Cost-effectiveness of yoga for managing musculoskeletal conditions in the workplace

Occup Med (Lond). 2017 Dec 30;67(9):687-695. doi: 10.1093/occmed/kqx161.


Background: Back pain and musculoskeletal conditions negatively affect the health-related quality of life (HRQL) of employees and generate substantial costs to employers.

Aims: To assess the cost-effectiveness of yoga for managing musculoskeletal conditions.

Methods: A randomized controlled trial evaluated an 8-week yoga programme, with a 6-month follow-up, for National Health Service (NHS) employees. Effectiveness in managing musculoskeletal conditions was assessed using repeated-measures generalized linear modelling for the Roland-Morris Disability Questionnaire (RDQ) and the Keele STarT Back Screening Tool. Cost-effectiveness was determined using area-under-the-curve linear regression for assessing HRQL from healthcare and societal perspectives. The incremental cost per quality-adjusted life year (QALY) was also calculated. Sickness absence was measured using electronic staff records at 6 months.

Results: There were 151 participants. At 6 months, mean differences between groups favouring yoga were observed for RDQ [-0.63 (95% CI, -1.78, 0.48)], Keele STarT [-0.28 (95% CI, -0.97, 0.07)] and HRQL (0.016 QALY gain). From a healthcare perspective, yoga yielded an incremental cost-effectiveness ratio of £2103 per QALY. Given a willingness to pay for an additional QALY of £20 000, the probability of yoga being cost-effective was 95%. From a societal perspective, yoga was the dominant treatment compared with usual care. At 6 months, electronic staff records showed that yoga participants missed a total of 2 working days due to musculoskeletal conditions compared with 43 days for usual care participants.

Conclusions: Yoga for NHS employees may enhance HRQL, reduce disability associated with back pain, lower sickness absence due to musculoskeletal conditions and is likely to be cost-effective.

Keywords: Back pain; cost-effectiveness; musculoskeletal conditions; occupational health; physical activity; randomized controlled trial; return-on-investment; sickness absence; workplace; yoga.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cost-Benefit Analysis / standards*
  • Cost-Benefit Analysis / statistics & numerical data
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Musculoskeletal Diseases / psychology
  • Musculoskeletal Diseases / therapy*
  • Psychometrics / instrumentation
  • Psychometrics / methods
  • Quality-Adjusted Life Years
  • State Medicine / organization & administration
  • Surveys and Questionnaires
  • Workplace / psychology
  • Workplace / standards
  • Yoga / psychology*