Yoga May Be Good for Stubborn Back Pain

Yoga may provide some relief for people with low back pain and improve their ability to perform everyday activities, according to a new review of research published in the Cochrane Library. But the authors say there’s a lack of high-quality evidence to back up their conclusion, and that more research is needed—especially on yoga’s long-term effects.

The review summarizes the results of 12 clinical trials involving more than 1,000 people in the United States, the United Kingdom and India. All participants had chronic, non-specific low back pain, meaning that their symptoms had lasted at least three months and were not explained by a specific disease or injury.

All of the studies compared practicing yoga in a class setting to other forms of exercise or to doing no back-focused exercises at all. Overall, the review found that compared to no exercise, yoga might improve back-related function—and reduce symptoms of lower back pain—by a small amount in the first six months to one year of practice.

The amount of improvement seen in most of the studies was minor, says lead author Susan Wieland, an assistant professor at the University of Maryland School of Medicine. “These differences were small, and might not be very meaningful to patients,” she says.

The studies also had follow-up periods of only 12 months or less. Larger studies that track results for longer lengths of time are needed to really understand how yoga might help these people, Wieland adds. Because of these limitations, Wieland and her co-authors determined that the evidence of yoga’s benefits for back pain was only of “low- to moderate-certainty.” For studies that compared yoga to other types of exercise, the findings were even less conclusive, providing “very low-certainty” evidence of minor differences.

The report also warns back pain sufferers to approach yoga with caution, as the mind-body practice could make their condition worse. In the review, about 5% more people experienced greater back pain after starting a practice, compared to those who did no exercise. This risk may be similar for any type of back-focused exercise, the authors note, and may not be specific to yoga.

Wieland also points out that all of the routines practiced in the studies were developed specifically for people with low back pain, and classes were led by experienced professionals. “If people are considering yoga, they should do their best to check that the program is safe and intended for back-pain sufferers, and that teacher has some amount of experience with this population,” she says.

Chronic low back pain is one of the most common and burdensome health problems in the United States. It’s often treated with over-the-counter medication and self-care methods like ice packs and heating pads. Current guidelines also suggest that physical activity and stretching and strengthening exercises can be beneficial.

“Research shows that being active is a smart thing to do,” says Wieland. It should be up to patients and their doctors to decide exactly how they want to be active, she adds, “but the evidence suggests that yoga can be one option to consider.”