PainRelief.com Interview with:
Hallie Tankha, Ph.D., Research faculty
Department of Wellness and Preventive Medicine
Cleveland Clinic, and first author of the study
PainRelief.com: What is the background for this study?
Response: Numerous studies have highlighted the benefits of yoga for individuals with chronic low back pain, including reductions in pain intensity, improvements in daily functioning (such as walking or climbing stairs), and better sleep quality. However, these studies used in-person yoga sessions. With the onset of the COVID-19 pandemic, healthcare delivery had to adapt quickly, and yoga was no exception. As virtual healthcare options continue to expand, this led us to wonder: could virtual yoga offer the same benefits as in-person classes for chronic low back pain?
PainRelief.com: What are the main findings?
Response: In our study, we randomized 140 patients into one of two groups: the ‘Yoga Now’ group, which participated in 12 weekly virtual group yoga sessions, and the ‘Yoga Later’ group, which was offered the same yoga program after the study concluded (serving as the control group). Participants in the ‘Yoga Now’ group experienced significantly greater improvements in back pain intensity, daily functioning, and sleep quality compared to the control group. Additionally, 34% fewer participants in the ‘Yoga Now’ group reported using pain medications, suggesting that virtual yoga may reduce reliance on opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, muscle relaxants, and other pain medications for those with chronic low back pain.
PainRelief.com: What should readers take away from your report?
Response: Virtual yoga is a safe and effective way to manage chronic low back pain, with the added benefit of flexibility in terms of when and where patients can participate. This flexibility helps to overcome common barriers to treatment reported by patients, such as transportation issues, scheduling conflicts, and geographic limitations. Offering yoga virtually also means we can reach patients who might otherwise be unable to attend, including those living in rural areas with limited access to yoga classes and individuals with limited mobility due to their back pain.
We also want to emphasize that no single treatment works universally for everyone. Patients have different needs, and treatment preferences vary widely. For this reason, we encourage healthcare providers to offer virtual yoga programs as part of a ‘menu’ of treatment options that patients can choose from, alongside other evidenced-based treatments including physical therapy and medications. We also urge patients with chronic low back pain to ask their healthcare providers about virtual yoga programs available through their healthcare systems.
Our virtual yoga program for chronic low back pain was designed to be accessible to all individuals of all ability levels, including those who have never practiced yoga before. It offers a practical, evidence-based approach to improving the quality of life for people struggling with chronic low back pain.
PainRelief.com: What recommendations do you have for future research as a results of this study?
Response: One of our most intriguing findings was that patients who did not attend every yoga session still experienced significant benefit from the program. This raises an important question: what “dose” of yoga—i.e., how many classes—are needed to achieve meaningful improvements in symptoms? To answer this, future studies will be needed to compare different lengths of virtual yoga programs, such as 12 sessions (the length used in our current study) vs. shorter programs, like 6 or even 4 sessions. The goal is to find the optimal balance between maximizing patient benefit, minimizing patient burden, and preserving healthcare provider resources.
We are also interested in understanding how virtual yoga affects patients with chronic low back pain who also have co-occurring mental health conditions, such as depression or anxiety. The prevalence of these conditions is higher among individuals with chronic pain compared to the general population, making it crucial to assess whether virtual yoga can help alleviate both physical and mental health symptoms. Given that yoga incorporates elements like mindfulness and breathwork, which have well-documented benefits for mental health, we believe virtual yoga has great potential to not only reduce back pain but also improve mood and overall well-being.
Finally, we are committed to expanding our research to include more diverse populations and different healthcare systems across various geographic locations. Our ultimate goal is to increase access to this safe evidence-based intervention for everyone, ensuring that more individuals can benefit from yoga as part of their treatment plan.
Citation:
Tankha H, Gaskins D, Shallcross A, et al. Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(11):e2442339. doi:10.1001/jamanetworkopen.2024.42339
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Last Updated on November 8, 2024 by PainRelief.com