Effectiveness of Yoga Versus Conventional Interventions for Back Pain: a “scoping review” or just wishful thinking?

Chronic back pain is a prevalent and debilitating condition, significantly impacting quality of life and functional independence. While conventional interventions, including physical therapy and pharmacological treatments, are commonly utilized, complementary practices like yoga are increasingly explored for their potential benefits in pain management and functional improvement.

This scoping review aimed to assess the existing evidence on the effectiveness of yoga compared to conventional interventions in reducing pain and back-related disability in older adults, highlighting key findings and identifying gaps for future research. The review followed the Arksey and O’Malley scoping review framework, systematically searching databases including PubMed, Scopus, and Web of Science. Studies were included if they:

• (1) involved older adults (aged 60 and above),
• (2) compared yoga with conventional back pain interventions,
• (3) measured outcomes related to pain intensity and back-related disability,
• (4) were published in peer reviewed journals.

A thematic analysis was performed to identify common findings, trends, and research gaps in the literature.

Twenty-four studies met the inclusion criteria, including randomized controlled trials, cohort studies, and observational research. Findings generally support the efficacy of yoga in reducing pain and disability among older adults, with many studies demonstrating comparable or superior results to conventional physical therapy interventions. Yoga was associated with additional benefits in psychological well-being, flexibility, and balance, which were less frequently addressed by conventional treatments. However, the studies varied in intervention types, duration, and measurement tools, limiting cross-study comparisons. Few studies examined long-term outcomes, highlighting a need for further longitudinal research.

The authors concluded that this evidence suggests that yoga is a viable alternative or adjunct to conventional back pain interventions in older adults, offering potential benefits for pain reduction, functional mobility, and quality of life. Despite these promising findings, the heterogeneity of studies and lack of long-term data indicate a need for further high-quality research to establish standardized protocols and evaluate sustained effects. Future studies should focus on randomized controlled designs with consistent measures to better inform clinical guidelines on integrating yoga into back pain management for older adults.

“Yoga is a viable alternative or adjunct to conventional back pain interventions”?

Really?

Based on what precisely?

We cannot know, because the paper does not even reference the primary studies. Nor does it provide essential details about them. Nor does it reveal what the ‘conventional interventions’ were. Nor does it address the problem of bias or methodological quality of the primary studies.

What we do know is that some (but not how many) uncontrolled studies were included. This means that the evidence is likely to be flimsy indeed.

It is, of course, possible that some form of yoga is an effective therapy for back pain but the above paper does not come anywhere near proving this hypothesis. Personally, I suspect that most treatments that include an element of exercise might be marginally helpful, but somehow doubt that one is dramatically better than the next.