In this blog for our Evidence for Everyday Health Choices series, Jack Leahy, Cochrane UK’s Communications and Engagement Officer, writes about his own experience of practising yoga and the latest Cochrane Reviews are systematic reviews. In systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. on yoga for people with A health condition marked by long duration, by frequent recurrence over a long time, and often by slowly progressing seriousness. For example, rheumatoid arthritis. non-specific low back pain to find out: is yoga good for your back?
“Keep twisting! Wring out all those toxins!”
“Now lie back and feel the stale blood drain out of your legs.”
“Relax and feel small to moderate improvements in back-related function at three and six months.”
Two of those quotations are biologically impossible instructions I have received in yoga classes; the other is based on a recent Cochrane Reviews are systematic reviews. In systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research.. Whilst I feel there is often too much ‘woo’ around yoga practice, I enjoy the classes and there is a growing evidence base for the benefits of yoga. It won’t wring toxins from your body (your liver and kidneys will do that), but let’s take a look at some of the evidence on yoga for chronic non-specific low back pain (or general back ache to most people).
What does the evidence say about yoga and back pain?
Low back pain
A recent Cochrane review concluded that yoga may improve back pain at three to four months compared to no exercise. However, the pain improvement was not enough to be meaningful to patients.
The review authors also found that yoga probably increases the A way of expressing the chance of an event taking place, expressed as the number of events divided by the total number of observations or people. It can be stated as ‘the chance of falling were one in four’ (1/4 = 25%). This measure is good no matter the incidence of events i.e. common or infrequent. of increased back pain compared to no exercise. To me, this is common sense, when you undertake any form of exercise, you increase your risk of injury!
They found it was unclear whether yoga was beneficial compared to other forms of exercise or whether adding yoga to another type of exercise was more effective than another type of exercise on its own.
The review authors also looked at whether yoga was beneficial for back function. That is to say, how yoga improved the activity-limiting aspects of low back pain. People taking part in the studies were asked to complete the Roland-Morris Disability Questionnaire to assess this. Did yoga help patients walk faster? Did it improve sleep quality? Did it help people putting on their socks in the morning? This last question really highlights how debilitating low back pain can be. Getting dressed in the morning can become a long struggle.
They found that yoga compared to no exercise may improve back function for up to a year. The review authors found that for back function, as with back pain, it was unclear whether yoga was beneficial compared to other forms of exercise or whether adding yoga to another type of exercise was more effective than another type of exercise on its own.
How reliable is the evidence?
The reason for the uncertainty in the results on back pain and function (all those mays and unclears) is that the studies the review authors looked at were poorly designed. Most of the studies were not Blinding is the process of preventing those involved in a trial from knowing to which comparison group a particular participant belongs.. That is to say both the participants (yogis) and the practitioners (yoga teachers) were aware who was practising yoga and who was not. This is pretty obvious, I think anyone who has been mid way through Camel pose (Ustrasana) is fully aware they are doing it. This leaves room for an unconscious Any factor, recognised or not, that distorts the findings of a study. For example, reporting bias is a type of bias that occurs when researchers, or others (e.g. drug companies) choose not report or publish the results of a study, or do not provide full information about a study. when the participants report on their back pain and function.
The review authors call for more, better-designed Clinical trials are research studies involving people who use healthcare services. They often compare a new or different treatment with the best treatment currently available. This is to test whether the new or different treatment is safe, effective and any better than what is currently used. No matter how promising a new treatment may appear during tests in a laboratory, it must go through clinical trials before its benefits and risks can really be known. comparing yoga to no exercise to improve the reliability of the effects of yoga. They also call for trials that investigate other important Outcomes are measures of health (for example quality of life, pain, blood sugar levels) that can be used to assess the effectiveness and safety of a treatment or other intervention (for example a drug, surgery, or exercise). In research, the outcomes considered most important are ‘primary outcomes’ and those considered less important are ‘secondary outcomes’. such as depression and quality of life.
What is my experience?
I’ve not been diagnosed with chronic low back pain, but after sitting at a desk all day, my shoulders and back feel stiff and are sometimes painful. After a yoga class, I feel better. What I take from the Cochrane review is that exercise may be good for chronic low back pain. Yoga is a form of exercise and may improve your back pain. But it is not clear that yoga is better than other forms of exercise.
I practise yoga because it is the only form of exercise that I have stuck with for any length of time. I have 3 pairs of swimming goggles and a pair of squash shoes that are longing to be taken out of the cupboard and fulfil their potential. Yet it is my yoga mat that reaches sweat-soaked Nirvana every week. Namaste.
Yoga Something done with the aim of improving health or relieving suffering. For example, medicines, surgery, psychological and physical therapies, diet and exercise changes. for chronic non-specific low back pain. Cochrane Database of In systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. 2017, Issue 1. Art. No.: CD010671. DOI: 10.1002/14651858.CD010671.pub2., , , , , .