A Letter Released to Chiropractic Physicians on
January 20, 2010

Therapeutic Yoga

At the Center for Musculoskeletal & Pain Medicine

A number of studies now confirm the effectiveness of different types of yoga for improving a variety of spine and joint pain complaints. The literature shows yoga improving conditions such as back pain¹, carpal tunnel², and even osteoarthritis.³ However, the risk of exacerbation or self-injury exists when patients initiate yoga incorrectly.⁴ The term “therapeutic yoga” refers to the guided performance of postures for the purpose of treating health conditions. If you have patients who may benefit from therapeutic yoga, you can refer them to the practice of Neal Taub, MD, for a therapeutic yoga assessment, individualized plan, and guided therapeutic yoga sessions.

Recently, the Annals of Internal Medicine published a study wherein 101 adults suffering from chronic low back pain were randomized to one of three treatment groups: therapeutic yoga, conventional therapeutic exercise, or The Back Pain Helpbook.¹ The conventional therapeutic exercise group received aerobic exercises, strengthening for the core muscles including back muscles, leg strengthening, and deep breathing. Both the exercise and yoga programs lasted 12 weeks. At 12 weeks, the yoga group proved superior to therapeutic exercise and to self-care in terms of back related function.

In addition to the strength and flexibility gains created by therapeutic yoga, emotional benefits of yoga may also progress treatment for spine and joint complaints. Emotional distress has an exacerbating and reciprocal relationship with chronic pain.⁵ Minimizing or eliminating the need for long-term pharmocological solutions often requires an approach for both the physical and the mental aspects of pain. Because yoga incorporates meditative aspects, therapeutic yoga can simultaneously address our patients mind and body challenges. Studies have shown yoga causing remission of emotional conditions for both non-depressed and clinically depressed patients.^6-8 In one study, 65% of clinically depressed patients completing a 20 class yoga program achieved remission even after anti-depressant medications created only partial remission.⁸

My practice frequently co-manages chronic pain conditions with chiropractic physicians. Prolotherapy, radiofrequency, neurodiagnostic testing, temporary nerve blocks, medical acupuncture, and therapeutic yoga serve as just a few of the helpful services available at my practice, The Center for Musculoskeletal and Pain Medicine.

Introducing Shelley Harris, RYT, LMBT Shelley Harris recently joined our team as a registered therapeutic yoga instructor and licensed massage and bodywork therapist.  She specializes in Flow Yoga and has more than 4,000 hours yoga teaching experience. Shelley develops individualized, therapeutic yoga programs for a range of patients and cases.  She helps patients suffering from minor injury pain, patients coping with chronic pain from illness, and patients wrestling with anxiety and depression.

References

1. Sherman K, Cherkin D, Erro J, et al. Comparing yoga, exercise, and a self-care book foor chronic low back pain. A randomized controlled trial. Ann Intern Med 2005; 143: 849-856.
2. Garfinkel M, Singhal A, Katz W, et al. Yoga-based intervention for carpal tunnel syndrome. JAMA 1998; 280: 1601-3.
3. Garfinkel M, Schumacher H, Husain A, et al. evaluation of a yoga based regimen for treatment of osteoarthritis of than hands. J Rheumatol 1994; 21: 21: 2341-3.
4. Garfinkel M. Yoga as a complementary therapy. Geriatrics and Aging. 2006; 9 (3): 190-194.
5. Croft P, Papageorgiou A, Ferry S, et al. Psychologic distress and low back pain. Evidence from a prospective study in the general population. Spine. 1995; 20: 2731-2737.
6. Khumar S, Kaur P, Kaur S. Effectiveness of Shavasana on depression among university students. Indian J Clin Psychol. 1993; 20: 82-87.
7. Janakiramaiah N, Gangadhar B, Murtjhy P, et al. Antidepressant efficacy of Sudarshan Kriya Yoga (SKY) in melancholia: a randomized comparison with electroconvulsive therapy (ECT) and imipramine. J Affect Disord. 2000; 57: 255-259.
8. Cook A, Davydov D, Ottaviani C, et al. Yoga as a complementary treatment of depression: Effects of traits and moods on treatment outcome. Evid Based Complement Alternat Med. 2007; 4 (4): 493-502.