Om My God: Yoga Medicates Pain!
For medicating back pain, the yoga evidence is as strong as a yogi’s eagle pose.
Researchers conducting a 2015 systematic review of yoga — back pain trials concluded: "Yoga can be recommended as an additional therapy to chronic low back pain patients."
What are the therapeutic takeaways?
* 6 months of biweekly Iyengar classes worked for about 45 yoga newbies with chronic lower back pain. In a 2009 NIH-funded study out of West Virginia University, they experienced significant reductions in pain intensity and functional disability in comparison to their counterparts receiving standard medical care—results seen midway through the intervention, at its end, and even 6 months post treatment.
* 3 months of weekly 75-minute Viniyoga classes that included 5 — 11 postures, breathing exercises, and guided deep relaxation, plus home practice"Both Iyengar and Viniyoga class participants experienced significant reductions in back pain intensity compared to a control group."(participants were asked to continue on their own for 20 minutes on non-class days) considerably eased 92 patients' chronic back pain in comparison to 45 peers who received a self-care book. In this 2011 NIH-funded trial reported in JAMA: The Journal of the American Medical Association, yoga’s pain-control benefits continued for more than 3 months after classes ended.
In a 2011 UK study, though, yoga bettered back function but not pain. After 313 adults with chronic or recurrent low back pain received Iyengar yoga classes (12 classes over 3 months) or usual medical care, the two groups had similar back pain reports. Yet the yoga group’s had significantly advanced back function, both at the end of the trial and 9 months later.
This evidence is convincing enough for both the American College of Physicians and the American Pain Society to recommend yoga, a "nonpharmacologic therapy with proven benefits… for chronic or subacute low back pain… in cases where patients do not improve with self-care."
The facts on the ground (and in mid-air) also instigated this National Institute of Health science-of-yoga video discussing how yoga can benefit people with chronic low-back pain and how to begin a practice safely.
"Studies are mixed―some say #yoga helps with musculoskeletal pain, others don’t." — NIH National Center for Complementary and Integrative Health tweet
Musculoskeletal pain is a wide arena, developing from injuries to bones, joints, muscles, tendons, ligaments, or nerves. Yoga intervention effects will vary. But when it comes to general musculosketal pain, the results are really robust.
Take these 3 studies:1Because work-related musculoskeletal pain is an occupational hazard of dentistry, a 2015 trial compared dentists who either practiced yoga,"About 46% of Indian dentists who did not exercise reported work-related musculoskeletal pain. Only 11% of Indian dentists who practiced yoga reported that same pain."enjoyed their physical activity of choice, or did not exercise. Researchers at Vishnu Dental College in India gave work-habit and musculoskeletal disorder questionnaires to hundreds of dentists attending a Mumbai dental conference. Of the 220 dentists who completed the survey, 34.5% had musculoskeletal pain—but only 11% of those who regularly practiced yoga did, compared to 22% of those who did other exercises and 46% who didn’t partake in physical activity whatsoever. (Caveats: Dentists who took the time to participate in the surveys might not be representative of all dentists, and this non-intervention study does not prove cause and effect.)2In another 2015 trial, University of Rochester researchers divided breast cancer survivors taking hormonal therapy (up to 50% of survivors on aromatase inhibitors report musculoskeletal symptoms) into a yoga intervention and a control group. The yoga beginners practiced 18 gentle Hatha and restorative postures, breathing exercises, and meditation for 75 minutes twice a week. After a month, they reported diminished general pain, fewer muscle aches, and less physical discomfort than the control group.3Moreover, another 2013 study found that 55 adults with musculoskeletal pain"Reclining Bound Ankle Pose and Inverted Legs Pose, each held for 20 minutes, led to significant back-pain relief."who received just one day’s dose of yoga—two 20-minute postures—produced significant symptom relief in comparison to a control group of 55 participants receiving a placebo treatment. The two poses alleviating their symptoms: Reclining Bound Ankle Pose and Inverted Legs/Legs Up the Wall Pose.
"Doctors may suggest #yoga as an extra way to help people cope with arthritis pain" — NIH National Center for Complementary and Integrative Health tweet @NIH_NCCIH
A yoga prescription succeeded in diminishing arthritis pain in 2 out of the 3 randomized controlled trials, researchers concluded in a 2013 systematic review. Not bad odds. Here are the 3 trials:1In the 2012 study, 250 Indian patients with osteo-arthritis in the knees were randomly assigned either to hatha yoga (postures, meditation, relaxation, breathing techniques, and education) for 40 minutes a day, or to an exercise regimen researchers deemed to be of similar intensity. After 2 weeks, the yoga group had significantly reprieved pain compared to the aerobics group, both at rest and while walking.2And in the 2013 study, UC David Geffen School of Medicine researchers compared 25 young women with rheumatoid arthritis: Eleven took Iyengar yoga classes (postures, relaxation, and education) for 1 hour twice a week while the other 15 stayed on the class waitlist. Six weeks later, yoga participants reported less perceived pain and diminished pain disability—and the benefits endured 2 months later.
Yet both trials had limitations. Independent meta-analysis researchers noted that the Indian hatha yoga trial had a "high risk of bias" and the"Many kinds of physical activity help reduce arthritis pain."University of California Iyengar trial a "risk of bias." The Iyengar study also involved very few participants and its control group did not exercise. Many kinds of physical activity, including walking, has been shown to help reduce arthritis pain, so the positive trial results might be the result of moving rather than moving into meditative postures.3Still, even the very small 2011 yoga — osteoarthritis pilot study that failed to lower participants' pain levels did benefit the yoga group. The 10 elderly patients who practiced chair yoga/sitting meditation for 45 minutes twice a week had significant improvements in disability compared to their counterparts who practiced Reiki (a Japanese «laying on hands» technique for stress reduction and healing).
Hence, the NIH’s qualified recommendation: "Doctors may suggest #yoga as an extra way to help people cope with arthritis pain."
"Yoga & neck #pain is a growing area of research. Pilot studies show short term benefits; more research is needed" — NIH National Center for Complementary and Integrative Health tweet
In a 2013 pilot, 18 patients with neck pain practiced Iyengar yoga for 90 minutes once a week. After 9 weeks they reported "reduced pain levels". Yet the sample size was very small and there was no control group.
The 2012 pilot involved more participants—77 adults—and included a self-care/exercise group"The Iyengar yoga novices reported much less neck pain than the self-care exercise group."a control for the same Iyengar yoga prescription. After 10 weeks, both groups reported reduced neck pain when moving, but the yoga novices experienced significantly more relief. Possibly confounding the results, the research assistants collecting the data knew which individuals were in each group, and the yoga trainees enjoyed more time, attention, and social interaction.
With neck pain, there aren’t any head-turning results just yet—but after all, the research is just warming up.
Getting to Om
Are you ready to move forward (perhaps into a standing forward bend)? Before you plow (pose) on to asanas, start smartly with these 2 steps:1 Choose Your School: Just like there’s great variety in yoga postures, there are many different schools of yoga practice. Consider what approach to yoga is most likely to match your temperament, objectives, and abilities. Harvard Medical School offers this run-down of yoga schools to help you choose the right one for you and Yoga Journal features this directory where you can search for yoga studios or teachers by zip code or city/state.
2 Secure Your Safety: Your risk of serious injury from yoga is very low, but it can happen. Be proactive: Keep these 5 things in mind and watch the National Center for Complementary and Integrative Health’s video on yoga do’s and don’ts.by