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July 21, 2020
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Study: Adults with chronic low back pain should be willing to try yoga, physical therapy

Patients who expect to do well with yoga and physical therapy have the best outcomes in the treatment of chronic low back pain, according published results.

Perspective from Lynne E. Gaskell

In a randomized controlled trial, researchers at Boston Medical Center analyzed 299 adults with chronic low back pain (cLBP), testing for “responders” to the effectiveness of three treatment options: yoga, physical therapy and a self-care intervention option. A response was defined as a minimum 30% improvement in the Roland Morris Disability Questionnaire, according to the abstract.

Eric J. Roseen, DC, MSc, and colleagues assigned each intervention group a 12-week treatment program, checking in with a phone call every 3 weeks. The self-care intervention group was assigned reading from The Back Pain Handbook, which consists of evidence-based cLBP management strategies, according to the abstract.

Researchers found 39% (116/299) of patients were “responders,” with 42% of the combined yoga or PT group and 23% of the self-care group responding to their respective treatment option.

“Predictors of response included having more than a high school education, a higher income, employment, few depressive symptoms, lower perceived stress, few work-related fear avoidance beliefs, high pain self-efficacy and being a nonsmoker,” the researchers wrote in the abstract.

A greater proportion of responders had low fear avoidance beliefs around physical activity and had used pain medicine in conjunction with their treatment option.

The researchers concluded that patients with cLBP who had a willingness to take a multidisciplinary approach – like yoga or physical therapy – in conjunction with pain medication responded the best to their treatment approach.