In the Journals

Yoga seen as noninferior to physical therapy for treatment of chronic low back pain

For patients with non-specific chronic low back pain, a manualized yoga program was non-inferior to physical therapy for both function and pain, according to recently published results.

Researchers identified 320 low-income, racially diverse adults with non-specific chronic low back pain and performed a 12-week, single-blind, three-group randomized noninferiority trial in which patients received either 12 weekly yoga classes, 15 physical therapy (PT) visits or an educational book and newsletters. Investigators performed a 40-week maintenance phase in which they compared yoga drop-in classes to home practice and PT booster sessions to home practice.

At 12 weeks, the Roland Morris Disability Questionnaire (RMDQ) was used to measure back-related function. Pain was measured with an 11-point scale. Other outcomes assessed included pain medication use, global improvement, satisfaction with intervention and health-related quality of life.

Investigators found yoga was noninferior to PT as demonstrated by the one-sided 95% lower confidence limits of 0.83 and 0.97 for RMDQ and pain, respectively. Investigators noted yoga was not superior to education for either RMDQ or pain. At 12 weeks, patients who participated in yoga and PT were 21 percentage points and 22 percentage points, respectively, less likely to use pain medication compared with patients in the education group.

According to researchers, at 1 year, improvements in both yoga and PT groups were maintained. There were no differences between yoga and PT groups with regard to maintenance strategies. Yoga and PT were also not significantly different with regard to the frequency of adverse events, which were mostly mild self-limited joint pain and back pain– by Monica Jaramillo

Disclosures: Saper reports grants from the National Center for Complementary and Integrative Health of the NIH during conduction of this study. Please see the full study for a list of all other authors’ relevant financial disclosures.

For patients with non-specific chronic low back pain, a manualized yoga program was non-inferior to physical therapy for both function and pain, according to recently published results.

Researchers identified 320 low-income, racially diverse adults with non-specific chronic low back pain and performed a 12-week, single-blind, three-group randomized noninferiority trial in which patients received either 12 weekly yoga classes, 15 physical therapy (PT) visits or an educational book and newsletters. Investigators performed a 40-week maintenance phase in which they compared yoga drop-in classes to home practice and PT booster sessions to home practice.

At 12 weeks, the Roland Morris Disability Questionnaire (RMDQ) was used to measure back-related function. Pain was measured with an 11-point scale. Other outcomes assessed included pain medication use, global improvement, satisfaction with intervention and health-related quality of life.

Investigators found yoga was noninferior to PT as demonstrated by the one-sided 95% lower confidence limits of 0.83 and 0.97 for RMDQ and pain, respectively. Investigators noted yoga was not superior to education for either RMDQ or pain. At 12 weeks, patients who participated in yoga and PT were 21 percentage points and 22 percentage points, respectively, less likely to use pain medication compared with patients in the education group.

According to researchers, at 1 year, improvements in both yoga and PT groups were maintained. There were no differences between yoga and PT groups with regard to maintenance strategies. Yoga and PT were also not significantly different with regard to the frequency of adverse events, which were mostly mild self-limited joint pain and back pain– by Monica Jaramillo

Disclosures: Saper reports grants from the National Center for Complementary and Integrative Health of the NIH during conduction of this study. Please see the full study for a list of all other authors’ relevant financial disclosures.