Tuesday, December 20, 2011
Yoga or stretching helps chronic back pain
Everyone hates stress, and for good reason. Stress makes us miserable. Perhaps for that reason, stress is blamed for virtually every disease for which the cause is still unknown. Later, when we discover the true cause, we find that it is unrelated to stress. We thought stress causes stomach ulcers before discovering the bacterium that is the true culprit. We thought stress caused heart attacks before a study comparing high-stress to low-stress individuals showed that this wasn't true. Stress causes gray hair? Nope. Genes cause gray hair. Irritable bowel syndrome is probably the next disease on this list. We're close to sorting out what causes it, and when we do, we can stop blaming stress.
So stress causes misery, which is bad enough, but we should be careful not to scapegoat it for other ills.
A study in the Archives of Internal Medicine last month adds another illnesses for which stress may not be relevant.
Chronic back pain is common and has no universally effective treatment. Lots of patients swear by yoga, and for many with chronic back pain it seems to improve their symptoms. Is this simply because the exercises stretch their backs and legs, or is the breathing and meditative component also helpful? After all, countless people attest to the stress-lowering properties of yoga. Shouldn't less stress decrease chronic pain?
To test this question, researchers enrolled over 200 patients with chronic back pain and randomized them to three groups. One group attended weekly yoga classes. A second group attended weekly stretching classes. A third group was given a self-care book teaching exercises for low back pain and was asked to follow the book's instructions independently. All the patients had their functional status and pain levels measured by periodic questionnaires.
As expected, the yoga group did better than the self-care group. But surprisingly, the yoga group did no better than the stretching group. This suggests that the benefit for back pain from yoga is entirely related to the stretching, with no additional improvement from the meditation and breathing exercises.
That's not to say that the breathing exercises and the meditation don't feel good, which might be reason enough to do them.
So chronic back pain may be another illness that doesn't have as much to do with stress as we thought. But stress makes us unhappy and strains our relationships. That's reason enough to find ways of managing stress.
The holidays are around the corner, which for some of us are particularly stressful. So when you're feeling very anxious and want to tell a loved one who is annoying you "You're giving me an ulcer," remember that he's not. Take a deep breath and say something like "You're not giving me an ulcer, a heart attack, or gray hair, but I wish you'd stop anyway."
Yoga, stretching both ease chronic back pain: U.S. study (Reuters)
Yoga May Help Low Back Pain. Mental Effects? Not So Much (Wall Street Journal)
A Randomized Trial Comparing Yoga, Stretching, and a Self-care Book for Chronic Low Back Pain (Archives of Internal Medicine)
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000. Holding privileges at Cedars-Sinai Medical Center, he is also an assistant clinical professor at UCLA's Department of Medicine. This post originally appeared at his blog.
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Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.
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