By Mr Ahmed-Ramadan Sadek, Neurosurgeon · Last reviewed October 2026 · 6 min read

What is yoga?

Yoga combines physical postures, breathing exercises and relaxation or meditation. There are many styles. Some, such as Iyengar or hatha yoga, are slower and focus on alignment, often using props like blocks and straps. Others, such as Ashtanga or “power” yoga, are faster and more demanding. Most research on back pain has used the gentler styles.

NICE suggests that people with low back pain consider a group exercise programme, which can include mind-body approaches such as yoga, chosen to suit their needs, preferences and abilities.^[1]

What the evidence says

The Cochrane review

The most thorough summary is a 2022 Cochrane review of 21 trials involving 2,223 people with chronic low back pain. Most participants were women in their 40s or 50s, and most trials used Iyengar, hatha or viniyoga.^[2]

• Yoga versus no exercise: after three months, yoga gave small improvements in back-related function and pain. On average these fell short of the size that most patients would notice as meaningful. People doing yoga were, however, more likely to say their back pain had improved or resolved, and quality of life improved slightly.
• Yoga versus other back exercise: there was probably little or no difference in back function at three months, and it remains uncertain whether yoga differs from other exercise for pain.
• Side effects: yoga caused more adverse events than no exercise, mostly increased back pain, but about the same as other forms of exercise.

The authors concluded that the choice between yoga, another exercise or no exercise may depend on availability, cost and personal preference. They also pointed out that none of the trials could be blinded, which tends to make treatments look better than they are.^[2]

Trials comparing yoga with physiotherapy and stretching

A UK trial run across 13 community venues offered 313 adults with chronic or recurrent low back pain either a 12-class, gradually progressing yoga programme or usual care. Everyone received a back pain education booklet. The yoga group had better back function at 3, 6 and 12 months, though back pain scores were similar between the groups.^[3]

In the US, a trial of 228 adults compared 12 weekly yoga classes, 12 weekly stretching classes and a self-care book. Yoga was better than the book, but it was no better than the stretching classes at any point.^[4] A larger trial of 320 adults, mostly on low incomes and with more severe pain and disability, found that 12 weeks of yoga classes were no worse than 15 physiotherapy sessions for function and pain. Both groups were less likely to be using pain medication at 12 weeks than people given only education, and the gains were maintained at one year. However, yoga was not shown to be better than education on the main outcomes.^[5]

Taken together, yoga looks like a reasonable form of exercise for chronic back pain, roughly on a par with physiotherapy exercise or a structured stretching class, rather than a uniquely powerful treatment.

Choosing a class

• Start gently. Look for classes described as beginners, gentle, therapeutic, or yoga for back care. Faster, heated or highly athletic styles are better left until you are confident.
• Check the teacher. Ask about their training, insurance and experience with people who have back pain.
• Small classes help. A teacher who can watch you and suggest modifications is worth more than a large, fast-paced session.
• Give it time. Most trials used weekly classes for about 12 weeks, often with home practice in between.
• Online classes can work well once you know the basics, but in-person guidance is useful at the start.

Adapting yoga for a sore back

• Use props freely: a block under your hands in forward bends, a strap around your foot for leg stretches, a folded blanket under your hips when sitting.
• Bend your knees in forward folds. There is no need to touch your toes.
• Keep twists and backbends small and controlled, and come out of them slowly.
• Many postures can be done lying down or on a chair if getting to the floor is difficult.
• If you have sciatica, ease off any pose that makes leg pain or tingling worse.
• If you have lumbar spinal stenosis, gentle forward-bending positions are often more comfortable than backbends.

Some soreness after a new class is common. In the UK trial, 12 of 156 people in the yoga group reported adverse events, mostly increased pain, compared with 2 of 157 in the usual care group.^[3] Pain that is sharp, spreads down a leg, or lasts more than a day or two after a class is a sign to ease back and speak to the teacher or your physiotherapist.

These can be signs of cauda equina syndrome or another serious condition that needs prompt assessment.

References

1. National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management (NG59). London: NICE; 2016 (last updated 2026). Link
2. Wieland LS, Skoetz N, Pilkington K, Harbin S, Vempati R, Berman BM. Yoga for chronic non-specific low back pain. Cochrane Database Syst Rev. 2022;11(11):CD010671. Link
3. Tilbrook HE, Cox H, Hewitt CE, et al. Yoga for chronic low back pain: a randomized trial. Ann Intern Med. 2011;155(9):569-78. Link
4. Sherman KJ, Cherkin DC, Wellman RD, et al. A randomized trial comparing yoga, stretching, and a self-care book for chronic low back pain. Arch Intern Med. 2011;171(22):2019-26. Link
5. Saper RB, Lemaster C, Delitto A, et al. Yoga, physical therapy, or education for chronic low back pain: a randomized noninferiority trial. Ann Intern Med. 2017;167(2):85-94. Link
6. Cramer H, Krucoff C, Dobos G. Adverse events associated with yoga: a systematic review of published case reports and case series. PLoS One. 2013;8(10):e75515. Link

This guide is general information and is not a substitute for advice about your own situation. Please speak to your GP, physiotherapist or specialist before starting a new treatment.