Yoga for Back Pain

If you have a back problem, it's best to get an okay from your doctor before trying yoga. Back pain is often the result of a biomechanical imbalance in spinal structures. Your doctor can advise you of:

• Any movements to avoid
• The most productive level of challenge
• Safety modifications
• Effects of interaction between exercise and your medications

Once you have had this conversation with your doctor, tell your yoga teacher about it. A good teacher will be able to respond to your medical limitations with the use of props (special aids) and modifications, allowing your experience with yoga to be safe and beneficial.

Unless you are a professional rehabilitation specialist, it is imperative to find a qualified yoga teacher. Do not try to teach yourself!

Doing yoga cultivates a balance between the flexibility and strength of the muscles of the body, often the real culprit in back pain. Most people are tight in key areas affecting the spine - in the hips and shoulders, for example. A system like yoga, which releases muscle tension, can improve back pain. While the emphasis is on stretching and flexibility, yoga also develops muscle strength.

There are a variety of yoga styles out there, ranging from gentle to vigorous. Also, some styles emphasize spirituality and emotions, while others, most notably hatha yoga, focus more on physical postures. For persons with back pain, a hatha yoga style is a good place to start, particularly classes that emphasize rest and restoration. Styles such as kundalini, ashtanga and bikram are specialized and challenging - not a good choice for back pain sufferers. A good rule of thumb: Gentle is better.

As a whole-body system, yoga develops body awareness and places emphasis on alignment. This means that the proper location of each body part (feet, knees, hips, spine, shoulder, head) affects all the others. Like Pilates, yoga emphasizes core work, although yoga has less abdominal strength development.

You may be wondering, "Will I be able to do yoga without creating more pain?" Most yoga classes utilize props. Props help bring the pose to you, when tight or weak muscles cannot fully bring you into the pose.

Yoga incorporates breathing techniques that can lead to stress relief and help you get through the challenge of the stretch. Often, yoga classes have a spiritual basis, offering techniques and the environment in which to work on deeper levels of healing and pain resolution.

Talking to your prospective yoga teacher can help you determine which class is right for you. Probe to find out how skilled the teacher is with back and neck pain, and learn how challenging the class is.

Some yoga teachers are big on manual adjustments, including stretching. In most cases, adjustments are helpful, but you may need to forgo them to avoid aggravating your pain. Discuss this with the yoga teacher before the class starts, to avoid an unwanted surprise.

Many yoga studios offer special focus classes, for example:

• Prenatal yoga
• Yoga for multiple sclerosis
• Yoga for athletes

Find out if there are any classes geared toward students with back pain. You may be in luck.

By its very nature, yoga is well suited to address back problems arising from postural alignment conditions.

Examples of conditions particularly suitable for yoga include (but are not limited to):

• Kyphosis
• Scoliosis
• Lordosis

With modifications and a gentle, prudent approach, beginner yoga can benefit those with other conditions as well, for example (but not limited to):

• Stenosis
• Problems with the intervertebral disk
• Nerve root issues

Yoga for Back Pain Research Studies

In the fall of 2011, two studies helped our understanding of the way yoga might be used for back pain relief. In Britain, a three-year study involving 313 participants and multiple instructors delivered a standardized program for chronic back pain sufferers. The yoga participants scored much better than the control group in all areas (pain, pain self-efficacy) except general health.

The other study, from the United States, compared yoga to an equivalent amount of stretching. This was a "comparative effectiveness study," and it found that for people who have mild to moderate back pain without sciatica, stretching did just as well as yoga. The study showed overall how valuable movement is in the healing process, said Debbie Turczan, M.S.P.T., a therapeutic yoga teacher and a clinical specialist in physical therapy, New York-Presbyterian/Weill Cornell Medical Center, New York City.

"Yoga teaches us to respect where our bodies are, rather than comparing our current abilities to what we used to be able to do or what someone else can do," she said.

Yoga for back pain can be quite a winner, but you must respect the limits placed on you by your pain. This necessarily involves "listening" to your body, a skill you will undoubtedly cultivate as a student of this ancient system.

Is Your Back Ready for Yoga?

Take the Yoga for Back Pain Quiz to find out if you are mentally and physically ready for a yoga practice that addresses back pain.

_Sources:

_{K.J. Sherman, D.C. Cherkin, J. Erro, D.L. Miglioretti, and R.A. Deyo. Comparison of Yoga, Exercise, and Education for the Treatment of Chronic Low Back Pain. Annals of Internal Medicine Vol 143 Issue 12 pp1-18. Dec 20 2005. http://www.annals.org/cgi/content/full/143/12/I-18}

_{Sherman KJ, Cherkin DC, Wellman RD, Cook AJ, Hawkes RJ, Delaney K, Deyo RA. A Randomized Trial Comparing Yoga, Stretching, and a Self-care Book for Chronic Low Back Pain. Arch Intern Med. 2011 Oct 24. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed?term=Sherman%20KJ%2C%20Cherkin%20DC%2C%20Wellman%20RD%2C%20et%20al.%20A%20randomized%20trial%20comparing%20yoga%2C}

_{Tilbrook HE, Cox H, Hewitt CE, Kang'ombe AR, Chuang LH, Jayakody S, Aplin JD, Semlyen A, Trewhela A, Watt I, Torgerson DJ . Yoga for chronic low back pain: a randomized trial. Ann Intern Med. 2011 Nov 1;155(9):569-78. http://www.ncbi.nlm.nih.gov/pubmed/22041945}

_{Email Interview. Debbie Turczan, M.S.P.T., clinical specialist in physical therapy, New York-Presbyterian/Weill Cornell Medical Center, New York City. November 2011.}