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Researchers divided 90 people, aged 23 to 66, who had mild to moderate functional disability as a result of back pain into two groups.
One group did 90-minute sessions of Iyengar yoga twice a week for six months. The other group continued whatever medical therapy or treatments they'd been doing.
At the three-month and six-month marks, a greater proportion of those who'd done yoga reported improvements in their pain and functioning as measured by questionnaires that asked about pain levels, difficulty performing physical tasks and pain medications being taken. Yoga participants also reported fewer symptoms of depression.
"The yoga group had less pain, less functional disability and less depression, compared with the control group," study author Kimberly Williams, a research assistant professor in the department of community medicine at West Virginia University, said in a statement. "These were statistically significant and clinically important changes that were maintained six months after the intervention."
The study is published in the September issue of Spine.
Iyengar yoga, a form of hatha yoga that's popular in the United States, builds strength, flexibility and balance by taking participants through a series of specific poses.
Dr. Todd J. Albert, chairman of the department of orthopedics at Thomas Jefferson University Hospitals and the Rothman Institute in Philadelphia, said the study, funded by the U.S. National Institutes of Health, was well-designed.
Lower back pain can cause people to stop exercising because of discomfort or fear of causing further injury to their back. The lack of activity can cause the back muscles to become "de-conditioned," or weakened, setting up conditions for even more chronic pain.
Exercises such as yoga help reverse the muscle weakness by strengthening muscles of the mid-section, including the back extensors, abdominals and gluteus, which are key for stabilizing the trunk and decreasing the load on the spine.
"Strengthening those muscles is like creating a brace around your torso," Albert explained.
Lower back pain represents between 20% and 25% of medical claims and exceeds $34 billion in annual direct medical costs, according to background information in the study.
Mary Lou Galantino, a professor of physical therapy at Richard Stockton College of New Jersey, said the study confirms previous research about the benefits of yoga for helping with conditions as varied as menopause and osteoarthritis. Other research has shown that yoga can improve mood in women with breast cancer.
"There is so much data excitingly pointing to the physical, psychological and spiritual benefits of yoga," Galantino said. "I also believe there's a social aspect to yoga. It can foster a sense of community and overarching well-being."
"In order to have a holistic approach to one's well being, you want to get to the physical, the psychological, the emotional and the spiritual," said Galantino, a yoga instructor. "That is integrated care. If done with proper breathing, postures and meditation, yoga does all of that. You have to have all of the elements. If we westernize it and make it solely an athletic program, then you may not receive all of the benefits."
Though there are many causes of lower back pain, the culprit is often a herniated disc or arthritis. Though people suffering from back pain may worry that exercise could make the pain worse, it's not likely to as long as you don't overdo it, Albert said.
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SOURCES: Todd J. Albert, M.D., chairman, department of orthopedics, Thomas Jefferson University Hospitals and the Rothman Institute, Philadephia; Mary Lou Galantino, PT, Ph.D., professor, physical therapy, Richard Stockton College of New Jersey; September 2009 Spine
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