Have chronic low back pain? Try virtual yoga, study suggests

From upi.com

NEW YORK, Nov. 1 (UPI) -- Virtual yoga can be a successful and accessible way to manage chronic low back pain -- a common ailment with major consequences, a new study suggests. The study was published Friday in JAMA Network Open.

Chronic low back pain may lead to physical and emotional suffering, while increasing healthcare costs, decreasing productivity and burdening healthcare professionals, according to the study.

Although clinicians first recommend trying nonmedical interventions, such as yoga, obstacles exist to practicing this mind and body technique, researchers said.

"If you have chronic low back pain and your doctor feels it's not urgent that you need surgery, then yoga classes like these may be a safe and effective approach for you," the study's senior author, Dr. Robert Saper, told UPI.

Among the two groups of study participants, those who did yoga had more significant reductions in pain intensity than those who waited to try the intervention.

Pain dropped by 42% in the first group compared to 2% in the comparison group. The ability to do daily activities, such as climbing stairs and carrying groceries, also improved 51% in the yoga group compared to only 11% in the control group, researchers found.

Surgical, oral medications and injections may not work well or could pose side effects, but the low-cost virtual option can empower people in managing chronic low back pain, said Saper, who is chair of the department of wellness and preventive medicine at the Cleveland Clinic in Ohio.

As a family physician, he has studied yoga's benefits for controlling chronic low back pain since 2007.

About 80% to 90% of adults will experience at least one episode of this type of pain, and as many as 20% may suffer from ongoing or recurrent aches, Saper said.

Surgical, oral medications and injections may not work well or could pose side effects, but low-cost virtual yoga can empower people in managing chronic low back pain, the study indicates. Photo by KoolShooters/Pexels

To conduct the study, Saper and his team divided 140 study participants into two groups.

Half engaged in 12 consecutive weekly, 60-minute, virtual, live-streamed hatha yoga group classes, while the other half waited to take the 12-week course.

The wait-list -- or yoga later group -- could pursue the virtual intervention after the study, but without assessments.

Researchers recruited adults ages 18 to 64 years old with chronic low back pain from the self-insured Cleveland Clinic Employee Health Plan.

They included people with a low back pain intensity score of at least 4 on an 11-point numerical rating scale, with higher scores indicating worse pain and daily back pain interference about half or more of the days.

"This study is different than previous ones because we offered the yoga classes virtually," Saper said.

Cleveland Clinic's instructors led the classes using a manual with yoga and breathing exercises developed for people with chronic low back pain, he noted.

"The yoga that we used was designed to be safe, gentle, easy for somebody to do who has never been exposed to yoga," Saper said, adding that participants had access to a handbook and videos to practice at home in between the weekly classes.

Other experts noted that the study demonstrated how well virtual yoga can treat chronic low back pain and improve function, while reducing the need for pain medication and enhancing the quality of sleep.

Dr. Brian Ralston, a family and sports medicine physician at Loyola Medicine in Berwyn, Ill., said the study confirmed what he already suspected -- that virtual yoga can decrease chronic low back pain, a common source of suffering. He was not involved in conducting the new research.

Technology has changed how people get and stay fit, said Ralston, who has practiced yoga for more than three decades and now does all types of workouts virtually.

A shift toward virtual fitness has intensified since the COVID-19 pandemic and "has boosted people's awareness and comfort with meeting remotely, and I think that also includes exercise," he said.

The study's publication in a very reputable medical journal adds credibility, said Dr. Ram Alluri, a spine surgeon at Keck Medicine of USC -- the University of Southern California in Los Angeles.

"Back pain is one of the leading causes of disability for people in the United States and worldwide," Alluri said.

"Access to yoga virtually shows immense promise as a treatment," he said, because it serves people who can't access a studio or afford in-person classes, which tend to cost more due to overhead expenses.

Virtual yoga can be as effective as in-person practice, said Radha Metro-Midkiff, executive director of Integral Yoga Institute NY in Manhattan's Greenwich Village neighborhood.

"Particularly, we find that when people are in their own environment, it can help them relax, be more mindful of their own bodies," Metro-Midkiff she said.

"It prevents them from overdoing it. That's because they have a tendency to not compare themselves to others."

https://www.upi.com/Health_News/2024/11/01/lower-back-pain-virtual-yoga-study/4961730422930/ 

"Sciatica ended my rowing career, but I'm just getting started in cycling"

From cyclingweekly.com

From rower to runner to Rás winner in four short years, Dom Jackson is making waves in UK cycling. Shane Stokes finds out more about his amazing switch from oars to pedals 

Dom Jackson joined an exclusive cadre of riders in May. Only seven British riders have won the Rás Tailteann - an annual international cycling stage race, held in Ireland - in its 69-year history. The Foran CT rider became part of that exclusive group, winning the five-day race outright after a superb display. That’s a big achievement for any rider, but given Jackson had been racing for just four seasons, having previously competed in a completely different sport, his victory was all the more extraordinary.

“At the start of every year, the team manager Tom Quaid asked for everyone’s goals for the year. The Rás was top of the list by a country mile,” Jackson tells Cycling Weekly. “It was the one thing that I had set my sights on from the end of last year.” Now 26, Jackson’s path into cycling has been an unusual one. He grew up in Kingston-on-Thames and was part of a Sea Scouts group as a child, spending much of his spare time in kayaks and canoes. His interest in watersports saw him take up rowing while at school, but he did not excel straight away.

                                                                                                                             (Image credit: Future)

“I used to cycle about half an hour into school every day,” he says. “I remember how during the first two or three years of rowing, I was more fussed about how quickly I could cycle home than the rowing itself,” he remembers. “But then towards the end of my school career, I hit puberty, grew quite a bit and actually got really pretty good at rowing.” While studying for A-levels, Jackson was selected by GB selectors for the Coupe de la Jeunesse races. “It is essentially a European Championships for rowing, but for juniors,” he explains. Encouraged by the experience, he resolved to knuckle down to the sport.

The school coach Neil Double recognised Jackson’s talent and encouraged him to try for the under-18 Lightweight 5,000m indoor rowing record in February 2016. The fast-developing teenager duly broke it, and went on to take bronze at the Junior World Championships and then fourth in the lightweight men’s pair at the under-23 Worlds in 2017. The following year, however, while studying at Newcastle University, his rowing progress was brought to a sudden halt when he picked up a back injury in the gym. He limped on with the resulting sciatica for a year and a half, but it essentially ended his rowing journey.

                                                                                              (Image credit: Dom Jackson)

“I couldn’t sit in a chair for more than 20 or 30 minutes before having to stretch, get up, walk around,” he explains. “I was doing all kinds of crazy things to get three hours’ sleep, then same again, get up and do some nerve flossing or stretching, and then another few hours’ sleep. Just rinse and repeat.” Jackson found that running helped his injury, but the sport failed to hold his interest during Covid, so he switched to cycling – albeit with caution to protect his back. “At first I found that if it sat a bit funny on the saddle, I was able to ride,” he says. “That summer it was so sunny and I was just really loving it.”

Progressing quickly, Jackson joined Kingston Wheelers in London (UK), started Zwifting during the next wave of Covid restrictions, and became addicted to improving his numbers. Getting ever fitter and faster, he began racing in the spring of 2021, and with decent results from the off, he was soon picked up by London team Foran CT. In April 2023 he travelled to Ireland with the team and rode the Kerry Group Rás Mumhan, winning the third stage and taking fifth overall – not bad for his second stage race. Upon returning, he ran the London Marathon in a very decent 2:43.17. Less than a month later, he was on the start line of his first Rás Tailteann. He finished seventh overall, and relished the experience.

“The Rás is huge,” he enthuses. “In the UK it’s seen as the stage race to win. It has so much history that it almost doesn’t need an introduction, because everyone in cycling knows about it. For lots of British riders, it’s the first time we witness crowds on the sides of the streets cheering for us, wanting us to do well.” He resolved to return and try to win.

                                                                                                                       (Image credit: Lorraine O'Sullivan)

Jackson describes himself as “very competitive” and someone who goes all-in. He booked himself an Airbnb in Sierra Nevada, Spain, in the build-up to this year’s Rás, spending a month training at altitude. “I was by myself because I wanted to be in the best shape possible,” he explains, “but a month in your own head–” he pauses. “There were definitely a few days when I had a bit of a mental wobble.” He stuck it out, fending off the what-if thoughts about how an inopportune puncture or missed break could undo all his preparation, and the rest is history.

Jackson was third on stage one, took over the yellow jersey the following day, and with the help of the team, defended it until the final stage. The win was never a foregone conclusion; in fact, it was the closest ever edition, with three riders locked on precisely the same time. “I went into the Rás with the attitude that I’ll just do as well as I possibly can,” he says, “so whatever the outcome, if I’d done my best I could be happy. To finish the last day still in yellow, it made all of the sacrifices, all of the training, all of the nutrition stuff instantly worth it.” The big win instantly raised Jackson’s profile on the domestic racing scene. “The reaction afterwards was amazing,” he says. “At local races, and elsewhere in the UK, people I don’t particularly know were coming up and saying, ‘Oh, really well done to you and your team over in Ireland’. It was just really lovely.”

A month after his big win in Ireland, Jackson finished 13th in the National Championship road race – best of those not on a professional or pro development team – and just two seconds off Ben Swift of Ineos Grenadiers. In July he was eighth in the 1.2-ranked GP de Pérenchies in France, and more recently he went to the French Alps on holiday and showed further progression. “I put out my best numbers ever going up Alpe d’Huez,” he says. “I’ve got the fastest time there this year, and 25th fastest all time.” On 3 September he also set a new record for the Box Hill climb, one of the most competitive segments on Strava, averaging 33.7kph (20.9mph) to cover the 2.2km in four minutes and five seconds, smashing the mark of Q36.5 pro Rory Townsend by eight seconds.

It’s eight years since that indoor world rowing achievement and now, aged 26, he’s still breaking records, still pushing his own boundaries. Having earned a sports psychology and biology degree in Newcastle, he runs his own coaching business. Like many riders in their mid-20s, he feels he is at a crossroads in his life. “I would love to get paid to ride my bike. Otherwise I’ll have to get myself a big boy job,” he reflects. “Something that pays well, working in the City or something, and then continuing to cycle but doing fewer hours – perhaps ride as a domestique at Foran for the next younger rider who’s coming through.”

Does he have a plan, something he hopes could yet secure an international contract? “I’ve been trying for the Zwift Academy,” he says. “I’ve been ticking off the workouts and will only find out if I’ve made it through the fi rst round, halfway through October. But so far, so good.” With past winners such as Jay Vine and Neve Bradbury breaking through this way, Jackson seems exceptionally well placed to follow suit.

https://www.cyclingweekly.com/fitness/sciatica-ended-my-rowing-career-but-im-just-getting-started-in-cycling

Save your spine

From newindianexpress.com

Poor posture can even trigger sciatica, causing pain that radiates from the lower back down to the legs

CHENNAI: Do you have a colleague who spends all day glued to their chair, consistently turning down chai or coffee breaks? Then this is a warning to that workaholic - get ready to spend your hard-earned salary on health bills! Experts say that prolonged sitting can lead to multiple health issues.

In light of World Spine Day on October 16, experts talk about these problems and gather tips on how to prevent them.

Referring to a recent study published by the International Journal of Health Sciences and Research, Dr Suman Tadagonda, sports medicine physician and specialist in spine and athletes health at nSure Healthy Spine, Hyderabad, said that globally, lower back pain affects more than 540 million people and the condition has doubled in the last 25 years.

“In India, 64% of Indian IT professionals reported symptoms of pain and discomfort. Data suggests that most of the workforce, due to longer sitting hours, develop a lot of musculoskeletal health issues. They suffer from discomfort and pain in the hips, legs, neck, and shoulders. And the concerning part is that they don’t realise the very existence of the problem,” he said. Though this study only refers to IT people, experts believe that the effects of longer sitting hours are the same for everyone.

When you sit for long hours, it’s obvious that your spine will be affected. Highlighting some common spine-related problems, Dr Venkatesh Yeddula, senior consultant neurosurgeon at CARE Hospitals, Hyderabad, said, “One of the most frequently observed issues is chronic lower back pain, often caused by slouched posture or long hours of sitting.

This can lead to disc degeneration or herniated discs.” He added that many young individuals also suffer from neck pain due to leaning towards screens. Other issues, such as shoulder pain and muscle imbalances, arise from weakened core muscles and tight hips. Poor posture can even trigger sciatica, causing pain that radiates from the lower back down to the legs.

Dr Suman added that the pressure on the spine in any form is a starting point for developing not only upper and lower back pain but also leads to scoliosis, kyphosis, and other problems.

But that isn’t all; spine issues often contribute to broader health problems. Dr Venkatesh said that headaches can result from neck strain due to poor posture. Additionally, improper spinal alignment can cause poor circulation, leading to fatigue and muscle stiffness. Over time, spinal misalignment may even affect respiratory function, making breathing less efficient. Chronic pain from spine issues can also contribute to mental health problems like stress, anxiety, and sleep disturbances.

PREVENTION TIPS

Dr Venkatesh Yeddula gives us some tips to care for our spines:

• Use a chair with proper lumbar support, adjust your screen to eye level, and keep your feet flat on the ground to maintain a neutral posture.

• Take breaks every 30-40 minutes. Stand up, stretch, and walk around to relieve pressure on the spine and improve circulation.

• Practice good posture by sitting upright, avoiding slouching, and using pillows or rolled-up towels for additional lumbar support if needed.

• Apart from regular physical activity like walking, swimming, or yoga, incorporate simple stretches for the neck, shoulders, back, and hips to reduce muscle stiffness and improve flexibility.

• Engage in core-strengthening exercises like planks or pilates to support your spine and reduce the risk of back injuries.

• Drink plenty of water to keep spinal discs hydrated. This improves their ability to cushion and support your movements.

• If needed, use a footrest to ensure your legs are properly supported and reduce lower back strain.

https://www.newindianexpress.com/cities/chennai/2024/Oct/19/save-your-spine-2 

Acupuncture helps sciatica in gold-standard clinical trial

From cosmosmagazine.com

A randomised-control trial has found that acupuncture can help reduce leg pain in patients with sciatica.

The study is published in JAMA Internal Medicine.

Acupuncture is a traditional Chinese practice involving the insertion of needles into specific points in the body, known as “acupoints”.

While there’s evidence it can help treat chronic pain, the researchers say there is a lack of high-quality evidence to support its use with sciatica.

The Chinese team of researchers enrolled 216 patients in the trial, all of whom had chronic sciatica from a herniated spinal disc.

Patients were randomly assigned to either an acupuncture group or a control group, where they received 10 treatment sessions over 4 weeks.

Patients in the acupuncture group were treated by licensed acupuncturists with at least 3 years of experience, while the control group received a “sham acupuncture” treatment from the acupuncturists.

“For the sham group, acupuncturists used nonacupoints away from the meridians, which are considered to have no effect; this is common practice for sham controls in acupuncture research,” write the researchers in their paper.

Patients weren’t told which group they were in, and a blinding test showed they were still unaware after receiving the treatment. The researchers also didn’t know which group the patients were in, with only the acupuncturists being unblinded.

The researchers followed up with the patients 1, 2, 6 and 12 months after the intervention, asking them to rate their pain and capability with surveys frequently used in health research.

They found that patients who had the acupuncture treatment consistently reported lower pain and higher function, both immediately after and a year after the treatment.

While the acupuncture group was still doing better than the sham acupuncture group at the 1-year mark, the difference had narrowed compared to the 4-week mark.

“Given the large effect sizes that this trial found, acupuncture should be considered to be a potential treatment option for patients with chronic sciatica from herniated disk,” write the researchers in their paper.

They also propose doing more research comparing acupuncture with painkillers and surgery, both of which can have mixed results in sciatica patients.

https://cosmosmagazine.com/health/medicine/acupuncture-helps-sciatica-in-gold-standard-clinical-trial/ 

Breaks from sitting can stop your back pain from getting worse

From thenewdaily.com.au

We know that prolonged periods of sitting increase the risk of death from cardiovascular disease and cancer.

Along the way to that early death, you have a higher chance of being overweight and experiencing depression.

We’ve been reporting on this issue for ten years, beginning with a cheery story:

‘Do you work in an office? Your job could be killing you’.

One more thing to keep in mind: sitting for hours at a time isn’t great for the back. Your pain while sitting might indicate a challenging condition such as a herniated disc or sciatica.

Chances are, though, your posture is to blame – slumping  more than sitting – along with your overall poor fitness.

                                                                                                       Photo: Getty

Prevailing advice

There’s a lot of advice on how to sit properly, how to set up your chair and desk correctly, and how to remember to keep your feet flat on the floor.

For a long time, we were told that sitting up straight was the preferred posture. Then some researchers said this lacked evidence.

Researchers from the University of Turku in Finland make the sensible point that you’re better off varying your posture than trying to stick to a perfect model.

Much of the research into prolonged sitting looks at consequences and potential ways of lowering your risk of early death.

The Finnish researchers, in a new study, take a real world approach, using overweight participants who already suffer back pain.

The question of the study is a simple one:

Can you prevent back pain from getting worse by reducing how much you sit each day?

Intuitively, the researchers say, “it is easy to think that reducing sitting would help with back pain, but previous research data is surprisingly scarce”.

The new study

Sixty-four adults that were overweight or obese or had metabolic syndrome were randomised into either an intervention group or a control group. These were people who spent most of their days sitting down.

“Our participants were quite normal middle-aged adults, who sat a great deal, exercised little, and had gained some extra weight,” said Turku Doctoral Researcher and Physiotherapist Jooa Norha.

“These factors not only increase the risk for cardiovascular disease but also for back pain.”

The intervention group aimed to reduce sedentary behaviour by one hour a day (measured with accelerometers) over six months. The control group continued their regular sitting habits.

Back pain intensity and pain-related disability were assessed.

The results? Sort of encouraging.

The participants were able to reduce their sitting by 40 minutes per day, on average, during the six-month study.

“Pain-related disability increased during the intervention in both groups,” the authors write.

“Back pain intensity increased significantly more in the control group than in the intervention group in which back pain intensity remained unchanged.

It’s somewhat depressing that, overall, the intervention group failed to get off their weakening buttock muscles for a lousy hour a day.

On the other hand, that they managed to prevent their pain from worsening suggests it may not take much more to actually decrease their pain.

Mr Norha summed it up:

“If you have a tendency for back pain or excessive sitting and are concerned for your back health, you can try to figure out ways for reducing sitting at work or during leisure time.

“However, it is important to note that physical activity, such as walking or more brisk exercise, is better than simply standing up.”

https://www.thenewdaily.com.au/life/2024/10/07/stop-back-pain-from-getting-worse