Virtual Yoga Eases Chronic Low Back Pain

TOPLINE: 
Virtual yoga classes significantly reduced chronic low back pain intensity and improved back-related function in health system employees. Improvements were sustained at 24 weeks, with reduced pain medication use and better sleep quality.
METHODOLOGY:
A single-blinded, 24-week, 2-arm, randomized clinical trial was conducted from May 3, 2022, through May 23, 2023, comparing live-streamed yoga classes with a wait-list control among adults with chronic low back pain.
A total of 140 participants aged 18-64 years with chronic low back pain were recruited from the Cleveland Clinic Employee Health Plan.
Inclusion criteria included a mean low back pain intensity score of at least 4 on an 11-point numerical rating scale and daily back pain interference about half or more of the days.
The intervention consisted of 12 consecutive weekly, 60-minute, virtual, live-streamed hatha yoga group classes.
Coprimary outcomes were mean pain intensity in the previous week on the 11-point numerical rating scale and back-related function as assessed using the 23-point modified Roland Morris Disability Questionnaire at 12 weeks.
TAKEAWAY:
Participants in the virtual yoga group showed greater reductions in mean pain intensity at 12 weeks (mean change, -1.5 points; P < .001) and 24 weeks (mean change, -2.3 points; P < .001) compared to the wait-list control group.
Back-related function improved significantly in the virtual yoga group at 12 weeks (mean change, -2.8 points; P < .001) and 24 weeks (mean change, -4.6 points; P < .001) compared to the control group.
Virtual yoga participants reported 21.2 percentage points less use of any analgesic medication during the past week at 24 weeks compared to the control group.
Sleep quality improved more in the virtual yoga group at 12 weeks (mean change, 0.4 points; P = .008) and 24 weeks (mean change, 0.4 points; P = .005) compared to the control group.
IN PRACTICE:
“Given the demonstrated noninferiority of yoga to physical therapy, structured virtual yoga programs and physical therapy are reasonable choices for patients with [chronic low back pain] depending on accessibility, cost, and patient preference. These findings support the call by the National Academy of Medicine for increased evidenced-based pain treatments that can be disseminated via technology-based platforms,” wrote the authors of the study.
SOURCE:
The study was led by Hallie Tankha, PhD, Cleveland Clinic in Cleveland. It was published online on November 1, in JAMA Network Open.
LIMITATIONS: 
The study had a low adherence rate, with only 36.6% of participants attending at least 50% of the yoga classes. There was also a higher rate of missing data in the yoga group compared to the control group. The study did not include a longer-term follow-up assessment beyond 24 weeks.
DISCLOSURES:
This study was supported by grants from Cleveland Clinic Healthcare Delivery and Implementation Science Center. Michael Rothberg, MD, MPH, disclosed receiving personal fees from the Blue Cross Blue Shield Association. Eric Roseen, DC, PhD, reported receiving grants from the National Institutes of Health National Center for Complementary and Integrative Health. Robert Saper, MD, MPH, disclosed receiving personal fees from UpToDate and grants from NCCIH related to yoga and tai chi for treatment of pain. Additional disclosures are noted in the original article.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
 
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