After the first 12 weeks, yoga practitioners were assigned to either keep taking classes or practice at home, with the help of a DVD, manual and yoga props.
At the 12-week point, both the yoga and physical therapy groups were faring better than the education group.
Almost half of the yoga group (48 percent) had seen a “clinically meaningful” improvement in their pain and disability — enough to make a difference in their daily lives, Saper explained.
That was also true for 37 percent of physical therapy patients, versus 23 percent of education patients. (While the yoga numbers look better, the difference between yoga and physical therapy was not statistically significant.)
Typically, both yoga practitioners and physical therapy patients saw the benefits last over one year, the researchers said.
“This was an excellent study,” said Dr. Stefan Kertesz, who wrote an accompanying editorial. To him, yoga should be “one more tool” that doctors suggest to back pain patients.
“But we also shouldn’t oversell it — the way drugs and procedures were historically oversold,” said Kertesz, an associate professor at the University of Alabama at Birmingham School of Medicine. “The reality is, yoga was not a panacea for most of these patients.”
In the real world, Kertesz said, the treatment decision will likely come down to a patient’s preferences — and what’s practical.
Saper agreed. “One yoga class can be $18 or $20,” he pointed out, and insurance is unlikely to cover it.
At the same time, Saper noted, physical therapy is expensive, and even insured patients can face steep co-pays.
Those kinds of barriers are a big problem, according to Kertesz. “How do we make these things more accessible to people?” he said.
People who are interested in yoga should be aware there are many different styles, Saper pointed out. The class “down the street,” he said, may not be appropriate for someone with serious pain issues.
The classes in the trial were standardized and included gentler poses — often aided with chairs and other props — breathing practices and meditation.
The study was published online June 19 in the Annals of Internal Medicine.
