Establishing the diagnosis of low back pain: patient selection for interventional pain medicine

Hatha yoga is more effective in improving kinesiophobia and subjective well-being when combined with self-compassion meditation in people with CLBP: a randomized control trial

Objective

The present study aims to examine whether combining hatha yoga practice with self-compassion meditation could influence kinesiophobia, emotions, perceived stress, and perceived disability among individuals with chronic low back pain when compared with hatha yoga alone.

Methods

The randomized controlled study included 70 participants with chronic low back pain (CLBP) who were randomly assigned to a Hatha yoga group (HY; n = 35) or a Hatha yoga group plus self-compassion meditation (HYSCM; n = 35). Participants followed a protocol for 8 weeks, and the assessments were carried out before and after the intervention, with a follow-up evaluation conducted after one month. The participants completed the PANAS, PSS, TSK, and RMQ questionnaires. A Generalized Estimating Equation was used to explore the effect of interventions.

Results

Both HY and HYSCM groups improved kinesiophobia, perceived disability, and stress at the follow-up. However, the HYSCM group shown a more significant reduction in kinesiophobia compared to the HY group. Moreover, significant improvement in positive affect and a reduction in negative affect over time in the HYSCM group were observed.

Conclusion

Hatha yoga practice when combined with self-compassion meditation led to extra benefits by exhibiting a prolonged effect, especially on kinesiophobia positive and negative effects.

Exercise intervention for patients with chronic low back pain: a systematic review and network meta-analysis

Purpose

Chronic low back pain (CLBP) is an aging and public health issue that is a leading cause of disability worldwide and has a significant economic impact on a global scale. Treatments for CLBP are varied, and there is currently no study with high-quality evidence to show which treatment works best. Exercise therapy has the characteristics of minor harm, low cost, and convenient implementation. It has become a mainstream treatment method in clinics for chronic low back pain. However, there is insufficient evidence on which specific exercise regimen is more effective for chronic non-specific low back pain. This network meta-analysis aimed to evaluate the effects of different exercise therapies on chronic low back pain and provide a reference for exercise regimens in CLBP patients.

Methods

We searched PubMed, EMBASE, Cochrane Library, and Web of Science from inception to 10 May 2022. Inclusion and exclusion criteria were used for selection. We collected information from studies to compare the effects of 20 exercise interventions on patients with chronic low back pain.

Results

This study included 75 randomized controlled trials (RCTs) with 5,254 participants. Network meta-analysis results showed that tai chi [standardized mean difference (SMD), -2.11; 95% CI, -3.62 to -0.61], yoga (SMD, -1.76; 95% CI -2.72 to -0.81), Pilates exercise (SMD, -1.52; 95% CI, -2.68, to -0.36), and sling exercise (SMD, -1.19; 95% CI, -2.07 to -0.30) showed a better pain improvement than conventional rehabilitation. Tai chi (SMD, -2.42; 95% CI, -3.81 to -1.03) and yoga (SMD, -2.07; 95% CI, -2.80 to -1.34) showed a better pain improvement than no intervention provided. Yoga (SMD, -1.72; 95% CI, -2.91 to -0.53) and core or stabilization exercises (SMD, -1.04; 95% CI, -1.80 to -0.28) showed a better physical function improvement than conventional rehabilitation. Yoga (SMD, -1.81; 95% CI, -2.78 to -0.83) and core or stabilization exercises (SMD, -1.13; 95% CI, -1.66 to -0.59) showed a better physical function improvement than no intervention provided.

Conclusion

Compared with conventional rehabilitation and no intervention provided, tai chi, toga, Pilates exercise, sling exercise, motor control exercise, and core or stabilization exercises significantly improved CLBP in patients. Compared with conventional rehabilitation and no intervention provided, yoga and core or stabilization exercises were statistically significant in improving physical function in patients with CLBP. Due to the limitations of the quality and quantity of the included studies, it is difficult to make a definitive recommendation before more large-scale and high-quality RCTs are conducted.