Effects of Iyengar Yoga and Yoga Nidra on inflammation, sleep, and disability in older men with chronic low back pain
DOI:
https://doi.org/10.47197/retos.v72.116839Keywords:
Back Pain, Disability, Inflammatory Marker, Relaxation, Sleep QualityAbstract
Background: Chronic low back pain (CLBP) is a widespread and debilitating condition in older adults, often involving both physical and psychological difficulties. Despite growing interest in mind-body therapies, there is limited evidence regarding the effects of structured yoga interventions specifically targeting older men with CLBP.
Objectives: This study aimed to examine the effects of a combined Iyengar yoga and Yoga Nidra program on inflammatory markers, sleep quality, and functional impairment in older male patients with CLBP.
Methodology: Fifty-five men aged 55–65 years with chronic low back pain were randomly assigned to either a 3-month combined Iyengar yoga and Yoga Nidra program (n=28) or standard care (n=27). Primary outcomes included inflammatory biomarkers (hs-CRP, IL-6, TNF-α), while secondary measures assessed sleep quality, functional disability, depression, and pain catastrophizing, with assessments conducted at baseline and after 3 months by blinded evaluators.
Results: Compared to controls, the intervention group demonstrated significantly greater reductions in all three inflammatory markers (p < 0.001), along with notable improvements in sleep quality (p < 0.001), functional disability (p < 0.001), depressive symptoms (p < 0.001), and pain catastrophizing (p < 0.001). No serious adverse effects were reported.
Discussion: The integrated yoga protocol effectively improved both physiological and psychological outcomes in older men with CLBP. These results suggest strong potential for using combined Iyengar yoga and Yoga Nidra as a holistic, safe, non-pharmacological approach to chronic pain management in aging populations.
Conclusions: This intervention holds promise for improving multidimensional health outcomes in older men with CLBP.
References
Angst, F., Angst, J., Ajdacic-Gross, V., Aeschlimann, A., & Rössler, W. (2017). Epidemiology of back pain in young and middle-aged adults: a longitudinal population cohort survey from age 27–50 years. Psychosomatics, 58(6), 604-613. https://doi.org/10.1016/j.psym.2017.05.004
Chang, J. R., Wang, X., Lin, G., Samartzis, D., Pinto, S. M., & Wong, A. Y. L. (2022). Are changes in sleep quality/quantity or baseline sleep parameters related to changes in clinical outcomes in patients with nonspecific chronic low back pain?: a systematic review. The Clinical journal of pain, 38(4), 292-307. https://doi.org/10.1097/AJP.0000000000001008
da Cruz Fernandes, I. M., Pinto, R. Z., Ferreira, P., & Lira, F. S. (2018). Low back pain, obesity, and inflammatory markers: exercise as potential treatment. Journal of exercise rehabilitation, 14(2), 168. https://doi.org/10.12965/jer.1836070.035
de Jong, M., Lazar, S. W., Hug, K., Mehling, W. E., Hölzel, B. K., Sack, A. T., Peeters, F., Ashih, H., Mischoulon, D., & Gard, T. (2016). Effects of Mindfulness-Based Cognitive Therapy on Body Awareness in Patients with Chronic Pain and Comorbid Depression. Frontiers in Psychology, 7, 967. https://doi.org/10.3389/fpsyg.2016.00967
de Vet, H. C. W., Foumani, M., Scholten, M. A., Jacobs, W. C. H., Stiggelbout, A. M., Knol, D. L., & Peul, W. C. (2015). Minimally important change values of a measurement instrument depend more on baseline values than on the type of intervention. Journal of Clinical Epidemiology, 68(5), 518-524. https://doi.org/10.1016/j.jclinepi.2014.07.008
Djalilova, D. M., Schulz, P. S., Berger, A. M., Case, A. J., Kupzyk, K. A., & Ross, A. C. (2019). Impact of yoga on inflammatory biomarkers: a systematic review. Biological Research for Nursing, 21(2), 198-209. https://doi.org/10.1177/1099800418820162
Dzierzewski, J. M., Donovan, E. K., Kay, D. B., Sannes, T. S., & Bradbrook, K. E. (2020). Sleep inconsistency and markers of inflammation. Frontiers in Neurology, 11, 1042. https://doi.org/10.3389/fneur.2020.01042
Fairbank, J. C. T., & Pynsent, P. B. (2000). The Oswestry disability index. Spine, 25(22), 2940-2953. https://doi.org/10.1097/00007632-200011150-00017
Hengartner, M. P., & Plöderl, M. (2022). Estimates of the minimal important difference to evaluate the clinical significance of antidepressants in the acute treatment of moderate-to-severe depression. BMJ evidence-based medicine, 27(2), 69-73. https://doi.org/10.1136/bmjebm-2020-111600
Herrero Babiloni, A., De Koninck, B. P., Beetz, G., De Beaumont, L., Martel, M. O., & Lavigne, G. J. (2020). Sleep and pain: recent insights, mechanisms, and future directions in the investigation of this relationship. Journal of Neural Transmission, 127, 647-660. https://doi.org/10.1007/s00702-019-02067-z
Inventory-Ii, B. D. (2010). Beck depression inventory-II. Corsini Encycl. Psychol, 1(1), 210. http://dx.doi.org/10.1002/9780470479216.corpsy0113
Ketenci, A., & Zure, M. (2021). Pharmacological and non-pharmacological treatment approaches to chronic lumbar back pain. Turkish Journal of Physical Medicine and Rehabilitation, 67(1), 1. https://doi.org/10.5606/tftrd.2021.8216
LaRowe, L. R., Bakhshaie, J., Vranceanu, A.-M., & Greenberg, J. (2023). Effects of a mind-body program for chronic pain in older versus younger adults. Journal of Pain Research, 3917-3924. https://doi.org/10.2147/jpr.s435639
Lee, C., Crawford, C., & Hickey, A. (2014). Mind–body therapies for the self-management of chronic pain symptoms. Pain Medicine, 15(S1), S21-S39. https://doi.org/10.1111/pme.12383
Longo, U. G., Berton, A., De Salvatore, S., Piergentili, I., Casciani, E., Faldetta, A., . . . health, p. (2021). Minimal clinically important difference and patient acceptable symptom state for the Pittsburgh sleep quality index in patients who underwent rotator cuff tear repair. 18(16), 8666. https://doi.org/10.3390/ijerph18168666
Maheshkumar, K., Dilara, K., Ravishankar, P., Julius, A., Padmavathi, R., Poonguzhali, S., & Venugopal, V. (2022). Effect of six months pranayama training on stress-induced salivary cortisol response among adolescents-Randomized controlled study. EXPLORE, 18(4), 463-466. https://doi.org/10.1016/j.explore.2021.07.005
Mattiuzzi, C., Lippi, G., & Bovo, C. (2020). Current epidemiology of low back pain. Journal of Hospital Management and Health Policy, 4. https://doi.org/10.21037/jhmhp-20-17
Moszeik, E. N., von Oertzen, T., & Renner, K.-H. (2022). Effectiveness of a short Yoga Nidra meditation on stress, sleep, and well-being in a large and diverse sample. Current Psychology, 41(8), 5272-5286. https://doi.org/10.1007/s12144-020-01042-2
Musto, S., & Hazard Vallerand, A. (2023). Exploring the uses of yoga nidra: An integrative review. Journal of Nursing Scholarship, 55(6), 1164-1178. https://doi.org/10.1111/jnu.12927
Padmavathi, R., Kumar, A. P., Dhamodhini, K. S., Venugopal, V., Silambanan, S., Maheshkumar, K., & Shah, P. (2023). Role of yoga in stress management and implications in major depression disorder. Journal of Ayurveda and Integrative Medicine, 14(5), 100767. https://doi.org/10.1016/j.jaim.2023.100767
Ragavee, S., Prashanth, S., Priyanka, S., & Maheshkumar, K. (2024). Immediate effect of Yoga Nidra (a yogic relaxation) on cardio-autonomic function in hypertensive patients: A case report. Journal of Indian System of Medicine, 12(4), 188-191. https://doi.org/10.4103/jism.jism_44_24
Ravi, P., Boopalan, D., Manickam, A., Vijayakumar, V., & Kuppusamy, M. (2024). Yoga Nidra as an Adjunctive Therapy in Idiopathic Intracranial Hypertension: A Case Study. Integrative and Complementary Therapies, 30(4), 166-169. https://doi.org/10.1089/ict.2024.72904.mk
Safiri, S., Nejadghaderi, S. A., Noori, M., Sullman, M. J. M., Collins, G. S., Kaufman, J. S., . . . Kolahi, A.-A. (2023). The burden of low back pain and its association with socio-demographic variables in the Middle East and North Africa region, 1990–2019. BMC Musculoskeletal Disorders, 24(1), 59. https://doi.org/10.1186/s12891-023-06178-3
Smyth, C. (1999). The Pittsburgh sleep quality index (PSQI). In (Vol. 25, pp. 10-10): SLACK Incorporated Thorofare, NJ. https://doi.org/10.3928/0098-9134-19991201-10
Sullivan, M. J. L., Bishop, S. R., & Pivik, J. (1995). The pain catastrophizing scale: development and validation. Psychological Assessment, 7(4), 524. https://doi.org/10.1037/1040-3590.7.4.524
Urits, I., Burshtein, A., Sharma, M., Testa, L., Gold, P. A., Orhurhu, V., . . . Spektor, B. (2019). Low back pain, a comprehensive review: pathophysiology, diagnosis, and treatment. Current pain and headache reports, 23, 1-10. https://doi.org/10.1007/s11916-019-0757-1
Van den Berg, R., Jongbloed, E. M., De Schepper, E. I. T., Bierma-Zeinstra, S. M. A., Koes, B. W., & Luijsterburg, P. A. J. (2018). The association between pro-inflammatory biomarkers and nonspecific low back pain: a systematic review. The Spine Journal, 18(11), 2140-2151. https://doi.org/10.1016/j.spinee.2018.06.349
Van Looveren, E., Bilterys, T., Munneke, W., Cagnie, B., Ickmans, K., Mairesse, O., . . . Goubert, D. (2021). The association between sleep and chronic spinal pain: a systematic review from the last decade. Journal of Clinical Medicine, 10(17), 3836. https://doi.org/10.3390/jcm10173836
Vanitha, A., Pandiaraja, M., Maheshkumar, K., & Venkateswaran, S. T. (2018). Effect of yoga nidra on resting cardiovascular parameters in polycystic ovarian syndrome women. National Journal of Physiology, Pharmacy and Pharmacology, 8(11), 1505-1508. https://doi.org/10.5455/njppp.2018.8.0411112082018
Vignesh, C., Chelliah Jesus Rajkumar, N., Elayaraja, M., Gogoi, H., & Govindasamy, K. (2024). Effect of Selected Yoga Interventions on Psycho-Physiological Function in IT Professionals with Chronic Back Pain—A Randomized Controlled Trial. Physical rehabilitation and recreational health technologies, 9(4), 256–268. https://doi.org/10.15391/prrht.2024-9(4).06
Vignesh, C., Rajkumar, N. C. J., Pramanik, M., Kumasi, B., Elayaraja, M., Bangari, D., Rawat, B., Sethi, D., Bhoria, Y., Setiawan, E., Gogoi, H., & Govindasamy, K. (2024). Effectiveness of yoga intervention on depression, stress, and sleep quality in IT professionals with chronic low back pain: A randomized controlled trial. Fizjoterapia Polska, 24(3), 410–416. https://doi.org/10.56984/8ZG020A3TN
Wankhar, D., Kumar, A. P., Vijayakumar, V., Velan, A., Balakrishnan, A., Ravi, P., . . . Balakrishnan Sr, A. (2024). Effect of meditation, mindfulness-based stress reduction, and relaxation techniques as mind-body medicine practices to reduce blood pressure in cardiac patients: A systematic review and meta-analysis. Cureus, 16(4). https://doi.org/10.7759/cureus.58434
Wheeler, C. H. B., Williams, A. C. d. C., & Morley, S. J. (2019). Meta-analysis of the psychometric properties of the Pain Catastrophizing Scale and associations with participant characteristics. Pain, 160(9), 1946-1953. https://doi.org/10.1097/j.pain.0000000000001494
Williams, K. A., Petronis, J., Smith, D., Goodrich, D., Wu, J., Ravi, N., . . . Gross, R. (2005). Effect of Iyengar yoga therapy for chronic low back pain. Pain, 115(1-2), 107-117. https://doi.org/10.1016/j.pain.2005.02.016
Wu, A., March, L., Zheng, X., Huang, J., Wang, X., Zhao, J., . . . Hoy, D. (2020). Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Annals of Translational Medicine, 8(6), 299. https://doi.org/10.21037/atm.2020.02.175
Yousuf, O., Mohanty, B. D., Martin, S. S., Joshi, P. H., Blaha, M. J., Nasir, K., . . . Budoff, M. J. (2013). High-sensitivity C-reactive protein and cardiovascular disease: a resolute belief or an elusive link? Journal of the American College of Cardiology, 62(5), 397-408. https://doi.org/10.1016/j.jacc.2013.05.016
Zhao, L., Manchikanti, L., Kaye, A. D., & Abd-Elsayed, A. (2019). Treatment of discogenic low back pain: current treatment strategies and future options—a literature review. Current pain and headache reports, 23, 1-9. https://doi.org/10.1007/s11916-019-0821-x
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Ajendra Narayan Samal, Shankar Kanagasabapathy, Masilamani Elayaraja, Karuppasamy Govindasamy, Ibnu Noufal Kambitta Valappil, Debajit Karmakar, Carmen Magdalena Camenidis, Farjana Akter Boby, Vlad Adrian Geantă
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and ensure the magazine the right to be the first publication of the work as licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of authorship of the work and the initial publication in this magazine.
- Authors can establish separate additional agreements for non-exclusive distribution of the version of the work published in the journal (eg, to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Is allowed and authors are encouraged to disseminate their work electronically (eg, in institutional repositories or on their own website) prior to and during the submission process, as it can lead to productive exchanges, as well as to a subpoena more Early and more of published work (See The Effect of Open Access) (in English).
This journal provides immediate open access to its content (BOAI, http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess) on the principle that making research freely available to the public supports a greater global exchange of knowledge. The authors may download the papers from the journal website, or will be provided with the PDF version of the article via e-mail.
