Yoga and physical therapy as treatment for chronic lower back pain also improves sleep

November 19, 2019

BOSTON- Yoga and physical therapy (PT) are effective approaches to treating co-occurring sleep disturbance and back pain while reducing the need for medication, according to a new study from Boston Medical Center (BMC). Published in the Journal of General Internal Medicine, the research showed significant improvements in sleep quality lasting 52 weeks after 12 weeks of yoga classes or 1-on-1 PT, which suggests a long-term benefit of these non-pharmacologic approaches. In addition, participants with early improvements in pain after 6 weeks of treatment were three and a half times more likely to have improvements in sleep after the full, 12-week treatment, highlighting that pain and sleep are closely related.

Sleep disturbance and insomnia are common among people with chronic low back pain (cLBP). Previous research showed that 59% of people with cLBP experience poor sleep quality and 53% are diagnosed with insomnia disorder. Medication for both sleep and back pain can have serious side effects, and risk of opioid-related overdose and death increases with use of sleep medications.

"Identifying holistic ways to treat these conditions could help decrease the reliance on these medications as well as keep patients safer and more comfortable," said Eric Roseen, DC, MSc, a researcher in the department of family medicine at BMC, who led the study.

The randomized controlled trial included 320 adults with cLBP from BMC and seven surrounding community health centers. At the beginning of the study, over 90 percent of participants with cLBP were found to suffer from poor sleep. Participants were assigned one of three different therapies for cLBP: physical therapy, weekly yoga, or reading educational materials. Previous research from BMC discovered that yoga and PT are similarly effective for lowering pain and improving physical function, reducing the need for pain medication. In this study, results for sleep improvements were compared over a 12-week intervention period and after 1 year of follow-up.

"The high prevalence of sleep problems in adults with chronic low back pain can have detrimental effects on a person's overall health and well-being," said Roseen, also an assistant professor of family medicine at Boston University School of Medicine. "This really emphasizes the need for providers to ask patients with chronic low back pain about the quality of their sleep. Given the serious risks of combining pain and sleep medications, nonpharmacologic approaches should be considered for these patients."
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This study was funded by the National Center for Complementary and Integrative Health (NCCIH), under grant numbers 1F32AT009272-01 and 5R01-AT005956.

About Boston Medical Center

Boston Medical Center is a private, not-for-profit, 514-bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. It is the largest and busiest provider of trauma and emergency services in New England. Boston Medical Center offers specialized care for complex health problems and is a leading research institution, receiving more than $116 million in sponsored research funding in fiscal year 2017. It is the 15th largest recipient of funding in the U.S. from the National Institutes of Health among independent hospitals. In 1997, BMC founded Boston Medical Center Health Plan, Inc., now one of the top ranked Medicaid MCOs in the country, as a non-profit managed care organization. Boston Medical Center and Boston University School of Medicine are partners in the Boston HealthNet - 14 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit http://www.bmc.org.

Boston Medical Center

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