1. Cain, Joanna E. BSN, RN

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A recent study determined that for people with moderate, chronic low-back pain, yoga-a type of exercise that stretches and strengthens the body through various poses coupled with breathing and mental concentration-is more effective than conventional therapeutic exercise or the information contained in a self-help book.

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The randomized, controlled study enrolled 101 participants, mostly college-educated white women between the ages of 40 and 50 years who had visited a primary care provider for low-back pain three to 15 months prior. Patients were excluded if they had undergone back surgery, had a diagnosis of the cause of the pain (including pregnancy, sciatica, spinal stenosis, spondylolisthesis, or metastatic cancer), had symptoms of severe disk disease, or received other treatment for back pain.


Participants were randomly assigned to one of three interventions: yoga classes, exercise classes, or receipt of a self-help book. The yoga and exercise interventions consisted of 12 weekly, 75-minute classes and a home regimen. The yoga group practiced postures and breathing in the style of yoga called viniyoga. The exercise group focused on education, aerobic exercises, and strengthening exercises. The self-help-book group received a copy of The Back Pain Helpbook, which emphasized fitness, lifestyle modification, and management of flare-ups.


Participants were interviewed by telephone at baseline and at six, 12, and 26 weeks to assess pain level, ability to perform daily activities, and medication use. In the yoga group, 78% of participants had reductions in their Roland Disability Scale scores (a standardized measure) of at least 2 points; 63% and 47% of participants in the exercise and book groups, respectively, showed reductions. The yoga group participants also reported taking less analgesics than those in the other two groups.


The authors suggest that viniyoga, with its combination of gentle exercise and mental focus, is safe and effective for moderate, chronic low-back pain (although they warn that more forceful styles of yoga, such as Bikram, may not be). They suggest further research with more diverse populations and with patients with more severe back pain.


Sherman KJ, et al. Ann Intern Med 2005; 143(12):849-56.