Effectiveness of Hatha Yoga Versus Conventional Therapeutic Exercises for Chronic Nonspecific Low-Back Pain

Abstract

<b><i>Objective:</i></b> To determine whether the effectiveness of Hatha yoga therapy is comparable to conventional therapeutic exercises (CTEs) for reducing back pain intensity and back-related dysfunction in patients with chronic nonspecific low-back pain (CNLBP). <b><i>Design:</i></b> The study was a prospective randomized comparative trial, divided into two phases: an initial 6-weekly supervised intervention period followed by a 6-week follow-up period. <b><i>Settings:</i></b> This study was conducted at Department of Physical Medicine and Rehabilitation and Centre for Integrative Medicine and Research of a tertiary care hospital. <b><i>Subjects:</i></b> Patients between 18 and 55 years of age with complaint of CNLBP persisting ≥12 weeks with pain rating ≥4 on a numerical rating scale (0-10). <b><i>Intervention:</i></b> A total of six standardized 35-min weekly Hatha yoga sessions (yoga group) and similarly 35-min weekly sessions of CTEs (CTE group), designed for people with CNLBP unaccustomed to structured yoga or CTE program. Participants were asked to practice on nonclass days at home. <b><i>Outcome measures:</i></b> The primary outcome measures were Defense and Veterans Pain Rating Scale (DVPRS) (0-10) and 24-point Roland Morris Disability Questionnaire (RDQ). Secondary outcomes were pain medication usage per week and a postintervention Perceived recovery (Likert seven-point scale) of back-related dysfunction. Outcomes were recorded at the baseline, 6-week follow-up, and 12-week follow-up. <b><i>Results:</i></b> Seventy subjects were randomized to either yoga (<i>n</i> = 35) or CTE group (<i>n</i> = 35). Data were analyzed using intention-to-treat, with last observation carried forward. Both yoga and the CTE group have shown significant improvement in back pain intensity and back-related dysfunction within both the groups at 6- and 12-week follow-ups compared to baseline. No statistically significant differences in the pain intensity (DVPRS; at 6 weeks: <i>n</i> = 35, difference of medians 1.0, 95% confidence interval [-5.3 to 3.0], <i>p</i> = 0.5; at 12 weeks: <i>n</i> = 35, 0.0 [-4.2 to 5.0], 0.7) and back-related dysfunction (RDQ; at 6 weeks: <i>n</i> = 35, 1.0 [-9.6 to 10.6], 0.4; at 12 weeks: <i>n</i> = 35, 0.0 [-8.8 to 10.6], 0.3) were noted between two groups. Improvements in pill consumption and perceived recovery were also comparable between the groups. <b><i>Conclusion:</i></b> Yoga provided similar improvement compared with CTEs, in patients with CNLBP.