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Yoga is Equivalent to PT in Chronic Low Back Pain Treatment

lobelsteve

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    I did my first yoga class last friday. Hot vinyasa. Never realized my hips and shoulders were near frozen. It was like a single person pnf stretching session. Very positive and enjoyable. Got a groupon for 5 classes for $29.
     
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    Dr. Ice

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      kamilo6

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        I wonder if you can point to yoga as a "physician directed exercise program" and still get the MRIs approved

        Yes. It will qualify as supervised HEP, but
        it just depends whether the medical note clearly states a medical practitioner recommends/condones yoga for the problem (ie. is "supervising"). If the patient self-reports injuring themselves during "strenous yoga" (whatever that means) before they see us then it changes the interpretation of yoga as HEP for medical necessity reviews.
        Don't forget to report the progress/outcome of yoga/HEP, and also report dates/duration of yoga/HEP.
         
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        SeniorWrangler

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          Yoga is pretty good in my opinion, it's got stretching, strengthening, relaxation therapy, and building tolerance for discomfort, all in a neat package with perky instructors.
          I always talk to patients about the different kinds and suggest they start with hatha yoga since it's way too easy to injure yourself in a fast-moving vinyasa class.
           
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          emd123

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            I've been doing yoga the past 10 months, after transitioning out of long distance running due to some injuries, and if you go to a tough studio that dose power vinyasa, hot yoga or some other form of high cardio yoga, it definitively will kick your arse. When I wear my apple watch to check calories it'll put me at about 800-850 calories for a 90 min class (heart rate can hit around high 160s, but average 125-140, which isn't bad for 90 min) whereas if I do a 30 min run, it will read out about 275 calories (avg HR 160s). I'm not particularly good at it, as I have zero inherent flexibility.

            Avoid the slow, stretching "yin" yoga stuff if you want an actual work out, it's generally a waste of time. That's good for flexibility only (not that that doesn't have value). I also try to stay away from the chanting, sanskrit nonsense-babble and all that hokum smokum. I'm not in it for enlightenment, just for the work out. (And the hot chicks in yoga pants.)

            I do know this, though, if I sent any of my patients to the yoga classes I do, they'd probably get dragged out of there on a back board, and sue me for pain and suffering, cuz it's a helluva lot harder than it looks.
             
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            bedrock

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              I've been doing yoga the past 10 months, after transitioning out of long distance running due to some injuries, and if you go to a tough studio that dose power vinyasa, hot yoga or some other form of high cardio yoga, it definitively will kick your arse. When I wear my apple watch to check calories it'll put me at about 800-850 calories for a 90 min class (heart rate can hit around high 160s, but average 125-140, which isn't bad for 90 min) whereas if I do a 30 min run, it will read out about 275 calories (avg HR 160s). I'm not particularly good at it, as I have zero inherent flexibility.

              Avoid the slow, stretching "yin" yoga stuff if you want an actual work out, it's generally a waste of time. That's good for flexibility only (not that that doesn't have value). I also try to stay away from the chanting, sanskrit nonsense-babble and all that hokum smokum. I'm not in it for enlightenment, just for the work out. (And the hot chicks in yoga pants.)

              I do know this, though, if I sent any of my patients to the yoga classes I do, they'd probably get dragged out of there on a back board, and sue me for pain and suffering, cuz it's a helluva lot harder than it looks.

              Yes to the last sentence. I've seen a lot of patients over 50 with spine problems that were caused by yoga.

              I wouldn't send a spine patient to yoga over PT, but it's fine to add it to your exercise program as you and Steve are doing.
               
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              bedrock

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                Patients need to stick to Hatha form.

                Or tai chi. I have yet to hear of acute disc due to tai chi...


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                tai chi is basically slow dancing. Not much stress there.

                Not just a risk of disk. Lots of my over 50 patients have worsened prexisting spondylolisthesia, spinal stenosis, and very commonly they exacerbate any facet joint degeneration. Extreme hyperextension isn't healthy, as deac pointed out by experience.

                If patients don't want to do PT, but want something more mindful, I send them to Pilates, not yoga.
                 
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