Yoga for Back Pain - Things to Know Before Starting

A woman completes a cycle of the yoga sun salutation.
One full cycle of the yoga sun salutation.. Kais Tolmats/E+/Getty Images

Yoga and the Problem Back

If you have a back problem, it's best to get an okay from your doctor or physical therapist before trying yoga. Ask your health provider about:

  • Movements you should avoid
  • The most productive level of challenge for you
  • Safety modifications to try
  • Effects of interaction between exercise and your medications.

What a Good Yoga Teacher Can Do

Once you have had this conversation with your health provider, talk to your yoga teacher, too.

A good instructor will be able to respond to your medical limitations with the use of props (special aids) and modifications.

As you talk to her, try to determine her credentials, as well as her level of experience with students who have neck or back pain.  You might also inquire about which classes are right for you in her opinion.  And if you have a particular class in mind, find out how challenging it will be.  Getting the answers to these questions will probably help you make an informed decision about how to start doing yoga for your pain.

Another thing to ask about is the prospective teacher's policy and style when it comes to manual adjustments.  Some instructors are big on these.  While adjustments can be helpful in certain situations, if you come to the session with a back injury or other condition, you may need to ask the teacher to refrain, in order to avoid aggravating your pain.

By the way, it's a good idea to discuss these issues with the yoga teacher before the class starts, to avoid an unwanted surprise.

And finally, unless you are a professional rehabilitation specialist yourself, it is imperative to find a qualified yoga instructor. Do not try to teach yourself!

Balance Is Key

Doing yoga cultivates a balance between the flexibility and strength of the muscles of the body, often the real culprit in pain, movement limitation, and disability.

A meta-analysis published in the September-October 2013 issue of Pain Research Management found that yoga may help decrease functional disability in the short term, and because of this may make a good adjunct treatment for chronic low back pain.

Yoga incorporates breathing techniques that may help relieve stress as well as help you get through the challenge of the stretch. Plus, the spiritual emphasis in certain types of yoga classes may provide an opportunity to work more deeply on healing and pain resolution.

Types of Yoga Suitable for Back Pain Sufferers

There are a variety of yoga styles out there, whose work intensity demands range from gentle to vigorous. Some emphasize spirituality and emotions, while others, most notably hatha yoga, focus more on physical postures. A hatha yoga style will likely be a good place to start, particularly when rest and restoration (called "R and R") is emphasized.

Styles such as Kundalini, Ashtanga and Bikram are specialized and challenging, and probably not a good fit for people with spine problems.

 

Many yoga studios offer special focus classes, for example:

Alignment and Body Awareness - The Hallmarks of Hatha Yoga

As a holistic system, yoga develops your body awareness and places emphasis on alignment. In yoga, the proper location of each body part (feet, knees, hips, spine, shoulder, head) affects all the others.

Like Pilates, yoga can involve core work, although a yoga session will probably afford you fewer opportunities to develop abdominal strength than Pilates.

Don't Try - Modify! An Introduction to Props

You may be wondering if you'll be able to do yoga without creating more pain.

As mentioned above, most yoga classes utilize props. Props help bring the pose to you, when tight or weak muscles cannot fully bring you into the pose.  This is one big way people with injuries or orthopedic medical conditions can make the practice of yoga a meaningful one.

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 program to people with chronic back pain. With the exception of general health, the yoga participants faired much better than the control group in all areas (pain, pain self-efficacy.) 

The other study, which was done in the United States, compared yoga to an equivalent amount of stretching. The researchers found that for people who have mild to moderate back pain without sciatica, stretching did just as well as yoga.

This second study showed overall how valuable movement is in the healing process, said Debbie Turczan, M.S.P.T.  Turczan is a therapeutic yoga teacher and a physical therapist in 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.

Is Your Back Ready for Yoga?

Yoga helps many people who deal with back pain, and it may help you.  The key, though, is to 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.

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:

Holtzman, S., PhD, Beggs, T., MA. Yoga for chronic low back pain: A meta-analysis of randomized controlled trials. Pain Res Manag. Sept-Oct. 2013 Accessed: Feb 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805350/

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.

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