Overcoming Pain

Why people experience chronic pain, and the power they have to de-intensify it

Yoga for Chronic Low Back Pain

It really does help.

A recent article in the “Clinical Journal of Pain” describes a rigorous effort to settle the question as to whether yoga truly helps chronic pain—in this case chronic low back pain. The researchers systematically reviewed randomized controlled trials comparing yoga to control conditions in patients with low back pain, with the goal of trying to make conclusions regarding pain, disability related to the back pain, generalized disability, health-related quality of life, and overall improvement.

After examining ten randomized controlled trials consisting of almost 1,000 chronic low back pain patients, the authors of the article found strong evidence for short-term positive effects on pain, disability related to the back pain, and overall improvement; likewise, there was strong evidence for the long-term effect on pain. And finally, there was moderate evidence for a long-term effect on disability related to the back pain. However, there was no evidence for any kind of effect on health-related quality of life.

It was already known that yoga improved function in those with chronic back pain.

The report confirmed what many were also already convinced of: Yoga has no adverse effects—at least for the chronic back pain population.

It is important to remember that nearly everyone has low back pain at some point in life. Men and women are equally affected. It occurs most often between ages 30 and 50, due in part to the aging process; but also as a result of sedentary life styles with too little (sometimes punctuated by too much) exercise. The risk of experiencing low back pain from disc disease or spinal degeneration increases with age. While low back pain unrelated to injury or other known cause is unusual in pre-teen children, a backpack overloaded with schoolbooks and supplies can quickly strain the back and cause muscle fatigue.

Exercise may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles. Maintaining and building muscle strength is particularly important for persons with skeletal irregularities. Doctors and physical therapists can provide a list of gentle exercises that help keep muscles moving and speed the recovery process. A routine of back-healthy activities may include stretching exercises, swimming, walking, and movement therapy to improve coordination and develop proper posture and muscle balance. Of course, yoga is another way to gently stretch muscles and ease pain. Any mild discomfort felt at the start of these exercises should disappear as muscles become stronger. But if pain is more than mild and lasts more than 15 minutes during exercise, patients should stop exercising and contact a doctor. (If there is some sort of neurologic damage, don’t make it worse.)

Mark Borigini, M.D., is a board-certified rheumatologist who has devoted his career to treating illnesses that cause chronic pain and disability.

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