Psychological factors such as depression, anxiety, fear and anger seem to have a greater impact than biomedical or biomechanical factors on Chronic Lower Back Pain disability.


In Chronic Lower Back Pain, the reduction in quality of life could be attributed to pain related sleep disturbances, fatigue, medication abuse[2] functional disability[3] and stress. 

In patients with fibromyalgia[4] and Chronic Lower Back Pain,[5] the degree of pain, perceived disability and Quality of Life were influenced more by their mental health status than the degree of physical impairment.

Yoga, with its holistic approach to improve overall quality of life, offers several self regulatory practices that aim at correcting these psychological factors that contribute to low Quality of Life. An integrated approach to yoga therapy that includes practices at physical, breathing, mental, intellectual and emotional levels has been shown to be effective in improving the Quality of Life in several chronic conditions such as fibromyalgia,[6] rheumatoid arthritis[7] and cancer. [8] 

Additionally, multidisciplinary biopsychosocial rehabilitation has been shown to be better than usual care in improving Quality of Life with reduction in pain and functional disability in patients with chronic back pain.[9]


References:
1. Padmini Tekur, Singphow Chametcha, Ramarao Nagendra Hongasandra, Nagarathna Raghuram. Effect of yoga on quality of life of CLBP patients: A randomized control study Int J Yoga. 2010 Jan-Jun; 3(1): 10–17

2. Moldofsky H, Lue FA. Disordered sleep, pain, fatigue and gastrointestinal symptoms in fibromyalgia, chronic fatigue and irritable bowel syndromes. New York: Elsevier Science Publishers; 1993.
3. Williamas AC, Nicholas MK, Richardson PH, Pither CE, Justins DM, Chamberlain JH, et al. Evaluation of a cognitive behavioral program for rehabilitating patients with chronic pain. Br J General Pract. 1993;43:513–8. [PMC free article] [PubMed]
4. Verbunt JA, Pernot DH, Smeets RJ. Disability and quality of life in patients with fibromyalgia. Health Qual Life Outcomes. 2000;6:8. [PMC free article] [PubMed]
5. Mason VL, Mathias B, Skevington SM. Accepting low back pain: Is it related to a good quality of life?Clin J Pain. 2008;24:22–9. [PubMed]

6. da Silva GD, Lorenzi-Filho G, Lage LV. Effects of yoga and the addition of Tui Na in patients with fibromyalgia. J Altern Complement Med. 2007;13:1107–13. [PubMed]
7. Haslock I, Monro R, Nagarathna R, Nagendra HR, Raghuram NV. Measuring the effects of yoga in rheumatoid arthritis. Br J Rheumatol. 1994;33:787–8. [PubMed]
8. Raghavendra R, Nagendra HR, Nagarathna R, Vinay C, Chandrashekara S, Gopinath KS, et al. Influence of yoga on mood states, distress, quality of life and immune outcomes in early stage breast cancer patients undergoing surgery. Int J Yoga. 2008;1:6–6. [PMC free article] [PubMed]

9. Lang E, Liebig K, Kastner S, Neundörfer B, Heuschmann P. Multidisciplinary rehabilitation versus usual care for chronic low back pain in the community: Effects on quality of life. Spine J. 2003;3:270–6. [PubMed]