Back Pain Archive

Two studies published in 2011 should encourage you to try yoga if you have a bad back. In one study, British researchers compared a 12-week yoga program with usual care provided by Britain's National Health Service and, not surprisingly, yoga proved to be more effective than routine care. In the other study, researchers at the Group Health Cooperative in Seattle compared yoga with "self-care" and exercise classes that were specially designed for the study. The exercise classes included some warm-ups and strength exercises, but most of the time (about 50 minutes) was spent on 15 different stretching exercises targeting the trunk and legs. The study ended in a tie, with yoga and the exercise classes having a similar effect on people's back pain, as measured by self-reported "bothersomeness" and, as in the British study, by the effect on back-related problems with walking, standing, and so on. Self-care finished a distant third.

The Group Health researchers noted that at a purely physical level, the yoga and the stretching classes were pretty similar. In some sense, the study compared yoga with a yoga-like set of stretching exercises.

Q. I am 72 years old and in good health. I've had left knee pain on and off for almost six months, nothing too severe, but it aches if I walk more than a mile or so, and I sometimes get sharp pain on the stairs. My doctor sent me for an MRI of both knees; it showed "mild to moderate osteoarthritis" in both knees and a torn meniscus in my right knee, which feels fine. I think I know what to do about my painful knee — but what should I do for the torn meniscus in my "good" knee?

A. Before we get to your interesting questions, some background information may be helpful.

Low back pain is extremely common; about 80% of us will experience an episode at some time in our lives. The pain usually goes away in a couple of months or so, but it often recurs. Some people develop a chronic form that lasts three months or longer. There are many treatments for chronic low back pain, but none have proved highly effective. Now, a large controlled trial has found that both yoga and stretching exercises are helpful in improving function and reducing symptoms. Results were published in Archives of Internal Medicine (Oct. 24, 2011).

The study. Researchers at Group Health Cooperative, a large nonprofit health care organization in Seattle, recruited 228 women and men with back pain and assigned them at random to 12 weekly 75-minute classes of yoga (92 patients) or conventional stretching exercises (91 patients), or to reading a self-care book on chronic low back pain (45 patients). The yoga classes were led by experienced instructors of viniyoga, which modifies the traditional postures for people with physical limitations. Licensed physical therapists led the stretching exercise classes. Both the yoga and stretching exercise groups were given handouts and instructional videos and encouraged to practice for 20 minutes on non-class days. Self-care participants were given The Back Pain Helpbook, which provides information on back pain and advice about exercising. In telephone interviews with participants at six weeks, 12 weeks, and 26 weeks after the program began, researchers assessed back-related physical functioning with a standardized questionnaire and asked participants to rate their pain on a 10-point scale.

For neck and shoulder pain, doctors once recommended rest, maybe the use of a neck brace, and waiting until the pain had ebbed away. Today there are recommending movement instead of rest. As described in Neck and Shoulder Pain, a newly updated Special Health Report from Harvard Health Publishing, there is mounting scientific evidence for the role of stretching and muscle strengthening in treating people with neck and shoulder pain. After a whiplash injury, for example, people heal sooner and are less likely to develop chronic pain if they start gentle exercise as soon as possible. For those with long-term pain (called chronic pain) results from controlled studies show that exercise provides some relief. Exactly how much exercise to do, what types are best, and how often it should be done have yet to be completely hashed out.

Two new studies, one from the United Kingdom and one from Seattle, show that people with lower back pain may get some relief by regularly doing yoga. In the British study, yoga classes were more effective than standard care at improving “back function,” meaning it reduced back-related problems that interfered with everyday activities like walking, standing, climbing stairs, and so on. In the Seattle study, yoga was just as good as special stretching classes designed for people with low back pain. In the real world, it’s probably easier to find a yoga class than a stretching class designed specifically for low back pain. While yoga is generally safe, if you want to use it to treat something like low back pain, talk it over with your doctor first—in both studies, yoga made back pain worse for a small percentage of people.

Health problems, or treatments for them, sometimes thwart sexual desire and sexual function. There may not be a quick fix for health-related sexual problems, but there are things you can do to enjoy your love life while taking care of the rest of your health.

Q. I have osteoporosis and a recent spine fracture. I hear there's a minor surgical procedure that can fix the fracture. Can you tell me anything about it?

A. Fractures of the bones in the spinal column (vertebrae) are common in people with osteoporosis; about 750,000 occur each year in the United States. In this type of fracture, called a compression fracture, the vertebra collapses, often causing pain, a gradual loss of height, or stooped posture. Even if the fracture doesn't cause obvious symptoms, having one fracture increases the risk of having another one. The cumulative effect of multiple fractures is chronic pain, disability, depression, and difficulty managing normal daily activities.

As usual, Harvard Health Publishing’ writers and editors have been busy covering a range of health topics. Here is a small sampling. To read more, visit us at www.health.harvard.edu. Health apps. Smart phones like the iPhone and Android aren’t just phones. They are also pocket-sized computers capable of running sophisticated applications, or apps. Hundreds of […]

Pain relief creams and ointments can get the medicine right to where it hurts, and the smell is often familiar and soothing. But do they work?

When something like a knee hurts, there's a natural tendency to rub it. And if it really hurts, most of us will think about popping a pain-relieving pill of some kind — acetaminophen (Tylenol) for starters, or perhaps one of the nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn).