Yoga a promising treatment option for those with neuropathic pain due to lumbar disc herniation

Pelin Yildirim

Stretch and strength-based yoga exercise exercises could be a promising treatment option for patients with neuropathic pain due to lumbar disc herniation (LDH), according to the findings of a recent randomised controlled trial (RCT).

The RCT, which was published in the journal Spine by Pelin Yildirim and Alper Gultekin (Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey) aimed to investigate the effect of a stretch and strength-based yoga exercise program on neuropathic pain due to LDH. “We hypothesised that yoga positively affects both LDH and neuropathic pain by increasing mobilisation, core muscle strength, and spinal and hamstring flexibility,” noted the researchers.

A total of 48 patients with neuropathic pain due to LDH were randomly assigned to a control group and a yoga group. All patients underwent a patient education program. The selected yoga exercise was taught and performed to the yoga group for one hour twice weekly for a total of 12 weeks.

Neuropathic pain (DN4 [Douleur Neuropathique 4] for diagnosis; LANSS [Leeds Assessment of Neuropathic Symptoms and Signs] for severity), low back pain (the short-form of McGill Pain Questionnaire), disability (Oswestry Disability Index), and function (modified Schober and passive knee extension test) were measured blind before and at one-, three-, and six-month follow-up. The patient global assessment was applied at six-month follow-up.

The intention-to-treat analysis showed a statistically significant difference in neuropathic pain, patient global assessment, low back pain, disability, and function in favour of the yoga group at post-treatment. In addition, the between-group effect sizes were moderate at six-months follow-up.

Speaking to Spinal News International, Yildirim said: “Treating neuropathic pain due to lumbar disc herniation is challenging. Its pharmacological management involves adverse effects, and these drugs can only lessen pain by 30-50%.

“In our trial, a step-by-step yoga program was performed within the range of the study participants’ tolerability, avoiding excessive flexion or extension of the lumbar spine for patients with neuropathic pain due to lumbar disc herniation. In conclusion, we achieved a high patient global assessment score with only minor adverse effects in the yoga group. We hope our trial encourages doctors in supporting exercise as medicine.”


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