Intended for healthcare professionals

Rapid response to:

Practice Guidelines

Low back pain and sciatica: summary of NICE guidance

BMJ 2017; 356 doi: (Published 06 January 2017) Cite this as: BMJ 2017;356:i6748
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Infographic available

Click here for a visual overview of assessment and management for those with low back pain and/or sciatica.

Rapid Response:

Yoga for Healthy Lower Backs Programme

As a social enterprise and educational yoga Institute, supported by Arthritis Research UK, dedicated to knowledge transfer, we welcome NICE's recommendation to offer patients the choice of yoga as a first step to managing low back pain. However, it is important to note that not all yoga classes would be suitable. With the vast array of different types of yoga available, it is helpful for healthcare professionals to note that the specific 'Yoga for Healthy Lower Backs' programme was designed by yoga specialists overseen by back pain experts and was used successfully in the University of York randomised control trial. This identification name is specifically is mentioned within the published Annals of Internal Medicine paper (and also in the NICE guidelines long version - H. Tilbrook et al and LH Chuang; 313 participants).

This 12-week mind-body, long-term self-management, back-care yoga course is specific and appropriate for beginners. It has a very gentle approach and is taught by highly-qualified and experienced yoga teachers who have additional British Wheel of Yoga recognised Yoga for Healthy Lower Backs Institute 300-hour training. Qualified and part-qualified teachers appear on a Register at and more information can be requested via The evidence-based programme is taught according to 12 class plans (according to a Teachers' Manual with allowable modifications for individualisation) by teachers trained by the same yoga programme designer, Alison Trewhela. Course attendees are supported to practise safely and appropriately at home through the original research's educational resources (relaxation CD, 5 home practice sheets, pain-relieving poses 'Menu sheet', hand-outs, students' manual).

There are over 350 Yoga for Healthy Lower Backs teachers throughout the UK with good course attendee outcomes. A study shows this 12-week course is performing better than in the original trial. It is currently being taught within the NHS in Cornwall and we have support of GPs and commissioners.

More can be seen via our social enterprise website and/or via November 2016 presentation link on the RCGP website (copy and paste - RCGP Website Link to Alison Trewhela’s 2016 Yoga for Healthy Lower Backs Presentation plus Dr. A Huette’s 2016 Yoga GP Quality Improvement Pilot Project Powerpoint

Competing interests: I was the lead yoga consultant who designed the yoga programme used in Arthritis Research UK randomised control trial (University of York) and run a social enterprise set up to educate and promote the yoga programme, Yoga for Healthy Lower Backs mentioned in the Annals of Internal Medicine published paper (for identification purposes).

03 February 2017
Alison M Trewhela
Yoga Researcher and Teacher
University of York, University of Exeter, Yoga for Healthy Lower Backs Institute, British Wheel of Yoga