Yoga as a Physical Therapy for Back Pain

Nichole Smith
Lesley University, Cambridge, Ma

Introduction

Back pain is a very common ailment in today’s society. It is estimated to affect every individual person at least once in their life. It is also found to be “the leading cause of lost man hours in trade and industry,” (Saraswati D. S., 1980) and one of the leading reasons people seek medical attention. Causes of back pain can range greatly, as there is no one particular cause of it. Many causes of back pain are generally related to work, because many jobs in North America require that “we spend our days sitting at desks, staring at computer screens” (Gudmestad, 2011, p. 26). Yoga has been one form of alternative medicine for back pain as a way to fore go drugs which could negatively affect the body in other ways, while relieving the pain. Inadequate flexibility of the back often causes back pain and discomfort, and yoga is one of the best alternatives to “fixing” flexibility problems. Yoga uses poses to stretch the body and increase oxygen to the muscles, which can increase flexibility, which could inevitably relieve one’s back pain.
Back pain has always been a factor in my life. Luckily, I have not been negatively affected enough by it that it has endangered my way of life, but I does make some physical things very uncomfortable or difficult to do. Until this yoga course at Lesley University, I was never part of a regular yoga class. At the beginning of this course I found that I had a lot of back pain at the end of the class, when we were in poses lying flat on the floor, like corpse pose. However, after several classes, I began to feel less and less pain until there was nothing left at all when doing corpse pose, or any other pose requiring me to lay flat on the floor. This posed the question, why does yoga help back pain? Is it the breathing techniques? The poses? A mixture? This is what I strive to answer.

Causes of Back Pain

As back pain affects everyone at one time or another, many question what causes it? The most common answer is their jobs. For many jobs in North America, people are required to sit down for an average of eight hours per day, usually staring at a computer screen. When travelling to get to that job, it is done in cars, trains, buses, even airplanes, where it is required to sit for an extended period of time to get to your destination (Gudmestad, 2011). All of this sitting is hurting a person’s posture, causing slouching and hunched backs, which results in back pain. The Mayo clinic staff defines 3 major categories of back pain: strains, structural problems, and rare but serious conditions. Most often back pain is caused from “strained muscles or ligaments, heavy or improper lifting, or after sudden awkward movement” (Martin, 2010, pp. 3-4). Other than jobs, the general lifestyle of people today is said to cause back pain. Dr. Swami Karmananda Saraswati states that because we live such a “sedentary lifestyle characterized by lack of exercise and overweight, both of which contribute to functional inadequacy of the back muscles,” (Saraswati D. S., 1980, p. 50) we are much more prone to back pain than those living in non-sedentary cultures. Other than jobs, our lifestyle of overeating, and lack of regular exercise, greatly affects our backs carrying around all the unnecessary excess weight. By including a regular yoga class into our schedules, and eating healthier, Dr. Swami Karmananda Saraswati says, we could both loose the excess weight and gain a stronger back which could lead to relieving our back pain.

The Yoga Pain Pill

In our western sedentary society, we are much quicker to take the easy and fast route to solve a problem. When we have a headache, we run and grab the “quick release tablets” of Advil, Tylenol, or whatever type of generic ibuprofen we have in our bathroom. The Mayo clinic lists the most likely types of treatments or drugs to be recommended to you if you visit your doctor for back pain: medications, physical therapy and exercise, injections, and surgery. There is no thought to alternative techniques to help. As for the physical therapies, which could include yoga, they recommend is ice, heat, muscle-relaxers, and electrical stimulation. There is not very much “physical” in the physical therapy option. However, with yoga making such a dramatic entrance into the general public as of late, it may begin to be an option to relieve pain physically. Recently, there have been several studies of how yoga works to relieve back pain, using several different types of yogas and other interventions. One approach mixes both Western and Eastern approaches to help solve back pain. It is pieced together with a wide range of both motion exercises and mental exercises including, “being immersed in physical therapy; wellness, yoga, tai chi, and qi gong classes; psychological and job counseling; art therapy; and peer support, they also learn anger management, assertiveness training, coping strategies, and relaxation techniques” (Kelly, 2011, p. 39). Yoga, however, is one of the key components to the program. Since living in such a sedentary lifestyle, stiff muscles and a small range of motion can amplify pain for some people, so “yoga helps them relax and begin to embrace the notion of moving again after so much physical stagnancy” (Kelly, 2011, p. 43). Many people found that the more physical work they did, the less they needed to rely on medications to help relieve the pain. This made them feel better both physically with less pain and mentally as their system wasn’t being injected with drugs, so their minds were clearer and were not being weighed down from the drugs.
Several Yoga teachers, both Eastern and Western praise yoga for its pain relieving abilities. For every different type of back pain, whether low back pain, middle, high, or neck, there is a different emphasis on exercise for that type of pain. Yoga exercises can be “done to address the structural problems in the joints and the spine as a whole. They can be therapeutic or preventative” (Saraswati S. B., 2000, p. 21). In the same way, there are different sessions of yoga which emphasize more than just posture practice and breathing, they also have “a specific focus: relaxation, strength building, flexibility, and large-muscle movement, asymmetric poses, strengthening the hip muscles, lateral bending, integration, and customizing a personal practice” (Sherman, Cherkin, Erro, Miglioretti, & Deyo, 2005, p. 852). Another group of doctors and scientists founded a study on yoga’s effectiveness in relieving recurrent or chronic low back pain in adults. They claim yoga is more beneficial to people with low back pain because “yoga offers a combination of physical exercise with mental focus, and patients are taught good posture, self-awareness, and self-care along with relaxation” (Tilbrook, et al., 2011, p. 572). After their twelve-week program of regular yoga sessions, versus general medication care, they found that the yoga program “led to greater improvements in back function than did usual care” (Tilbrook, et al., 2011, p. 575) and thus, less pain for the participants with recurrent or chronic pain. After reading through these several studies how is it people are not using yoga more as a pain reliever, and relying more on pills?

Breathe Away the Pain

Along with the physical aspects of yoga, breathing techniques are also very helpful in relieving pain. By concentrating on your breathing patterns, you can relax your body, and relieve the stress your muscles are holding, which is usually causing the pain in your back. By focusing on your breathing, you can connect more to your mental state, which would bring you to “the ‘spiritual stretching,’ breathing, and relaxation regimes in the popular practice of yoga” (Singleton, 2010). By focusing on your breathing, and connecting with your mental state you can release a lot of the stresses you are physically and mentally holding. Krishnamurti talks about the silence of the mind and how by learning to silence the mind, and meditate you can attain freedom from everything which holds too tight and hurts you. By finding this silence, and peace, in the physical aspects of yoga, you will be able to release the anxieties, tensions, and pain you hold in your physical body as well as the mind.
Many people, as a way of coping with recurrent pain “take sleeping pills, always keep the television on, or do other things that help block out their own consciousness” (Kelly, 2011, p. 38). Dealing with continual and recurrent pain is difficult physically and psychologically, and yoga is a great alternative to drugs to help relieve the stresses of both. Whilst doing the physical poses, you are able to reflect on your mind, to acknowledge the thoughts and let them go. It is a great way to both relieve stress, pain and baggage.
Muktibodhananda states in the Hatha Yoga Pradipika, that when breathing during yoga poses the “lungs should expand fully and the stomach should extend outwards” (Muktibodhananada, 1998), this gives the practitioner the full stretch of the pose, both in and out. This allows the stretch to be more effective and allows the stretch to go deeper. “Abdominal breath and full breath activate the abdominals and massage the spine from inside, especially when done lying prone as in advasana, jyestikasana and makarasana” (Saraswati S. B., 2000, p. 20). This also allows the muscles to get increased amounts of oxygen which are beneficial for them, along with getting the stretch to increase strength and flexibility in the muscles. All of these factors together help to relieve the pain and strengthen the muscles as a preventative measure for future back pain.

Why Yoga works

Yoga, is said to be a great physical therapy for back pain for a number of reasons. The primary reasons are the most obvious: the physical ones. In a nutshell, “Yoga loosens muscles that have been tightened by inactivity, stress, and tension. It helps release muscle spasms, corrects postural problems, increases range of motion, and enhances flexibility” (Kelly, 2011, p. 40). By working to do this you will strengthen the muscles of the back, which will help relieve the pain. “If you train yourself to use your lower back skillfully, you'll not only eliminate mid-back pain but also strengthen your lower back” (Cole, 2010, p. 32). Along with the many physical benefits of yoga and its relief of pain, are the psychological benefits. When enduring pain, generally all one hopes to do is sit, or lie down and relax, or sleep away the pain. Thoughts of relieving the pain and getting away from the pain, generally take up most of the time and focus at work. However, with yoga these thoughts can be left behind, just like the pain. Even while at work, by using the yogic breathing techniques and doing some meditation, the pain can be relieved. By doing yogic practices and working to calm the mind, while also calming the body, one can get much further in their yoga practice of relaxation and meditation and relieve the stress and pain.

Conclusion

Yoga holds many aspects as a beneficial physical exercise for the body. However, it is much more than just a physical workout in specific poses. Working with the mind, body, and breath, it can be a great way to relieve back pain, which ails everyone at some time in their lives. Whilst others may not feel the same pain, some having recurrent or even chronic pain, and others only slight pain once and a while, yoga can be a great way to treat and even prevent back pain. By strengthening the mind and muscles, a person could overcome back pain in a very effective way, which helps not just the pain but also the person’s own overall well-being, both physically and mentally.

References

Cole, R. (2010). Easy Seat. Yoga Journal, 32-34.
Gudmestad, J. (2011). Better Posture 101. Yoga Journal, 26-27.
Kelly, A. L. (2011). Team Up To Fight Pain. Yoga Journal, 38-46.
Krishnamurti, J. (1999). This Light in Oneself: True Meditation. Boston: Shambhala Publications Inc.
Martin, D. P. (2010, February 9). Back Pain. Retrieved 2011, from Mayo Clinic: http://www.mayoclinic.com/health/back-pain/DS00171
Muktibodhananada, S. (1998). Hatha Yoga Pradipika. New Delhi: Thomson Press (India) Limited.
Saraswati, D. S. (1980). Yoga and Back Pain. Yoga Magazine, 48-53.
Saraswati, S. B. (2000). Yoga and The Management of Back Pain. Yoga Magazine, 16-22.
Sherman, K. J., Cherkin, D. C., Erro, J., Miglioretti, D. L., & Deyo, R. A. (2005). Comparing Yoga, Exercise, and a Self-Care Book for Chronic Low Back Pain. Annals of Internal Medicine, 849-856.
Singleton, M. (2010). Yoga Body: The Origins of Modern Posture Practice. New York: Oxford University Press.
Tilbrook, H. E., Cox, H., Hewitt, C. E., Kang'ombe, A. R., Chuang, L.-H., Jayakody, S., et al. (2011). Yoga for Chronic Low Back Pain. Annals of Internal Medicine, 569-578.