complementary Medicine, Peninsula Medical School, 25 Victoria Park Road, Exeter, Devon, UK.
Clinical Rheumatology (Impact Factor: 1.77). 05/2011; 30(9):1257-62. DOI: 10.1007/s10067-011-1764-8
Source: PubMed

ABSTRACT It has been suggested that yoga has a positive effect on low back pain and function. The objective of this systematic review was to assess the effectiveness of yoga as a treatment option for low back pain. Seven databases were searched from their inception to March 2011. Randomized clinical trials were considered if they investigated yoga in patients with low back pain and if they assessed pain as an outcome measure. The selection of studies, data extraction and validation were performed independently by two reviewers. Seven randomized controlled clinical trials (RCTs) met the inclusion criteria. Their methodological quality ranged between 2 and 4 on the Jadad scale. Five RCTs suggested that yoga leads to a significantly greater reduction in low back pain than usual care, education or conventional therapeutic exercises. Two RCTs showed no between-group differences. It is concluded that yoga has the potential to alleviate low back pain. However, any definitive claims should be treated with caution.

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Available from: Edzard Ernst, Aug 11, 2015
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    • "Four large (í µí±› = 90–313) [1] [2] [3] [4] and five smaller randomized controlled trials (RCTs) (í µí±› = 20–80) [5] [6] [7] [8] [9] have demonstrated yoga is an effective treatment for reducing pain and improving function in adults with cLBP. Meta-analyses [10] [11] [12] and practice guidelines from the American Pain Society and American College of Physicians [13] support yoga as an evidence-based treatment for cLBP with at least moderate benefit. "
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    ABSTRACT: Background. Previous studies have demonstrated that once-weekly yoga classes are effective for chronic low back pain (cLBP) in white adults with high socioeconomic status. The comparative effectiveness of twice-weekly classes and generalizability to racially diverse low income populations are unknown. Methods. We conducted a 12-week randomized, parallel-group, dosing trial for 95 adults recruited from an urban safety-net hospital and five community health centers comparing once-weekly (n = 49) versus twice-weekly (n = 46) standardized yoga classes supplemented by home practice. Primary outcomes were change from baseline to 12 weeks in pain (11-point scale) and back-related function (23-point modified Roland-Morris Disability Questionnaire). Results. 82% of participants were nonwhite; 77% had annual household incomes <$40,000. The sample's baseline mean pain intensity [6.9 (SD 1.6)] and function [13.7 (SD 5.0)] reflected moderate to severe back pain and impairment. Pain and back-related function improved within both groups (P < 0.001). However, there were no differences between once-weekly and twice-weekly groups for pain reduction [-2.1 (95% CI -2.9, -1.3) versus -2.4 (95% CI -3.1, -1.8), P = 0.62] or back-related function [-5.1 (95% CI -7.0, -3.2) versus -4.9 (95% CI -6.5, -3.3), P = 0.83]. Conclusions. Twelve weeks of once-weekly or twice-weekly yoga classes were similarly effective for predominantly low income minority adults with moderate to severe chronic low back pain. This trial is registered with NCT01761617.
    Evidence-based Complementary and Alternative Medicine 06/2013; 2013:658030. DOI:10.1155/2013/658030 · 1.88 Impact Factor
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    • ", 1 description of studies on yogic breathing [6] [7], 1 summary [8] Fatigue 1 systematic review [9] Anxiety and anxiety disorders 1 systematic review [1], 1 Cochrane review on meditation therapy [10], 1 description of studies on yogic breathing [6] [7], 1 summary [8] Stress 1 systematic review [11] Posttraumatic stress disorder 1 review article [12] Physical fitness 1 critical review [13] Sympathetic/parasympathetic activation 1 systematic review [14] Cardiovascular endurance 1 review [15] Blood pressure and hypertension 1 systematic review [14] Pulmonary function 1 review [15] Glucose regulation 3 systematic reviews [14] [16] [17] Menopausal symptoms 1 review [18], 1 systematic review [19] Musculoskeletal functioning and pain 3 systematic reviews [20] [21] [22], 2 reviews [23] [24] Cancer 2 reviews [25] [26], 2 meta-analyses [27] [28] Epilepsy 1 Cochrane review [29] healthy persons as well as patients with cancer, multiple sclerosis, dialysis, chronic pancreatitis, fibromyalgia, and asthma [9]. Overall, a small positive effect with an SMD of 0.28 [0.24–0.33] "
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    ABSTRACT: This report summarizes the current evidence on the effects of yoga interventions on various components of mental and physical health, by focussing on the evidence described in review articles. Collectively, these reviews suggest a number of areas where yoga may well be beneficial, but more research is required for virtually all of them to firmly establish such benefits. The heterogeneity among interventions and conditions studied has hampered the use of meta-analysis as an appropriate tool for summarizing the current literature. Nevertheless, there are some meta-analyses which indicate beneficial effects of yoga interventions, and there are several randomized clinical trials (RCT's) of relatively high quality indicating beneficial effects of yoga for pain-associated disability and mental health. Yoga may well be effective as a supportive adjunct to mitigate some medical conditions, but not yet a proven stand-alone, curative treatment. Larger-scale and more rigorous research with higher methodological quality and adequate control interventions is highly encouraged because yoga may have potential to be implemented as a beneficial supportive/adjunct treatment that is relatively cost-effective, may be practiced at least in part as a self-care behavioral treatment, provides a life-long behavioural skill, enhances self-efficacy and self-confidence and is often associated with additional positive side effects.
    Evidence-based Complementary and Alternative Medicine 09/2012; 2012(3):165410. DOI:10.1155/2012/165410 · 1.88 Impact Factor
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    • "Only studies that used yoga postures explicitly as an intervention were included; interventions that employed other aspects of yoga, such as yogic breath, yogic philosophy, ayurvedic herbs, or mindfulness as the primary intervention, were not included, as the effects of asana or integrated yoga programs were of primary interest. Information on trial design, randomization, blinding, drop out rate, inclusion and exclusion criteria, details about treatment and control conditions, main outcome measures, and main results were extracted, as has been done in previous reviews of yoga for certain conditions [20]. Studies were evaluated independently by two reviewers (K. "
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    ABSTRACT: Objectives. Yoga is used for a variety of immunological, neuromuscular, psychological, and pain conditions. Recent studies indicate that it may be effective in improving pregnancy, labour, and birth outcomes. The purpose of this paper is to evaluate the existing literature on yoga for pregnancy. Methods. Six databases were searched using the terms "yoga AND pregnancy" and "yoga AND [post-natal OR post-partum]". Trials were considered if they were controlled and evaluated a yoga intervention. All studies were evaluated for methodological quality according to the Jadad scale and the Delphi List. Results. Six trials were identified: three were randomized controlled trials (RCTs) and three were controlled trials (CTs). The methodological quality and reporting ranged from 0-5 on the Jadad scale and from 3-6 on the Delphi List. Findings from the RCT studies indicate that yoga may produce improvements in stress levels, quality of life, aspects of interpersonal relating, autonomic nervous system functioning, and labour parameters such as comfort, pain, and duration. Conclusions. The findings suggest that yoga is well indicated for pregnant women and leads to improvements on a variety of pregnancy, labour, and birth outcomes. However, RCTs are needed to provide more information regarding the utility of yoga interventions for pregnancy.
    Evidence-based Complementary and Alternative Medicine 08/2012; 2012:715942. DOI:10.1155/2012/715942 · 1.88 Impact Factor
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