Yoga For Back Pain

Back pain is a problem that may afflict anyone at any age, causing significant disability. It affects eight out of ten people at some point in their lives and can range from minor pain to acute, stabbing pain. Acute back pain strikes quickly and lasts for a few days to a few weeks while chronic back pain lasts for longer than three months (1). Back pain is also one of the most common reasons people seek emergency treatment. Both adult and pediatric populations have a wide range of possible etiologies (2).

Lower Back Pain

Low back pain (LBP) is among the most common musculoskeletal problems in modern society, leading to substantial healthcare costs (3) (4). LBP is pain that occurs between the 12th rib and the inferior gluteal folds, with or without leg pain, and is nonspecific in 90 percent of cases (5, 6).

Chronic low back pain is caused by long periods of sitting and poor posture. Many authors defined back pain as lumbar, sacral, or lumbosacral spinal pain that is continuous or essentially continuous but low level, punctuated by exacerbations of pain, each of which is classified as “acute” (4). LBP has a complicated etiology that is still unknown. Physical and (partially) psychosocial occupational factors, on the other hand, appear to play a significant role in the etiology of the disease (7).

Upper Back Pain

The upper back, in comparison to the lower back (lumbar spine), is exceptionally resistant to injury and pain. Upper back pain is usually caused by long-term bad posture or an injury that surpasses the thoracic spine’s sturdiness (8).

Relation between Yoga and Back Pain – How Yoga can help with Backpain

Chronic low back pain is associated with other issues such as anxiety, depression, and disability, as well as a lower quality of life.

Patients suffering from LBP are restricted in their daily activities and may experience inappropriate neuromuscular adaptations in order to maintain and/or preserve functions such as walking, running, or other activities (11).

Yoga may be precisely what the doctor prescribed if you’re suffering from back pain. Yoga is a mind-body therapy that is often recommended for the treatment of back pain and the stress that it causes. The right poses can help you relax while also strengthening your body (9, 10).

Even a few minutes of yoga practice per day can help you become more aware of your body. This will help you notice where you’re tense and where you’re out of balance. You can use this awareness to re-establish balance and alignment in your life (9).

Yoga may lower LBP, but the mechanisms by which this is accomplished are unknown. They include an increase in tissue flexibility and oxidation, as well as a relaxation effect and the release of enkephalins or endorphins in the lower back.

A few researchers have examined the mechanisms that yoga may use to help people with back pain.  Sherman et al. searched into serotonin, cortisol, dehydroepiandrosterone (DHEA), and brain-derived neurotrophic factor (BDNF) as possible mediators. Self-efficacy and hours of back exercise were the most important factors in the effect of yoga. Back pain was also influenced by poor sleep quality (12, 13, 14).

Yoga Poses, Breathing Exercises for Backpain

Yoga is an eight-limbed practice that involves physical and mental training in the pursuit of self-realization. Personal discipline, postures/poses (“asanas”), breathing, concentration, contemplation, meditation, and absorption/stillness are all accompanied by the eight components. Yoga poses are one of eight components of a broader discipline of physical, mental, and spiritual health, according to traditional definitions.

Hatha Yoga & Iyengar Yoga

BKS Iyengar, the inventor of Iyengar yoga, is the most well-known Hatha Yoga practitioner.

Hatha Yoga

Postural alignment, breathing, concentration, and meditation are all common elements of modern Hatha yoga. Hatha Yoga is the most traditional type of yoga, involving asanas, pranayama, and meditation (which includes kriyas, mudras, and bandhas) which continually promote positive self-esteem (12).

Iyengar Yoga

B. K. S. Iyengar is the originator and name of Iyengar Yoga. B. K. S. Iyengar improved on the Hatha yoga style by introducing additional props to assist people in achieving difficult postures with assistance. Props such as belts, blocks, and blankets are frequently used as aids in performing the asanas in this style. Beginning students, the elderly, and those with physical limitations can safely perform the asanas with the help of the props, reducing the risk of injury or strain (12, 15).

Iyengar Yoga can assist to relieve lower back pain in a number of ways. Iyengar yoga is ideal for people suffering from acute back pain, but it is not intended to be a substitute for medical treatment. When you sit on the floor and straighten your legs to the front (dandasana), tight hamstrings might pull the rear of the pelvis downwards, limiting the lumbar spine’s curvature (16).

Yoga Poses For Backpain

Upward Forward Fold Pose (Ardha Uttanasana Yoga)

The upward forward bend, also known as a forward fold, stretches the hamstrings and back muscles while releasing tight, tense shoulders.

How to Practice

1. Standing straight with your feet shoulder-width apart and your knees loose, not locked, is a good place to start.
2. Exhale and bend forward, reaching toward the floor, hinged at the waist.
3. Don’t worry if you can’t reach the floor all the way; simply stop where your hamstrings feel a comfortable stretch.
4. Five to seven times, repeat the pose. Hold the position for 5 to 10 breaths on the last bend.

Downward-Facing Dog (Adho Mukha Svanasana)

Downward-Facing Dog is a position in which you are facing downwards. Back extensors are the large muscles that help form your lower back, support your spine, and help you stand and lift objects. This Pose strengthens and tones the arms and legs, opens and strengthens the shoulders in flexion, lengthens the hamstrings, stretches the calves, and prepares the body for heating.

How to Practice

1. Begin by getting down on your hands and knees, slightly in front of your shoulders.
2. Raise your knees away from the floor and lift your tailbone toward the ceiling by pressing back.
3. For an extra hamstring stretch, gently press your heels against the floor.
4. Repeat the pose five to seven times and holding the position for 5 to 10 breaths each time.

Triangle Pose (Utthita Trikonasana)

Triangle pose can help lengthen your muscles along the sides of your chest area while stretching the muscle fibers along your outer hip while strengthening your back and legs.

How to Practice

1. Begin by standing up straight and touching your toes.
2. After that, start to move three to four feet back and point your left foot out at a 45-degree angle.
3. Open up the pose by stretching your right arm toward the ground and your left arm toward the ceiling while keeping both your right and left legs straight.
4. Don’t overstretch if you can’t touch the ground with your right arm at first; only bend as far as you can while keeping your back straight.
5. Switch to the other side and repeat as needed after holding the position for 5 to 10 breaths.

Child’s Pose (Balasana)

Child’s pose may also seem to be a rest, but it is an active stretch that helps elongate the back. It’s also a great way to unwind before going to bed after a long, exhausting day.

How To Practice

1. Start on all fours with your arms straight out in front of you, then sit back until your glutes (butt muscles) are just above — but not touching — your heels.
2. For a good, soothing stretch, hold the position for 5 to 10 breaths and repeat as needed.

Pigeon Pose (Eka Pada Rajakapotasana)

Pigeon pose stretches hip rotators and flexors, but it can be difficult for beginners. Tight hips can contribute to lower back pain, which may not seem like the most obvious position to treat.

How To Practice

1. With your feet together, begin in Downward-Facing Dog.
2. Then, with your left knee drawn forward and turned out to the left, lower both legs to the ground, bent and nearly perpendicular to your right leg.
3. You can simply extend your back right leg straight behind you, or seasoned Pigeon posers can carefully pull your back foot off the ground and toward your back for an added hamstring stretch.
4. Hold the position for 5 to 10 breaths and repeat as per needed.

Cat-Cow Stretch (Chakravakasana) 

Cow and Cat stretches loosen your back muscles and are ideal for an achy, sore back, whether as part of a yoga routine or as a warm-up for another workout.

How To Practice

1. Begin in all-fours position by slowly pressing your spine up and arching your back into Cat pose.
2. Move to Cow by scooping your spine in, pressing your shoulder blades back, and lifting your head for a few seconds.
3. Moving from Cat to Cow assists in bringing your spine into a neutral position, which soothes and relieves tension in your muscles.
4. Repeat 10 times, smoothly switching from Cat to Cow and back to Cat.
5. As needed, repeat the sequence.

Upward Facing Dog Stretches (Urdhva Mukha Svanasana)

This pose opens the chest, stretches the abdominal muscles, and engages the back.

How To Practice

1. Begin by lying flat on your back with your palms facing down by your ribs.
2. Lift your chest off the floor with the strength of your back, not your hands, while drawing your legs together and pressing the tops of your feet into the floor.
3. At first, keep your legs straight out in front of you.
4. Repeat as needed, holding the position for 5 to 10 breaths.

Boat Pose (Navkasana)

Navkasana (boat) helps with spinal alignment, abdominal and spine strengthening, and stress relief.

How to Practice

1. Lie flat on your back with your arms by your sides on the mat.
2. Inhale and slowly raise your upper body and both legs off the ground. Your sacral spine (butt) should be the only part of your body that touches the ground.
3. Hold the pose for as long as you can, then exhale and return to savasana position.

Locust Pose

Locust Pose improves flexibility and reduces back pain while also strengthening the core and energising the body.

How To Practice

1. Place your palms on the ground and lie down on your stomach.
2. Join the two feet together. Raise the bottom part of your waist slowly while maintaining your legs straight.
3. Hold this posture for a while.
4. Place both hands behind your tummy and elevate your feet as high as you can.
5. The front of the waist should be able to touch the ground.

Cobra pose

The cobra pose is beneficial for stretching shoulder and chest muscles, reducing lower back stiffness, making the spine more flexible, and making the chest and head more active.

How To Practice

1. Lie down on your stomach to do this asana.
2. Keep your hands close to your shoulders and elevate your chest to the point where your arms are straight. Do this while extending your legs.
3. Bring your toes in and slowly lower your head behind you.
4. Slowly return to your starting position and repeat 3-5 times.

Wind-Relieving Pose (Pavanamuktasana)

Pawanmuktasana (Wind-Relieving Pose) helps to stimulate intestinal function. It improves the liver’s performance. It also strengthens the spine, particularly the lumbar area, when combined with its counter posture Setubandhasana.

How To Practice

1. Lie on your back on the yoga mat. Keep your arms by your side and your feet together.
2. Inhale first, then exhale while bringing both knees to your chest.
3. Your thighs should be pressed towards your torso, and your hands should be clasped around your legs.
4. Take a few deep breaths in and out of this position. Tighten the grip when breathing and relax it while inhaling.

Conclusion

Previous back pain episodes, high physical demands of work, low job satisfaction, age, back weakness, and smoking are all risk factors for low back pain. Treatment and disability seeking for chronic low back pain is more influenced by psychosocial factors than by individual clinical characteristics or workplace physical demands.

Yoga appears to be just as effective as other non-pharmacologic treatments at reducing back pain’s functional disability. Yoga proved to be a useful and safe way to treat chronic low back pain.

References and Further Reading

1. https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906?p=1
2. Freburger, J. K., Holmes, G. M., Agans, R. P., Jackman, A. M., Darter, J. D., Wallace, A. S., … & Carey, T. S. (2009). The rising prevalence of chronic low back pain. Archives of internal medicine, 169(3), 251-258.
3. Furlan, A. D., Clarke, J., Esmail, R., Sinclair, S., Irvin, E., & Bombardier, C. (2001). A critical review of reviews on the treatment of chronic low back pain. Spine, 26(7), E155-E162.
4. Pradhan, B. B. (2008). Evidence-informed management of chronic low back pain with watchful waiting. The Spine Journal, 8(1), 253-257.
5. https://www.spine-health.com/conditions/spine-anatomy/lumbar-spine-anatomy-and-pain
6. Furlan, A. D., Brosseau, L., Imamura, M., & Irvin, E. (2002). Massage for low-back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine, 27(17), 1896-1910.
7. Seidler A, Liebers F, Latza U (2008) Prevention of low back pain at work. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 51(3):322–333
8. https://www.spine-health.com/video/spine-anatomy-overview-video  
9. 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: a randomized, controlled trial. Annals of internal medicine, 143(12), 849-856.
10. Posadzki, P., & Ernst, E. (2011). Yoga for low back pain: a systematic review of randomized clinical trials. Clinical rheumatology, 30(9), 1257-1262.
11. Hammill, R. R., Beazell, J. R., & Hart, J. M. (2008). Neuromuscular consequences of low back pain and core dysfunction. Clinics in sports medicine, 27(3), 449-462.
12. Chang, D. G., Holt, J. A., Sklar, M., & Groessl, E. J. (2016). Yoga as a treatment for chronic low back pain: A systematic review of the literature. Journal of orthopedics & rheumatology, 3(1), 1.
13. Sherman KJ, Wellman RD, Cook AJ, Cherkin DC, Ceballos RM. Mediators of yoga and stretching for chronic low back pain. Evid Based Complement Alternat Med. 2013;2013:130818.
14. Lee M, Moon W, Kim J. Effect of yoga on pain, brain-derived neurotrophic factor, and serotonin in premenopausal women with chronic low back pain. Evid Based Complement Alternat Med. 2014;2014:203173.
15. 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(1-2), 107-117.
16. Crow, E. M., Jeannot, E., & Trewhela, A. (2015). Effectiveness of Iyengar yoga in treating spinal (back and neck) pain: a systematic review. International Journal of Yoga, 8(1), 3.

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