Online yoga classes relieved chronic lower back pain and reduced the need for pain-relieving medications, a new study shows.
People with back pain who took 12 weeks of virtual, live-streamed yoga classes also slept better and exercised more easily than participants on a waiting list for the classes, according to the study published in early November in JAMA network opened reported.
“Their pain level was really cut in half,” he said Dr. Robert Sapersenior author of the study and chair of the Cleveland Clinic’s Department of Wellness and Preventive Medicine.
“I find this very exciting because we have a huge proportion of patients, 95% of patients, that sometimes we don’t know what to do,” said Dr. Roger Hartl, neurosurgical director of Och Spine at New York-Presbyterian/Weill Cornell Medical Center, who was not involved in the study.
Virtual yoga would be something that could be offered to such patients, he added. “Why not, if it works, is it safe and effective?”
Americans spend an estimated $135 billion per year on healthcare related to low back pain an estimated 80% of adults suffer from it, previous studies have shown.
The new study focused on healthcare workers, a group with high levels of back pain.
The study authors note that patients often find it challenging to attend in-person yoga classes. “As a result, medications and other high-risk interventions are often prescribed despite their limited effectiveness and risk of side effects,” the study said.
After the COVID-19 pandemic forced many yoga teachers to offer classes online, Saper and his colleagues decided to test the effectiveness of virtual yoga in what they believe is the first study of its kind.
Researchers divided 140 Cleveland Clinic employee health plan patients in Ohio and Florida with chronic lower back pain into two groups: one received virtual hatha yoga classes and the other was on a yoga waiting list.
At the start of the study, participants, mostly white, college-educated women between the ages of 38 and 59, reported that their back pain levels were about 6 out of 10. After six weeks, the pain levels reported by the yoga students dropped to 4. and after six months it dropped to 3. The pain levels of those on the waiting list remained constant.
At the start of the study, 74% of participants were taking some form of pain medication. Six months later, less than a third of yoga practitioners were taking painkillers, while more than half of waitlist patients continued to take aspirin, ibuprofen, opioids and other painkillers.
“I think this expands the list of options for patients,” Saper said of the study results.
Earlier this year, Hartl and his colleagues at Och Spine published a similar study showing that a 12-week virtual program of tai chi, qigong and meditation relieved pain and improved sleep in adults with low back pain.
“Obviously yoga is somewhat different,” Hartl said, “but I definitely think this is all going in the right direction, which is that these types of virtually guided interventions can be really helpful with patients.”
Numerous previous studies have shown the benefits of yoga or other back-related exercises to relieve chronic lower back pain or improve function. However, the quality of evidence in many of these was not high, note the authors of a Cochrane Review 2021. This is partly because it is difficult to blind participants to the fact that they are doing yoga.
Saper noted that yoga, “like many other self-care practices, is not a quick fix.”
First, practitioners must learn how to perform yoga postures correctly and safely. The lessons in the study were tailored to beginning yoga students, and trained teachers showed students how to use supportive tools, such as blocks and chairs, to modify poses to suit their skill level.
Students in the study received video recordings and detailed workbooks to help them practice safely independently.
The National Institutes of Health considers yoga generally safe “for healthy people when performed properly, under the guidance of a qualified instructor,” but warns, “as with other forms of physical activity, injuries can occur.”
Studies have documented a range of injuries associated with yoga, especially among the elderly.
Three of the participants in the new study who took yoga classes reported temporary flare-ups of back pain, possibly related to the yoga.
Saper advises people who experience back pain to ask their doctor if therapeutic yoga is right for them. People suffering from chronic pain should only take yoga classes that are tailored to them, he said.
Saper also tells yoga practitioners to “listen to your body as you move and adjust accordingly.”
Stretching can cause discomfort, he said. But he added: “If you feel pain, you have to come out of the pose or ask the instructor for variations.”
Ronnie Cohen is a journalist based in the San Francisco Bay Area who focuses on health and social justice issues.
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