Have chronic low back pain? Try virtual yoga, study suggests

NEW YORK, Nov. 1 (UPI) -- Virtual yoga can be a successful and accessible way to manage chronic low back pain -- a common ailment with major consequences, a new study suggests.

The study was published Friday in JAMA Network Open.

Chronic low back pain may lead to physical and emotional suffering, while increasing healthcare costs, decreasing productivity and burdening healthcare professionals, according to the study.

Although clinicians first recommend trying nonmedical interventions, such as yoga, obstacles exist to practicing this mind and body technique, researchers said.

"If you have chronic low back pain and your doctor feels it's not urgent that you need surgery, then yoga classes like these may be a safe and effective approach for you," the study's senior author, Dr. Robert Saper, told UPI.

Among the two groups of study participants, those who did yoga had more significant reductions in pain intensity than those who waited to try the intervention.

Pain dropped by 42% in the first group compared to 2% in the comparison group. The ability to do daily activities, such as climbing stairs and carrying groceries, also improved 51% in the yoga group compared to only 11% in the control group, researchers found.

Surgical, oral medications and injections may not work well or could pose side effects, but the low-cost virtual option can empower people in managing chronic low back pain, said Saper, who is chair of the department of wellness and preventive medicine at the Cleveland Clinic in Ohio.

As a family physician, he has studied yoga's benefits for controlling chronic low back pain since 2007.

About 80% to 90% of adults will experience at least one episode of this type of pain, and as many as 20% may suffer from ongoing or recurrent aches, Saper said.

To conduct the study, Saper and his team divided 140 study participants into two groups.

Half engaged in 12 consecutive weekly, 60-minute, virtual, live-streamed hatha yoga group classes, while the other half waited to take the 12-week course.

The wait-list -- or yoga later group -- could pursue the virtual intervention after the study, but without assessments.

Researchers recruited adults ages 18 to 64 years old with chronic low back pain from the self-insured Cleveland Clinic Employee Health Plan.

They included people with a low back pain intensity score of at least 4 on an 11-point numerical rating scale, with higher scores indicating worse pain and daily back pain interference about half or more of the days.

"This study is different than previous ones because we offered the yoga classes virtually," Saper said.

Cleveland Clinic's instructors led the classes using a manual with yoga and breathing exercises developed for people with chronic low back pain, he noted.

"The yoga that we used was designed to be safe, gentle, easy for somebody to do who has never been exposed to yoga," Saper said, adding that participants had access to a handbook and videos to practice at home in between the weekly classes.

Other experts noted that the study demonstrated how well virtual yoga can treat chronic low back pain and improve function, while reducing the need for pain medication and enhancing the quality of sleep.

Dr. Brian Ralston, a family and sports medicine physician at Loyola Medicine in Berwyn, Ill., said the study confirmed what he already suspected -- that virtual yoga can decrease chronic low back pain, a common source of suffering. He was not involved in conducting the new research.

Technology has changed how people get and stay fit, said Ralston, who has practiced yoga for more than three decades and now does all types of workouts virtually.

A shift toward virtual fitness has intensified since the COVID-19 pandemic and "has boosted people's awareness and comfort with meeting remotely, and I think that also includes exercise," he said.

The study's publication in a very reputable medical journal adds credibility, said Dr. Ram Alluri, a spine surgeon at Keck Medicine of USC -- the University of Southern California in Los Angeles.

"Back pain is one of the leading causes of disability for people in the United States and worldwide," Alluri said.

"Access to yoga virtually shows immense promise as a treatment," he said, because it serves people who can't access a studio or afford in-person classes, which tend to cost more due to overhead expenses.

Virtual yoga can be as effective as in-person practice, said Radha Metro-Midkiff, executive director of Integral Yoga Institute NY in Manhattan's Greenwich Village neighborhood.

"Particularly, we find that when people are in their own environment, it can help them relax, be more mindful of their own bodies," Metro-Midkiff she said.

"It prevents them from overdoing it. That's because they have a tendency to not compare themselves to others."