Introduction: The purpose of this critical review is to determine the effectiveness of yoga as a therapy to reduce pain and improve function in chronic low back pain.
Methods: A literature search was performed to locate randomized controlled studies, with keywords being, “Yoga Treatment and Chronic Low Back Pain” and “Yoga and Chronic Back Pain”. Within the 5 studies, adults with chronic low back pain participated in a yoga program or a control group.
Discussion:Four studies utilized yoga therapy and showed improvements in function and pain at the end of the protocol. One study showed significant improvement in pain levels as early as 4 weeks. Improvements in spinal flexibility, pain self- efficacy, depression and reduced use of medication were also seen. As a collective group, these articles provide evidence that yoga therapy is beneficial to reduce chronic low back pain and improve function, with results lasting between 4 weeks to 1 year.
Conclusion: The study supports the use of yoga as an intervention to address chronic low back pain. Yoga helps to improve functional disability and reduce pain intensity.
Keywords: Yoga and Chronic Back Pain; Yoga Treatment and Chronic Low Back Pain
Low back pain is a very common medical condition. At least 75-80% of Americans have had at least one episode of back pain in their lifetime . Therapeutic exercise is used traditionally for treatment of chronic low back pain . It has been reported that yoga treatments include not only exercise, but also attention to posture, self- awareness, breathing, mental focus and relaxation . Yoga is a complementary alternative therapy with approximately 14.9 million people in the United States doing yoga, 21% of which use it for back and neck pain . Yoga has been shown to be effective in improvement of neck pain and function . The purpose of this literature review was to critically evaluate the literature to see if yoga therapy is beneficial to reduce pain and improve function in patients with chronic low back pain.
A literature search was conducted on July 18, 2016 and July 19, 2016 using PubMed database. Language was limited to English. Keywords included: “Yoga Treatment and Chronic Low Back Pain” which yielded 74 articles and “Yoga and Chronic back pain” which yielded 95 articles. The search was further narrowed and customized in the database by selecting randomized controlled trials. “Yoga treatment and chronic low back pain” yielded 18 articles and “yoga and chronic back pain” yielded 19 articles. 18 of the 19 articles were the same on both searches. Articles were
excluded if yoga was not incorporated into treatment or if the inclusion criteria did not contain subjects with chronic low back pain. Titles and abstracts were then reviewed to select studies that contained subjects with chronic low back pain and that showed yoga as an intervention for back pain. A total of five studies that fit the criteria were selected for review. Additional references were ascertained by cross referencing applicable articles.
Five articles addressing the effect of yoga therapy on low back pain were reviewed. As a collective group, these articles support the use of yoga therapy for chronic low back pain, to improve function and reduce pain [6-10].
Four studies utilized yoga therapy and showed improvements in function and pain at the end of the protocol [6-10]. The pilot study by Cox, et al.  showed significant difference in improvement of pain levels as early as 4 weeks. Some studies individually also showed improvements in other aspects, such as, Tekur, et al.  showed improvement in spinal flexibility and Williams, et al.  showed reduced use of pain medication. Improvements in pain self-efficacy and depression along with improvements in functional disability were seen in studies by Tillbrook, et al.  & Williams, et al.  respectively.
Some of the limitations seemed to be usage of self- reliance
instrumentation, missing data, small size and non- attendance for
Outside of the five studies that were reviewed, Sherman et
al.  found that self- efficacy and also sleep were important
psychological benefits of yoga on low back pain. Williams et
al.  study included in our review has shown to improve
depression. An important research direction could be to study the
effects of yoga on other psychological factors affecting low back
pain. Overall, yoga seems to be a well- positioned intervention to
reduce pain and improve function.
As a collective group, these articles provide evidence that yoga
therapy is beneficial to reduce chronic low back pain and improve
function, with results lasting between 4 weeks to 1 year Table 1.
The study supports the use of yoga as an intervention to
address chronic low back pain. Yoga helps to improve functional
disability and reduce pain intensity. Further research is needed
to evaluate the psychological benefits of yoga therapy in low back