Yoga treatment for chronic back pain also improves sleep

Yoga is an effective approach 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) and published in the Journal of General Internal Medicine.

The randomized controlled trial included 320 adults with chronic low back pain from BMC and seven surrounding community health centers. At the beginning of the study, over 90 percent of participants with chronic low back pain were found to suffer from poor sleep. Participants were assigned one of three different therapies for chronic low back pain, physical therapy, weekly yoga, or reading educational materials. Previous research from BMC discovered that yoga and physical therapy 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 one year of follow-up.

The research showed significant improvements in sleep quality lasting 52 weeks after 12 weeks of yoga classes or one-on-one physical therapy, which suggests a long-term benefit of these non-pharmacologic approaches. In addition, participants with early improvements in pain after six 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. Previous research showed that 59 percent of people with chronic low back pain experience poor sleep quality and 53 percent 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.

"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 Eric Roseen, DC, MSc, lead author of the study and a researcher in the department of family medicine at BMC. "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."