Virtual yoga program effectively reduces intensity of chronic low back pain

Key takeaways:

• The 12-week virtual yoga program reduced symptom intensity in adults with chronic low back pain.
• The data support virtual yoga as an evidence-based treatment for those with chronic low back pain, an author said.

Individuals with chronic low back pain who participated in a virtual yoga class experienced a significant reduction in symptoms, according to results of a randomized study published in JAMA Network Open.

Participants also reported less use of pain medications and greater sleep quality.

Healio previously reported that lower back pain affected over 600 million people worldwide as of 2020 and may impact more than 800 million people by 2050.

Robert Saper, MD, MPH, chair of the department of wellness and preventive medicine at Cleveland Clinic and the study’s senior author, told Healio that he has been studying the effects of yoga classes on chronic low back pain for almost 2 decades.

“We all know how the [COVID-19] pandemic so dramatically caused us to pivot in so many domains in our society and in health systems, and yoga is no different,” he explained. “Many people were starting to offer virtual yoga, virtual fitness classes and so forth. But it had never been studied to see if it was also [as] effective as in-person classes were.”

In the randomized clinical trial, the researchers assigned 140 participants (mean age, 47 years; 80.7% women) to either a 12-week, 60-minute virtual yoga program or to a waitlist control group.

Pain intensity — measured with an 11-point rating scale — and back-related function, measured with the 23-point Roland Morris Disability Questionnaire, served as the study’s primary outcome measurements

Secondary outcomes included changes in sleep quality and the use of analgesic medications.

Saper and colleagues found that intervention participants had significantly greater improvement in pain intensity (mean change = 1.5 points; 95% CI, 2.2 to 0.7) and back-related function (mean change = 2.8 points; 95% CI, 4.3 to 1.3) vs. waitlist participants at 12 weeks.

The improvements in pain intensity (mean change = 2.3 points; 95% CI, 3.1 to 1.6) and back-related function (mean change = 4.6 points; 95% CI, 6.1 to 3.1) among the intervention participants persisted at 24 weeks’ follow-up.

Intervention participants also reported a 21.4 absolute percentage point decrease in use of any analgesic medications at 12 weeks and a 21.2 absolute percentage point decrease at 24 weeks compared with waitlist participants.

Researchers also reported greater improvements in sleep quality among the yoga intervention group vs. waitlist participants at 12 weeks (mean change = 0.4; 95% CI, 0.1-0.7) and 24 weeks (mean change = 0.4; 95% CI, 0.1-0.7).

They also noted that few adverse events occurred in either treatment group.

The researchers acknowledged the short follow-up period as a study limitation.

Still, the findings show that virtual yoga “is an option for our patients with chronic low back pain,” Saper said.

“I'm not saying it's a superior option, but it is an option that's evidence based that can be recommended [such as] other therapies like physical therapy can be,” he said. “I think as family doctors and primary care doctors, we need to broaden that list [of treatment options] because what's appealing to one patient may not be appealing to the other patient. The more choices we have that we know are scientifically based, the better.”

Hallie Tankha, PhD, a research faculty at Cleveland Clinic and the study’s first author, told Healio that she would next like to explore the effect of yoga on the mental health of patients with low back pain.

“We know that the prevalence of mental health disorders in our patients with chronic pain is elevated compared with the general population,” she told Healio. “So, [can] yoga be effective for patients who are also struggling with depression or anxiety along with their chronic pain?”

References:

• Cleveland Clinic. Research shows Cleveland Clinic’s therapeutic virtual yoga program can be effective for chronic low back pain. Available at: https://newsroom.clevelandclinic.org/2024/11/01/research-shows-cleveland-clinics-therapeutic-virtual-yoga-program-can-be-effective-for-chronic-low-back-pain. Published Nov. 1, 2024. Accessed Nov. 10, 2024.
• Tankha H, et al. JAMA Netw Open. 2024;doi:10.1001/jamanetworkopen.2024.42339.