An article in the Guardian, recently:
Only 10% of non-surgical treatments for back problems kill pain, says review
As a Yoga Teacher and Yoga Therapist, and indeed in the latter role with a specialist interest in both Back Health and Pain, you might expect me to be railing against this, and extolling Yoga’s benefits.
Indeed NICE (National Centre for Clinical Excellence) already do a good job of this – Low back pain and sciatica in over 16s: assessment and management – where although yoga isn’t mentioned specifically, they do say “Consider a group exercise programme (biomechanical, aerobic, mind–body or a combination of approaches) within the NHS for people with a specific episode or flare-up of low back pain with or without sciatica” which sounds like Yoga to me. They also go on to say “Consider psychological therapies using a cognitive behavioural approach for managing low back pain with or without sciatica but only as part of a treatment package including exercise”, which encapsulates Yoga Therapy very well.
Truth is I’m not surprised by the reports findings as, surprise, our backs are complicated.
Where reports like this fall down is, in my view, three fold.
First they look a population based outcomes and tend to ignore the individual – a treatment may not work for a majority of people, even a significant majority, but if you are the one of the minority where it did work, then happy days! In other words, no one model or modality suits everyone.
Second, often interventions are looked at in isolation, whereas the reality is a combination of approaches probably suits most people, eg exercise and some mild pain relief, or as NICE say, as quoted above, “psychological therapies… …as part of a treatment package including exercise”. There is an additive effect of using a combination of interventions.
Finally, the cumulative protective effect of interventions is ignored. EG you had a couple of back pain flare ups, so your decide to take up Yoga or Pilates to keep you back flexible and strong, invest in a better office chair and eye level monitor, etc. The next flare up is a lot less troubling, or maybe avoided all together.
In short they simplify matters and look in the abstract, indeed much medical research does, rather than looking at real life.
Yoga may, or may not, help with an acute back pain flare up or long term chronic back pain. However when practised, and taught, with care and intelligence, the chances are it will improve someone’s situation, especially when part of a integrative approach with, maybe, massage, input from a Osteopath, Physio or Chiropractor, some pain relief, and some addressing of causes if known. The key is an integrative approach; not a one size fits all treatment; not a take-this-pill-and-everything-is-alright approach; not a quick fix, but a nuanced combination that suits the individual.
Ethically, as Yoga Therapist, I am never going to claim that one Yoga session will cure someone’s back flare up; likewise I’m never going to claim that by itself Yoga does it all; I’m not going to claim Yoga will help everyone. I’ll be honest; in most cases Yoga, done well and carefully, will help rather than hinder.
