You may feel like the last thing you would want to do when you have back pain of any kind is so Yoga. This may be the case if you have never done Yoga before or are new to it. I am going to break down the ins and outs of Yoga for Back Pain in this article, providing you with a clearer picture and a better understanding, as well as lifestyle tips that will help mitigate back pain and inflammation from pestering you to begin with!
Lower Back Pain
Lower back pain (LBP) is a chronic issue and the most common and costliest medical problem in the world today. Most of the causes of LBP are categorized as “Non-specific” meaning that there is no definite cause; only in a limited number of cases is the root cause known. Distinguishing between chronic and acute lower back pain is that acute LBP often lasts for no more than three (3) months and disappears often without treatment. However, if acute LBP is persistent in its recurrence an evaluation of lifestyle and state of mind are essential as an acute issue can become something greater with time.
There are several hypotheses for the causes of LBP in people, one being genetic adjustments to the spine to accompany a more erect spine over time. Another that the human spine is not properly adapted to the modern environment. The later may be more possible to our society, as it has also been theorized that LBP will continue to increase as our society becomes more sedentary in its behaviour.
Hip musculature, which is seen in far more women than in men, is a contributing factor to lower back pain. In a 2000 study published in The Clinical Journal of Sports Medicine and a 2002 study from the Medicine and Science in Sports and Exercise, male and female athletes were observed for the strength of their hip muscles in relation to lower back pain. Female athletes were almost twice as likely to suffer from lower back pain in comparison to male athletes. When core strengthening programs were implemented to aid in the elimination of LBP, no significant advantages were seen, and in women, it was seen to cause a greater negative effect. Although it is very important to strengthen the core, it is also imperative to bring flexibility and motion back into the hips.
A study from 2010 published in the Journal of Sports Sciences compared male golfers with back pain to those without to see what the major difference or restriction was. Many golfers are affected by lower back pain as a result of musculoskeletal disorder, which is often a result of an injury. Golfers who experience lower back pain would flex their spines and use more of their left side when back swinging; they had less motility, less flexibility and placed a great deal of pressure on their spines, which over time brought them more pain. Golfers with no back pain had twice as much rotation in their hips, more trunk flexibility and more core strengthening during their swings, they placed far less attention on spinal flexibility.
From these study’s and countless others like them, although core flexibility is important, motility and flexibility of the hips cannot be ignored, especially when dealing with individuals with lower back pain. This is where the beauty of yoga comes in because it can address all three areas, core strengthening and hip flexibility and motility as well as so much more.
Contributing factors for LBP
- Less activity
- atypical spinal loading/lifting
- sleeping on a soft mattress
- sitting for long periods of time
- sitting in a chair that does not properly support the spine
- pregnancy (later stages)
- Chronic Fatigue Syndrome
- Breast Implant Disease
- Chronic Lyme Disease
- Gulf War Illness
- Prolonged corticosteroid use
Psychological Issues can also contribute to LBP, in fact, it has become an increasing causal factor of lower back pain. Possible psychological contributing factors include…
- work unhappiness
- dissatisfaction with life
- high stress
- poor mental health
Dysfunctional Movement Patterns
Dysfunctional Movement Patterns (DMP) as a result of repetitive motion or a constant restrictive posture can also result in lower back pain. Placing a great deal of strain on your muscles where it is to perform a motion or to be very still can cause the muscles to fatigue, bring about body aches, nerves to die and other tissues in the body to suffer as a result. Musicians, factory workers, artists, chefs may all experience this. To help prevent DMP or reverse its progress, yoga can be very beneficial. By incorporating yoga positions into your daily routine, flexing and stretching your body can help in improving muscle motility and prevent pain. It is also important to bring awareness to the body so that you can catch DMP before it progresses to far (nerve damage).
Sometimes you may experience pain on only one side of the lower back, either the right or the left. This can be the result of an injury to the corresponding side of the upper or lower body, as well as dysfunction of internal organs.
Lower Left Back Pain
- Damage to soft tissue that su[pports the spine
- Issues with the pelvic region, kidneys (kidney stones or an infection), intestinal issues
- Issues with reproductive organs such as; gynecological disorders, fibroids, endometriosis
- Ulcerative colitis
Lower Right Back Pain
- Injury to the tissues surrounding and/or supporting the spine
- Spinal structure
- Cauda Equina Syndrome
- Kidney and Liver Issues
- Ulcerative Colitis
- Gallbladder Inflammation
As with any imbalance in the body, there is always an underlying cause or causes that need to be addressed. It can be hard to pinpoint exactly what the issue might be, therefore bringing in positive change into your life, through exercise such as yoga, healthy eating and a positive mindset healing can begin to take place.
The great thing about yoga is that it requires no cost, though I would recommend that you take classes at the beginning especially if you are new to the practice. Classes will provide you with an opportunity to learn the proper form of the positions, they are also fantastic because you can ask the yoga teacher to focus on a specific area of the body during the practice, such as your lower back. I’ve done this before, and though you may not feel a great difference after one class after three or five the pain should have drastically minimized. Yoga classes are also a great place to ask the teacher for advice on what movements or positions would be best for your lower back pain.
There are several things that need to be remembered if one is suffering from Lower Back Pain.
- Stay active and/or increase activity – not moving may have put your back into a funk, so make sure you are on your feet, going on walks (deep breathing), practising yoga or tai chi.
- Get enough sleep! If you can make sure your mattress is firm and instead of sleeping on a mountain of pillows sleep on one or none at all
- Watch what you eat! Certain foods can be very inflammatory, making your diet more alkaline and inflammation mitigating will aid in reducing pain and discomfort
- Reduce stress. Practise meditation, deep breathing and practise changing your state of mind towards issues, people and things that may cause you stress.
- Medication can be helpful, however, it will not keep one from a risk of hurting ones back as it will simply mask the body’s warning signs of pain. Remember – pain is an important feeling as it can aid in the prevention of injury
Yoga and the Unity of Body and Mind
Yoga means yoke (a link being joined together) or unity of the body and mind. Although it is a practice that is associated with Hinduism, it can be practised by anyone of any faith or no faith at all. One of the most important aspects of yoga is the promotion of proper posture. In today’s modern world we are often found very stagnant, often sitting and more often than not slouching in our seats, necks cracked looking down at desks, keyboards, screens, etc. The practice of yoga brings about proper alignment, aiding in the increase of motility.
I myself sit for most of the day, I do my best to take an hour out of my day to go for a walk, stretch my legs and body, but sometimes there isn’t time. However, even when running short on time I do find a moment here or there to stretch, and going to a yoga class three times a week has made such a difference in how I feel from day to day. Before, when I sent most of my day on my feet, my back would also be negatively affected and strained, going for massages, though wonderful became costly, and sometimes there would be the long wait before I would be able to come in for an appointment as my massage therapist was too busy.
Yoga once you have become familiar with it, can be done at any time anywhere. All the equipment you truly need is your own body and mind. It is a time for quite a meditation, for bringing awareness to the self and the present moment. It builds strength and flexibility as well as channelling healing throughout the body.
It is the intention of yoga to bring peace to the chaos of conflicting feelings, passions and thoughts. yoga is also a beneficial practice for the improvement in the function and balance of the circulatory, respiratory, digestive and hormonal systems of the body. It also assists the individual in bringing an awareness of the self, providing emotional stability as well as an openness of the mind.
Parts of Yoga Practice
There are three parts to the practice of Yoga …
- Asana – a Sanskrit word that means ‘pose’ or ‘posture’. It is the practice of the physical posture, though also utilizing full awareness of the body inside and out and making sure that both sides of the body are perfectly aligned and in balance – so as to not pose any stress on the body’s organs, muscles and bones. They aid in cleansing the body, by increasing circulation so as to remove toxins and nourish the cells of the body.
- Pranayama – the yoga breathing exercise. Prana means ‘energy’ and Ayama means ‘storing’. It is not deep breathing, it is gentle controlled breathing that focuses on each individual movement of the body during the process of inhalation and exhalation. It aids in linking the postures of Asana with the breath, by this connecting the mind and allowing it to focus better.
- Meditation – Bringing relaxation through silent thought. There is more than a single way to meditate, so you can find one that will work for you. It is a journey that takes an individual from where they are at present to where they wish to be and towards what they wish to accomplish through the use of mindfulness, compassion and peace.
Different styles of yoga
There are also several different Styles of Yoga and though yoga has been shown to be very effective in the management and elimination of back pain, not all styles of yoga are suited for individuals who are experiencing LBP.
- Iyengar Yoga – Uses Hatha yoga techniques and focuses on the precision of movement, posture and position as well as controlled breathing. It is a very safe and beneficial exercise for individuals with lower back pain.
- Viniyoga – Therapeutic style of Hatha yoga. effective and safe treatment for individuals with LBP and CLBP.
- Ashtanga Yoga – Power Yoga. There are three disciplines to this style of yoga; ethical practises and principles, self-restraint, mental detachment. It is vigorous aerobically and not the best style for lower back pain unless the individual is already experienced in the yoga.
- Bikram Yoga – Hot yoga which utilizes Hatha yoga techniques and practised in a room that is heated between 35–42°C (95–108°F) and holds humidity at approximately 40%. The intense heat, unless one is experienced, is not the most comfortable for individuals with lower back pain.
Yoga has been around for over 2000 years and over that time has not only been beneficial for healing and nurturing the mind and soul but also the body. There are numerous positions that are beneficial for preventing and aiding to heal lower back pain. The philosophy of yoga is also beneficial for aiding the individual in stress management and prevention as well as allowing the individual to move forward and feel more fulfilled and happy with life. Stress and unhappiness are a major contributing factor to lower back pain and should not be overlooked.
Science has also taken a look at yoga and the results are very positive for lower back pain. Yoga has been shown through several different studies to aid patients across the board. There were some instances where individuals decided to no longer continue with weekly yoga routine however they were few and far between. For individuals who live very stagnant lives yoga may seem a bit overwhelming, however, it does not need to be forced and can be slowly moved into at a pace that is most comfortable for the client.
Scientific journals have also shown that the practice of yoga aids in a change of the perception of pain. This result in pain becoming less bothersome, less common in their day to day activity as well as less intense. Individuals in the studies also found that through the practice of yoga their daily lives became more manageable and they were better able to listen to their bodies.The practice of Iyengar yoga, had very confident pain relieving statistics. 64% of individuals in a study looking into the benefits of Iyengar yoga had their pain intensity decreased, 77% found that their functional disability had been reduced and 88% were able to reduce pain medication intake or stop taking it all together.
Six Yoga Positions to Aid Lower Back Pain
There are many different positions that can be done to aid lower back pain, below I will go over six basic poses.
One Legged King Pigeon or Eka Pada Rajakapotasana
This pose is a back bender and a hip opener. It begins on all fours, with the knees positioned under the hips and the hands below the shoulders. Move by bringing the right knee towards the back of one’s right wrist and moving the right foot to rest above the left knee on the floor. Slowly move the left leg out and back so that from the thigh ot the foot it is resting on the floor, it should extend straight from the hip and not be angled. Allow the right ankle or foot to rest comfortably in front of the left hip. Allow your arms to rest beside you and hold the pose which practicing your breathing.
Repeat this for the left leg as well. Keep in this pose for up to a minute.
Extended Child’s Pose or Utthita Balasana
This is a restorative yoga pose. It calms the nervous system and aids in reducing both stress and fatigue. This position aids in lengthening the spine, making it wonderful at relieving tension in the spine as well as hips and knees.
The Extended Child’s Pose begins with the individual kneeling on the floor. Bring the big toes together and position oneself to sit on one’s heels. Allow oneself, when comfortable to separate the knees from each other – thus widening the hips. With controlled breathing, exhale and proceed to lower the torso to lay between the thighs – move one’s body as close to the ground as comfortable. Lengthen the body out from the pelvis, shoulders and neck – stretch the whole body forward. Gently lay one’s hands on the floor in front of the body stretching forward.
Hold this position for between 30 seconds to a few minutes.
Cow or Bitilasana
This position is both a back bender and a chest opener. Begin on hands and knees, with a straight back, this will be the neutral position, with the knees below the hips and shoulders, elbows and wrists all aligned. Let the eyes rest on the floor below and the head is relaxed.
Inhaling, gently bend the back outwards allowing the stomach to move closer to the floor. Lift the head to look forward.
Exhaling, gently reposition the body back into the neutral position.
Practise this between 10-20 times.
Seated Forward Bend or Paschimottanasana
This is a seated forward bending position, which helps with stretching out the vertebral column as well as the shoulders and hamstrings. Begin this position by sitting on the floor with the legs straight out in front, heels together.
Inhale, extend the torso forward at the hips, lengthening away from the pelvis towards the feet. If they can be reached grab the sides of one’s feet with the hands, otherwise grab the legs at the furthest possible reach trying to move closer to the feet with each new stretch. If one can move down further – though this need not be rushed – allow the lower abdomen to descend to the thighs, proceeded by the upper abdomen, ribs and finally the head.
Using controlled breathing allow each new inhalation to stretch the body further forward while with each exhalation allow the body to relax slightly.
Stay in this pose for between 1-3 minutes.
Downward-Facing Dog or Adhomukha svanasana
Is a Inversion yoga pose and benefits the body by calming the mind and gently stimulating the nervous system, reducing stiffness and slowing down the heartbeat.
Begin this pose with hands and knees on the ground, allowing the knees to be below the hips and the hands to rest slightly in front of the shoulders with the hands stretched out form the palms. Exhaling, gently begin to move the knees off the floor. Push the thighs and knees back till they are straight and push the heels into the floor, while keeping them parallel. Do this in a slow rolling motion upwards. Keep the arms straight and strong in front and the head held firmly between the arms. Do not forget to control one’s breathing.
Keep the position for between 1 to 3 minutes.
Upward-Facing Dog or Urdhvamukha Shavasana
This back benign pose aids in strengthening the vertebral column as well as stretching out the lower back and trunk of the body, opening up the lung cavity. Begin this pose by lying face down on the floor, stretching out the legs parallelly. Have one’s hands by the chest with the elbows bent in towards the body and the hands spread out wide at the palms. Inhaling press up with the hands, slowly straightening the arms and lifting the torso up so as to bring the body into a right angle. Keep the legs firm and push upwards from the hips. Make the shoulders firm against the back and open the chest forward. Control breathing gently.
Keep this pose for between 15-30 seconds.
Other poses that may benefit the lower back …
- Torso stretch or Bharadvajasana
- Reclining hero stretch or Supta Virasana
- Plow Pose or Halasana
- Triangle Pose or Trikonasana
What Else Can One Do To Reduce Lower Back Pain?
There are many lifestyles and dietary changes that one can do to positively influence and impact one’s life and aid in pain reduction or its occurrence in the first place. Below are a few articles that will help get you on the right path!!
Beverages to Alkalinize the Body
Reishi Hot Chocolate – Also aids in calming the body and nervous system
Superfoods that Reduce Inflammation and aid in Balancing Mood
Bussing, A., Ostermann, T., Ludtke, R., & Michalsen, A. (2012). Effects of Yoga Interventions on Pain and Pain-Associated Disability : A Meta Analysis. The Journal of Pain. Vol 13 (1) pages 1-9. Online Available at PubMed.
Castillo, E. R., & Lieberman, D. E. (2015, January 10). Lower back pain. Available online from https://academic.oup.com/emph/article/2015/1/2/1795271/Lower-back-pain
Dechanet, J.M. (1980). Yoga in Ten Lessons. The Harmony of mind & body through exercise. New York: Cornerstone Library.
Delitto, A., George, S. Z., Dillen, L. V., Whitman, J. M., Sowa, G., Shekelle, P., . . . Godges, J. J. (2012). low back pain.Journal of Orthopaedic & Sports Physical Therapy,42(4).
Ehrlich, G.E. (2003). Low Back Pain. Bulletin of the World Health Organization. 81 (9), page 671-676.
Fisherman, L., & Ardman, C. (2012). Yoga for Back Pain. W.W. Norton and Company: New York.
Iyengar, B.K.S. (2006). Iyengar Yoga for beginners. An introduction to the classic poses. London: Dorling Kindersley Limited.
Lindsay, D., & Horton, J. (2010). Comparison of Spine Motion in Elite Golders with and without low back pain. Journal of Sports Sciences. Volume 20, Issue 8, Pages 599-605.
Msot, C.W. (2007). Muscular Retraining for Pain-free Living. Trumpeter: Boston.
Nadler, S.F., Malanga, G.A., DePrince, M. Stitik, T.P., Feinberg, J.H. (2000). The Relationship Between Lower Extremity Injury, Low Back Pain and Hip Muscle Strength in Male and Female Collegiate Athletes. Clinical Journal of Sports Medicine. Volume 10, Issue 2, Pages 89-97.
Nadler, S.F., Malanga, G.A., Bartoli, L.A., Feinberg, J.H., Prybicien, M., DePrince, M. (2002). Hip Muscle Imbalance and Low Back Pain in Athletes: Influence of Core Strengthening. Medicine and Science in Sports and Exercise. Page 9-16.
Nespor, K. (1991). Pain Management and Yoga. International Management of Psychosomatics. Vol 38. (1-4) page 76-81.
Patrick, N., Emanski, E., & Knaub, M.A. (2014). Acute and Chronic low back pain. Med Clin N AM. 98, pages 777-789
Sawyer, A. M. (2012). Impact of Yoga on Low Back Pain and Function: A Systematic Review and Meta-Analysis.Journal of Yoga & Physical Therapy,02(04)
Sherman, K. J. (2011). A Randomized Trial Comparing Yoga, Stretching, and a Self-care Book for Chronic Low Back Pain.Archives of Internal Medicine,171(22), 2019. Online Available at PubMed.
Sorosky, S., Stilp, S., & Akuthota, V. (2007). Yoga and pilates in the management of low back pain.Current Reviews in Musculoskeletal Medicine,1(1), 39-47. Online Available at PubMed.
Tekur, P., Singphow, C., Nagendra, H. R., & Raghuram, N. (2008). Effect of Short-Term Intensive Yoga Program on Pain, Functional Disability and Spinal Flexibility in Chronic Low Back Pain: A Randomized Control Study.The Journal of Alternative and Complementary Medicine,14(6), 637-644. Online Available at PubMed.
Torgerson, D. (2012). A pilot randomised controlled trial of yoga for chronic low back pain.Http://isrctn.org/>.
Tul, Y., Unruh, A., & Dick, B. (2010). Yoga for Chronic Pain Management: A Qualitative Exploration. Scand J Caring Sci, Vol 25, Issue 3, pages 435-443. Online Available at PubMed.
Williams, K., Abildso, C., Steinberg, L., Doyle, E., Epstein, B., Smith, D., . . . Cooper, L. (2009). Evaluation of the Effectiveness and Efficacy of Iyengar Yoga Therapy on Chronic Low Back Pain.Spine,34(19), 2066-2076. Online Available at PubMed.
Williams, K. A., Petronis, J., Smith, D., Goodrich, D., Wu, J., Ravi, N., . . . Steinberg, L. (2005). Effect of Iyengar yoga therapy for chronic low back pain.Pain,115(1), 107-117. Online Available at PubMed.
Wren, A. A., Wright, M. A., Carson, J. W., & Keefe, F. J. (2011). Yoga for persistent pain: New findings and directions for an ancient practice.Pain,152(3), 477-480. Online Available at PubMed.
Wollaars, M. M., Post, M. W., Asbeck, F. W., & Brand, N. (2007). Spinal Cord Injury Pain: The Influence of Psychologic Factors and Impact on Quality of Life.The Clinical Journal of Pain,23(5), 383-391. Online Available at PubMed.