“This evidence-based yoga programme could (or should!) be the way forward for back pain treatment. It is affordable, empowers patients and offers long-term benefits to society.” ”Now it has been shown that this one-off self-management treatment would save costs within an NHS setting – what are we waiting for?”
On this social enterprise website, click here for our Tri-Fold YHLB Information Leaflet and find information about:-
How the specific ’Yoga for Healthy Lower Backs’ evidence-based (Annals of Internal Medicine) gentle, yoga programme offers:-
1. Long-term improvements for those with a history of low back pain, plus benefits for the whole person (body and mind);
2. Health and Wellbeing / Health Promotion (this gentle, beginners’ appropriate yoga helps people to have the confidence to get back to being physically active and encourages positive mental health);
3. Self-management (with yoga home practice sheets, Relaxations CD and manual) - the majority in our research were still practising yoga at home the recommended amount (30 minutes twice a week) at the 12-month follow-up;
4. Fully-resourced (educational resources available from Arthritis Research UK charity-funded research; trained teachers available);
5. Safe and enjoyable group activity in the community (patient choice);
6. Specifically trained, experienced yoga teachers adhering to the programme (with understanding of back dysfunction, individual patient needs, medical terminology, Inclusion Criteria, Red Flags and more);
7. Cost-effectiveness / cost savings for the NHS, society and individuals - potential shown in ‘Cost Evaluation’ published paper – University of York (Spine). Savings likely to be even more impressive as patients only need one 12-week course to continue to self-manage for longer than the 12 months studied in our research;
8. One of the most effective, similarly rigorously-tested treatment options currently available (shown in Forest Plot graph Annals of Internal Medicine);
9. Education of patient – posture, lower back function, breathing, mental perspective, pain perception - with advice on how to use this information throughout daily life;
10. QIPP and other Department of Health health provision improvement initiatives can be addressed;
11. Evidence of long-term self-management – those offered the 12-week yoga course had an average of only 3.83 days off work over the 12 months studied compared to 12.29 in the non-yoga group;
12. Benefits to NHS staff, e.g. courses offered to hospital staff to reduce absenteeism.
- The University of York, Department of Health Sciences, York Trials Unit’s rigorous RCT research led by Prof. David Torgerson adds more evidence to show that yoga decreases chronic and recurring low back pain. This research was generously funded by the charity Arthritis Research UK and they are supportive of our endeavours to make this research have the impact it deserves for the benefit of others.
- Link from our Home Page to our Nov 1st 2011 main RCT results paper published in ‘Annals of Internal Medicine’, showing appropriate, specialized group yoga classes (our fully-resourced ‘Yoga for Healthy Lower Backs’ programme) to be a ‘safe and effective treatment option that clinicians should consider recommending for patients with a history of chronic or recurrent low back pain’.
- Newly published Economic Evaluation paper (Abstract March 16th 2012; Full paper August 15th 2012) in ‘Spine’ Journal, shows ‘Yoga for Healthy Lower Backs’ would be likely to be cost-effective within the UK NHS and of great value to society and the economy, e.g. an average of 3.83 days off work for the yoga group compared to approx. 12.29 days in the non-yoga control group over a 12-month period. Follow the link to the Abstract here:- http://www.ncbi.nlm.nih.gov/pubmed/22433499. For link to full published paper (N.B. subscription or purchase only; not open access) click here http://journals.lww.com/spinejournal/Abstract/2012/08150/A_Pragmatic_Multicentered_Randomized_Controlled.10.aspx . For a link to Arthritis Research UK’s report of the University of York’s press statement August 16th 2012 – click here http://www.arthritisresearchuk.org/news/press-releases/2012/august/yoga-a-cost-effective-treatment-for-back-pain-sufferers.aspx .
- Short video film giving an overview of the ‘Yoga for Healthy Lower Backs’ classes. ‘Annals of Internal Medicine’ requested that we make this film for use as a supplement to the online published paper and this links from their site. Link top right or top bar Video Page (Video 1).
- Our published Trial Protocol paper ‘A pragmatic multi-centred randomized controlled trial of yoga for chronic low back pain: trial protocol’ Helen Cox, Helen Tilbrook, John Aplin, Ling-Hsiang Chuang, Catherine Hewitt, Shalmini Jayakody, Anna Semlyen, Marta O Soares, David Torgerson, Alison Trewhela, Ian Watt, Gill Worthy, is found at ’Complementary Therapies in Clinical Practice’ (2010).
- Other research into low back pain as background to, plus support for, our Research Findings. View our Research Page.
- Tri-fold Information Leaflet, Powerpoint Presentation (health professional version ready soon), links to press coverage and more on our Promotional Resources Page.
- Details of these cost-effective group ’Yoga for Healthy Lower Backs’ courses that have the potential to provide long-term as well as short-term improvements – enabling patients to self-manage with potential added health benefits, e.g. less depression, improved joint alignment and muscular balance, less headaches, lower blood pressure.
- All ‘Yoga for Healthy Lower Backs’ yoga teachers listed on our website are already qualified yoga teachers from various yoga schools and methods with considerable teaching experience. Whilst training, they attend four training days (2 + 2), study and practise the yoga programme extensively at home over approx. a 6-month period, and are mentored and supported throughout the time that they teach their first course (Approx. 135 hours total training time). (Courses are 6 weeks, mid-course break, plus 6 weeks.) Ofqual course accreditation is being worked on. CPD is in place.
- The published pilot trial paper ‘A randomised controlled trial of yoga for the treatment of chronic low back pain: Results of a pilot study’ Helen Cox, Helen Tilbrook, John Aplin, Anna Semlyen, David Torgerson, Alison Trewhela, Ian Watt can be found at Complementary Therapies in Clinical Practice, 16 (2010) 187-193.
- Sales of the Relaxations CD help fund this Website and the yoga programme development work of our social enterprise Yogaforbacks.
- Commissioning (perhaps AQP), for local or national provision of ‘Yoga for Healthy Lower Backs’ to enable ‘social inclusion’ is our aim. Contracts would be secured, organized and accountable via our community interest company – ‘Yoga for Healthy Lower Backs Ltd’ (not trading currently).
- Contact email@example.com for discussions about potential in your region, especially with regard to Public Health, NHS/CCG and Health and Wellbeing Board and Adult Social Care partnership working.
- Arthritis Research UK have featured us twice in their ‘Arthritis Today’ magazine and also in their ‘Synovium’ Newsletter which goes to Health Professionals.
- HUMAN RESOURCES / OCCUPATIONAL HEALTH personnel can visit our Healthy Workplace Page to find out how the Relaxations CD would be a potentially useful educational resource for employees. Also for information about how our one-off, group basis, 12-week course would be likely to decrease work absenteeism by approx. 70%, as well as offering long-term benefits contributing to health and wellbeing in the workplace.
Contact us, via our contact page, for help with provision of this evidence-based biopsychosocial, safe, effective and cost-effective treatment with the aim of arranging to provide a team of trained yoga teachers in your locality. We are aiming to have teams of teachers providing within NHS settings.
Many thanks for your interest.
The ‘Mail on Sunday’ picked up the Press Release Statement sent out by The University of York and reported on our recently published cost-effectiveness paper in Spine journal like this – follow the link below.
‘Prescribing yoga on the NHS could slash annual £1.37billion back pain bill, say experts
- Bad back sufferers taking part in the yoga programme had far fewer days off work than those in the control group By Claire Bates
PUBLISHED:12:33 GMT, 17 August 2012| UPDATED:12:33 GMT, 17 August 2012′
Arthritis Research UK reported it like this – read below or follow link http://www.arthritisresearchuk.org/news/press-releases/2012/august/yoga-a-cost-effective-treatment-for-back-pain-sufferers.aspx.
Yoga: a cost-effective treatment for back pain sufferers?
Specialised group yoga classes could provide a cost-effective way of treating patients with chronic or recurrent low back pain, according to the UK’s largest ever study of the benefits of yoga.
Funded by Arthritis Research UK and led by the University of York, the study provides an evaluation of a specially-developed 12-week group yoga intervention programme compared to conventional general practitioner (GP) care alone.
The results published in Spine, show that the yoga intervention programme – ‘Yoga for Healthy Lower Backs’ – is likely to be cost effective for both the UK National Health Service (NHS) and wider society.
The cost assumed for yoga intervention is important in determining whether this is an efficient use of NHS resources. As yoga classes are not currently available through the NHS, the researchers examined a range of possible costs. They conclude that if the NHS was to offer specialist yoga and managed to maintain the cost below £300 per patient (for a cycle of 12 classes), there is a high probability (around 70 per cent) of the yoga intervention being cost effective. Researchers also found that those taking part in the yoga programme had far fewer days off work than those in the control group.
On average, a control group participant reported 12 days off due to back pain, whereas those in the yoga group had four days off. The cost associated with taking time off was £1,202 for a control group member, compared with £374 for a yoga group member. The study was carried out by researchers from the University of York’s Department of Health Sciences and the Centre for Health Economics, and the Hull York Medical School.
Chief Investigator Professor David Torgerson, Director of York Trials Unit, in the University of York’s Department of Health Sciences, said: “Back pain represents a significant burden to the NHS in the UK and to society as a whole. As well as the associated health care costs, it is also a major cause of work absenteeism which leads to a productivity loss to society. “While yoga has been shown as an effective intervention for treating chronic and low back pain, until now there has been little evidence on its cost effectiveness. In our study we evaluated a specially-designed yoga class package by using individual-level data from a multi-centred randomized controlled trial. On the basis of the 12-month trial, we conclude that 12 weekly group classes of specialised yoga are likely to provide a cost-effective intervention for the treatment of patients with chronic or recurrent low back pain.”
Back pain is estimated to cost the NHS £1.37 billion and the health care sector £2.10 billion a year. It is also one of the most common conditions treated in primary care in the UK with about 2.6 million people seeking advice from their GP about back pain each year.
Professor Alan Silman, medical director of Arthritis Research UK, said: “We welcome the fact that not only has yoga been found to help people manage their back pain, but that it is also cost effective, and results in fewer sick days. It is another option for people who are struggling to manage their condition, and one that encourages the move to self-management. Yoga is an intervention that has been proven to make their everyday lives easier and their pain more manageable. “We’d hope that on the back of this, more people with back pain are encouraged to take up the yoga programme.” The trial involved two groups of people who were identified as having chronic or recurrent back pain. A group of 156 people were offered group yoga classes specially designed to improve back function, while a second control group of 157 people received GP care alone. Both groups received usual GP care, which could have involved, for example, referral to pain clinics and physiotherapists or prescription of painkillers.
The 12-week yoga programme was delivered by 12 experienced yoga teachers. It was designed by Alison Trewhela, an Iyengar Yoga teacher and senior practitioner in yoga on the British Register of Complementary Practitioners, in collaboration with yoga teacher Anna Semlyen, a back care advisor to the British Wheel of Yoga.
Alison Trewhela said: “GPs and commissioners are showing great interest in this yoga programme. Many consider it could be the primary treatment option because it offers long-term positive outcomes, as well as a multi-disciplinary combination of taught skills that suits the bio-psycho-social nature of the condition of chronic low back pain. “Within its confidence-boosting, gradually-progressing environment, the gentle ‘Yoga for Healthy Lower Backs’ course addresses joint mobility, muscle-strengthening, emphasis on the breath, mental attitude to pain and perspective on life lessons, postural awareness and low back education, relaxation techniques, and advice about other potentially health-giving techniques and benefits.”
More information on the York Trials Unit’s randomized controlled trial is available at www.yogatrial.co.uk. Lower back pain sufferers, yoga teachers and health professionals can also learn more about the ‘Yoga for Healthy Lower Backs’ programme at www.yogaforbacks.co.uk, a website created by the yoga teachers involved.