Our aim is to show the general public and referrers where they can find the very same yoga programme delivered to the same standards and protocols as in the research itself carried out by the York Trials Unit, noting this was overseen by experts, was deemed by top international peer-reviewed journals to be significant, and is cited in much research and the media as being relevant.
SPECIALISED YOGA FOR CHRONIC LOW BACK PAIN – Evidence to Consider
As requested, below is a list of research to be considered for the assessment. Those shown below in coloured font represent our University of York (York Trials Unit in The Department of Health Sciences) and Arthritis Research UK randomised controlled trial research with 313 participants within which our ‘Yoga for Healthy Lower Backs’ yoga programme was used. ‘Yoga for Healthy Lower Backs’ is purposefully printed as a Heading in the American College of Physicians’ journal ‘Annals of Internal Medicine’ H. Tilbrook et al 2011 primary paper in order to identify it as a ‘best practice’ ‘specialised’ yoga programme compared to ‘general’ yoga.
Our www.yogaforbacks.co.uk social enterprise and The Institute of Yoga for Healthy Lower Backs Institute’s educational work is important at a time when Google Searches currently come up with over 16 million entries for ‘back pain yoga’. PubMed shows well over 100 papers concerning yoga and back pain. Our research papers have been cited in a further 100+ research papers and reviews.
References:-
NICE guidelines currently mentions ‘yoga’ in relation to ‘low back pain’ in its ‘Clinical Knowledge Summaries’ at Ref. http://cks.nice.org.uk/back-pain-low-without-radiculopathy#Search?q=yoga. The Low Back Pain NICE guidelines C88 are currently under review and ‘specialised yoga’ is being considered during the review process.
A Cochrane review of yoga for low back pain is currently under way and this includes our research.
Research Papers
1. ‘Yoga for chronic low back pain: a randomized trial’. Tilbrook HE, Cox H, Hewitt CE,Kang’ombe RA, Chuang LH, Jayakody S, Aplin JD, Semlyen A, Trewhela A, Watt I, Torgerson DJ. Annals of Internal Medicine 2011 Nov 1; 155(9): 569-78 (Attached.)
2. ‘A pragmatic multicentered randomized controlled trial of yoga for chronic low back pain: economic evaluation.’. Chuang LH, Soares MO, Tilbrook H, Cox H, Hewitt CE, Aplin J, Semlyen A, Trewhela A, Watt I, Torgerson DJ. Spine (Phila Pa 1976). 2012 Aug 15; 37(18):1593-601.
3. ‘A randomised controlled trial of yoga for the treatment of chronic low back pain: Results of a pilot study.’ Helen Cox, Helen Tilbrook, John Aplin, Anna Semlyen, David Torgerson, Alison Trewhela, Ian Watt. Complementary Therapies in Clinical Practice, (2010 November) 16 (4): 187-193. (Pilot aiming to deduce recruitment and set-up protocols.)
4. ‘A pragmatic multi-centred randomized controlled trial of yoga for chronic low back pain: trial protocol.’ Helen Cox, Helen Tilbrook, John Aplin, Ling-Hsiang Chuang, Catherine Hewitt, Shalmini Jayakody, Anna Semlyen, Marta O Soares, David Torgerson, Alison Trewhela, Ian Watt, Gill Worthy. Complementary Therapies in Clinical Practice, (2010 November) 16 (2): 76-80.
5. ‘Evaluation of the effectiveness and efficacy of Iyengar yoga therapy on chronic low back pain.’ Williams K1, Abildso C, Steinberg L, Doyle E, Epstein B, Smith D, Hobbs G, Gross R, Kelley G, Cooper L. Spine, 2009 Sept 1; 34(19):2066-76. (Based on two previous published studies: K Williams et al 2003 International Journal of Yoga Therapy No. 13, and K Williams et al 2005 Pain 115;107-117.)
6. ‘Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial.’ Sherman KJ, Cherkin DC, Erro J, Miglioretti DL, Deyo RA. Annals of Internal Medicine 2005 Dec 20; 143(12):849-56.
7. ‘Yoga for chronic low back pain in a predominantly minority population: a pilot randomized controlled trial.’ Saper RB, Sherman KJ, Cullum-Dugan D, Davis RB, Phillips RS, Culpepper L. Altern Ther Health Med. 2009 Nov-Dec; 15(6):18-27.
8. ‘Disc extrusions and bulges in nonspecific low back pain and sciatica: Exploratory randomised controlled trial comparing yoga therapy and normal medical treatment’. Monro R, Bhardwaj AK, Gupta RK, Telles S, Allen B, Little P. J Altern Complement Med. 2014 Sep 29 (Epub ahead of print.)
9. ‘Effect of short-term intensive yoga program on pain, functional disability and spinal flexibility in chronic low back pain: a randomized control study.’ Tekur P1, Singphow C, Nagendra HR, Raghuram N. J Altern Complement Med. 2008 Jul;14(6):637-44.
10. ‘Compliance effects in a randomised controlled trial of yoga for chronic low back pain: a methodological study.’ Tilbrook HE, Hewitt CE, Aplin JD, Semlyen A, Trewhela A, Watt I, Torgerson DJ. Physiotherapy. 2013 Dec 4. pii: S0031-9406(13)00118-1
11. ‘The impact of modified Hatha yoga on chronic low back pain: a pilot study.’ Galantino ML, Bzdewka TM, Eissler-Russo JL, Holbrook ML, Mogck EP, Geigle P, Farrar JT. Altern Ther Health Med. 2004 Mar-Apr;10(2):56-9.
12. ‘Yoga for Veterans with Chronic Low Back Pain’ Groessl E, Weingart K, Aschbacher K, Pada L, Baxi S. Journal of Alternative Complementary Medicine. 2008 14(9): 1123-1129
Reviews
1. ‘Yoga for functional ability, pain and psychosocial outcomes in musculoskeletal conditions: a systematic review and meta-analysis.’ Ward L, Stebbings S, Cherkin D, Baxter GD. Musculoskeletal Care. 2013 Dec; 11(4):203-17.
2. ‘A systematic review and meta-analysis of yoga for low back pain.’ Cramer H, Lauche R, Haller H, Dobos G. Clin J Pain. 2013 May; 29(5):450-60.
3. ‘Effects of yoga interventions on pain and pain-associated disability: a meta-analysis.’ Büssing A, Ostermann T, Lüdtke R, Michalsen A. J Pain. 2012 Jan; 13(1):1-9
4. ‘Yoga for Chronic Low Back Pain: New Evidence in 2011’. Groessl EJ 2012. J Yoga Phys Therapy 2:e108. (http://omicsonline.org/2157-7595/2157-7595-2-e108.php)
5. ‘Yoga as a Treatment for Low Back Pain: A Review of the Literature.’ Erik J. Groessl 2012. Marisa Sklar and Douglas Chang.
6. ‘Yoga for low back pain: a systematic review of randomized clinical trials.’ Posadzki P, Ernst E. Clin Rheumatol. 2011 Sep; 30(9):1257-62
7. ‘Yoga and pilates in the management of low back pain.’ Sorosky S1, Stilp S, Akuthota V. Curr Rev Musculoskelet Med. 2008 Mar;1(1):39-47
8. ‘Practitioner-based complementary and alternative therapies for the treatment of rheumatoid arthritis, osteoarthritis, fibromyalgia and low back pain’ University of Aberdeen - Working Group:
Professor Michael Doherty – professor of rheumatology, University of Nottingham
Professor Edzard Ernst – emeritus professor of complementary medicine, Peninsula Medical School
Margaret Fisken – patient representative, Aberdeenshire
Dr Gareth Jones (project lead) – senior lecturer in epidemiology, University of Aberdeen
Professor George Lewith – professor of health research, University of Southampton
Dr Hugh MacPherson – senior research fellow in health sciences, University of York
Professor Gary Macfarlane (chair of committee) – professor of epidemiology, University of Aberdeen
Professor Julius Sim – professor of health care research, Keele University
Jane Tadman – representative from Arthritis Research UK, Chesterfield. Yoga for low back pain is given a score of ‘4 out of 5’ for research evidence and a ‘Green’ (best) for safety. http://www.arthritisresearchuk.org/shop/products/publications/patient-information/living-with-arthritis/cat-report.aspx#sthash.ZuwZRIsI.dpuf
9. ‘Components and reporting of yoga interventions for musculoskeletal conditions: A systematic review of randomised controlled trials’ Lesley Ward, Simon Stebbings, Daniel Cherkin, G David Baxter (A Trewhela contributed). Complementary Therapies in Medicine, 2014 October; 22(5): 909-919
10. ‘Effectiveness of Iyengar Yoga in treating spinal (back and neck) pain: A systematic review.’ Edith Meszanos-Crow, Alison Trewhela, et al, International Journal of Yoga. Abstract Conclusion states ‘Database research form the following sources (Cochrane library,NCBI PubMed, the Clinical Trial Registry of the Indian Council of Medical Research, Google Scholar, EMBASE, CINAHL, and PsychINFO) demonstrated inclusion and exclusion criteria that selected only Iyengar yoga interventions, which in turn, identified six randomized control trials dedicated to compare the effectiveness of yoga for back and neck pain versus other care. The difference between the groups on the post intervention pain or functional disability intensity assessment was, in all six studies, favoring the yoga group, which projected a decrease in back and neck pain. Overall six studies with 570 patients showed, that Iyengar yoga is an effective means for both back and neck pain in comparison to control groups. This systematic review found strong evidence for short-term effectiveness, but little evidence for long-term effectiveness of yoga for chronic spine pain in the patient-centered outcomes.’
Further Supportive Evidence to Show Links with This Yoga
1. University of York yoga trial website www.yogatrial.co.uk 2011
2. ‘Got back pain? Try yoga.’ Arthritis Research UK January 2012. http://www.arthritisresearchuk.org/arthritis-information/arthritis-today-magazine/155-winter-2012/yoga-trial.
3. ‘Yoga a cost-effective treatment for back pain sufferers?’ Arthritis Research UK August 2012. http://www.arthritisresearchuk.org/news/press-releases/2012/august/yoga-a-cost-effective-treatment-for-back-pain-sufferers.aspx
Compiled by Social Enterprise www.yogaforbacks.co.uk
Alison Trewhela, Cornwall, UK
www.yogatrewhela.co.uk (personal), www.yogaforbacks.co.uk (social enterprise)
Email:
Lead Yoga Consultant on The University of York yoga trial management team (2006-Present), Designer of the YHLB programme, YHLB teacher trainer, YHLB teacher).
Iyengar Yoga Teacher (certificated IYUK – teaching since 1984)
Specialist Tutor in Yoga for medical students (since 2004), University of Exeter Medical School.
Specialist Advisor in Yoga for Institute of Complementary and Natural Medicine (and winner of 2013 Award).
Senior Practitioner in Yoga on British Register for Complementary Practitioners.
Professional Associate of BackCareUK
Director and Principle Tutor of ‘The Yoga for Healthy Lower Backs Institute’.
‘YOGA for Healthy Lower Backs’ social enterprise www.yogaforbacks.co.uk partner.