Efficacy and safety of yoga for the management of chronic low back pain: an overview of systematic reviews

Xianshuai Zhang; Tianying Chang; Wenlong Hu; Mingpeng Shi; Yating Chai; Siyi Wang; Guohui Zhou; Mingze Han; Minghui Zhuang; Jie Yu; He Yin; Liguo Zhu; Changwei Zhao; Zhenhua Li; Xing Liao

doi:10.3389/fneur.2023.1273473

Efficacy and safety of yoga for the management of chronic low back pain: an overview of systematic reviews

Front Neurol. 2023 Oct 27:14:1273473. doi: 10.3389/fneur.2023.1273473. eCollection 2023.

Authors

Xianshuai Zhang^#¹, Tianying Chang^#², Wenlong Hu³, Mingpeng Shi¹, Yating Chai⁴, Siyi Wang¹, Guohui Zhou¹, Mingze Han¹, Minghui Zhuang⁵, Jie Yu⁵, He Yin⁵, Liguo Zhu⁵, Changwei Zhao², Zhenhua Li², Xing Liao⁶

Affiliations

¹ Changchun University of Chinese Medicine, Changchun, Jilin, China.
² Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China.
³ Shenzhen People's Hospital, Shenzhen, China.
⁴ Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin, China.
⁵ China Academy of Chinese Medical Sciences, Wangjing Hospital, Beijing, China.
⁶ Center for Evidence-Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China.

^# Contributed equally.

Abstract

Background: Yoga is a non-pharmacological conservative therapeutic modality that can be employed for the management of chronic low back pain (CLBP). In this overview, we have summarized and evaluated data from current systematic reviews (SRs) on the use of yoga for CLBP.

Methods: We comprehensively searched SRs on the use of yoga for CLBP in nine electronic databases from inception to September 2023. The methodological quality was evaluated using the Assessment of Multiple Systematic Review Scale-2 (AMSTAR-2). The reporting quality of the included SRs was evaluated using the Preferred Reporting Item for Systematic Review and Meta-Analysis-2020 (PRISMA-2020), and the quality of data was graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Two independent researchers performed the screening, data extraction, and quality assessment process of SRs.

Results: A total of 13 SRs were included. The results of the AMSTAR-2 indicated that the methodological quality of the included studies was relatively low. The PRISMA-2020 checklist evaluation results indicated that methodological limitations in reporting, especially regarding data processing and presentation, were the main weaknesses. The GRADE assessment indicated that 30 outcomes were rated moderate, 42 were rated low level, and 20 were rated very low level. Downgrading factors were mainly due to the limitations of the included studies.

Conclusion: Yoga appears to be an effective and safe non-pharmacological therapeutic modality for the Management of CLBP. Currently, it may exhibit better efficacy in improving pain and functional disability associated with CLBP. However, the methodological quality and quality of evidence for SRs/MAs in the included studies were generally low, and these results should be interpreted cautiously.

Keywords: AMSTAR-2; GRADE; chronic low back pain; systematic review; yoga.

Publication types

Systematic Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the 2023 Chinese Medicine Evidence-Based Capacity Enhancement Project, Changchun, China and the National Key R&D Projects (Grant Numbers: 2021YFC1712801 and 2021YFC1712802).