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A weak little study of yoga, exercise for neck pain

added Jul 20, 13 • updated Jun 5, 15
Cramer H, Lauche R, Hohmann C, Lüdtke R, Haller H, Michalsen A, Langhorst J, Dobos G. Randomized-controlled trial comparing yoga and home-based exercise for chronic neck pain. Clin J Pain. 2013 Mar;29(3):216–23. PubMed #23249655.
Tags: self-treatment, stretch, neck, exercise, treatment, muscle, head/neck, spine

PainSci summary of Cramer 2013 ★★☆☆☆?2-star ratings are for studies with glaring flaws, bias, and/or conflict of interest, lesser journals. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.

A small, low-quality experiment that optimistically concludes “yoga was more effective in relieving chronic nonspecific neck pain than a home-based exercise program.” Unfortunately, better research will be required to confirm this. I entirely agree with Dr. Edzard Ernst about this study: “One does not need to be an expert in critical thinking to realise that… the positive outcome might be unrelated to yoga.”

~ Paul Ingraham

original abstract

OBJECTIVES: Chronic neck pain is a significant public health problem with only very few evidence-based treatment options. There is growing evidence for the effectiveness of yoga for relieving musculoskeletal disorders. The aim of this study was to evaluate the effect of Iyengar yoga compared with exercise on chronic nonspecific neck pain.

METHODS: Patients were randomly assigned to either yoga or exercise. The yoga group attended a 9-week yoga course and the exercise group received a self-care manual on home-based exercises for neck pain relief. The main outcome measure was the present neck pain intensity (100 mm visual analog scale). Secondary outcome measures included functional disability (Neck Disability Index), pain at motion (visual analog scale), health-related quality of life (Short Form-36 questionnaire), cervical range of motion, proprioceptive acuity, and pressure pain threshold.

RESULTS: Fifty-one patients (mean age 47.8 y ; 82.4% female) were randomized to yoga (n=25) and exercise (n=26) intervention. After the study period, patients in the yoga group reported significantly less neck pain intensity compared with the exercise group [mean difference: -13.9 mm (95% CI, -26.4 to -1.4), P=0.03]. The yoga group reported less disability and better mental quality of life. Range of motion and proprioceptive acuity were improved and the pressure pain threshold was elevated in the yoga group.

DISCUSSION: Yoga was more effective in relieving chronic nonspecific neck pain than a home-based exercise program. Yoga reduced neck pain intensity and disability and improved health-related quality of life. Moreover, yoga seems to influence the functional status of neck muscles, as indicated by improvement of physiological measures of neck pain.

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