There are many possible reasons your back is hurting you right now. And there are many possible treatments you might explore to get rid of the pain. In nearly every case, the best solution is non-invasive, involves no medications and costs little or nothing–exercise.
When you are doubled over with pain, it’s hard to contemplate any sort of movement. It’s hard to even get out of bed, but if you can get yourself moving, two particular types of exercise are likely to give you positive results–yoga and stretching.
Pain causes muscles to get tight, and tight muscles cause even more pain in a never-ending cycle. Stretching helps to lengthen and relax tissues that have become contracted as a protective mechanism. With just a little movement, you’ll find yourself able to tolerate more than you thought. Physical activity gets blood flowing, and circulation is necessary for any kind of healing.
Yoga is often recommended; in some cases, even prescribed. And there are good reasons for doing so. Yoga poses are designed to make you more aware of your body and to understand its limitations as well as its potential.
Better Posture, Balance
When yoga is practiced properly on a regular basis, the result is improved posture and balance with head, shoulders, spine and pelvis in proper alignment.
Yoga hardly qualifies as pumping iron, but it is nevertheless an effective way to strengthen muscles, particularly the core body muscles that are essential to a healthy spine. If you’re one of the fortunate 20 percent who have never had back pain, a good yoga class may be your best way of avoiding it.
The yoga practice of holding a position for an extended time is not meant to cause discomfort. But it does require strong concentration and awareness of specific muscles and muscle groups. Well conditioned muscles are the key both to preventing and treating back pain.
The most important physical benefits of yoga, according to most experts, come from the stretching. Holding a gentle pose for 10 to 60 seconds requires flexing one muscle while relaxing its opposing muscle. The goal is balanced muscle tension, relaxation and increased flexibility.
In many cases, tension and tightness, particularly in the hamstring muscles at the back of the thigh, are enough by themselves to bring on pain. But even when the initial pain resulted from severe trauma to the spine or a herniated disc, muscles seize up and contribute to a continuing pain cycle.
Most yoga teachers, of course, will stress the mental, emotional and spiritual benefits. It’s a state of mind that encourages meditation, balance and harmony. Deep, free and rhythmic breathing relaxes the body and encourages circulation, reducing stress and the perception of pain.
Negative emotions and high levels of stress can be either a cause or an effect of chronic pain. In either case, deep breathing, relaxation and stress reduction can go a long way toward reducing the perception of pain.
At least 10 published studies have confirmed the benefits of yoga as effective back pain therapy. The largest to date, a British study published in the Annals of Internal Medicine [November 1, 2011], followed 313 adults with chronic or recurring low back pain for a year. All were given a back pain education booklet and 156 were also offered lyengar yoga classes once weekly for three months.
After three months, subjects taking the yoga classes had better back function and more confidence performing every day activities than subjects in the control group, even though they had no significant reduction of pain. Subjects were not required to continue the yoga classes, but about two thirds did. And improved back function was reported at six months, nine months and a year after the end of the study period.
These results, the authors concluded, suggest “that group yoga may improve back function...more than exercise and manipulation, cognitive behavioral treatment, and 6 sessions of 1-on-1 Alexander technique but not as much as 24 sessions.”
A U.S. study published a week earlier [October 24, 2011] in the Annals of Internal Medicine included 228 mentally healthy adults, most of whom had remained fairly active despite their moderate back pain. One third of the subjects took weekly yoga classes; another third took weekly stretching and strengthening classes; and a control group was given a book on coping with back pain.
At the end of three months, both the yoga and stretching groups showed greater improvement of their back pain. About 40 percent of each group (compared to 20 percent of the control group) were able to reduce their use of pain killing medications.
Considering the mental and spiritual components of yoga, the researchers were surprised that those in the stretching and strengthening group had comparable benefits.
Yoga advocates would be reluctant to concede that it is primarily the physical training of yoga that is beneficial for relieving back pain (as this study seems to suggest). Mental and physical effects are closely linked, they would point out. And, in fact, the stretching classes used in the study were similar to yoga in emphasizing specific poses and routines.
Both the yoga and stretching classes focused specifically on the muscle groups of the back and legs. The viniyoga approach used for the study avoids power moves and adapts the principles of yoga to the physical condition of each patient.
Both stretching and yoga require an active effort on the part of the patient. And this effort pays off by reducing the need for medication or surgery. These studies confirm what doctors already knew: it’s important not to become dependent on pain killers nor to rush too quickly into any invasive treatment.
If the yoga approach seems attractive to you, seek out a class for beginners and a teacher who is well versed in back problems and comfortable making adjustments for patients with chronic pain. Whether it’s stretching or yoga, the key is flexibility combined with relaxation and deep breathing.
It should be noted that about 15 percent of subjects in both the yoga and stretching groups reported a worsening of their back pain. That’s about the same percentage reported for any back pain therapy. Before taking any class, you should seek your doctor’s input regarding your specific diagnosis and moves you should and shouldn’t do.
REFERENCES:
Anne Asher, “Yoga for back pain,” About.com Back and Neck Pain, updated January 27, 2013.
Megan Brooks, “Yoga improves back function in patients with low back pain,” Medscape Medical News, October 31, 2011 (Archives of Internal Medicine 2011;155:569-578).
Megan Brooks, “Yoga, stretching ease chronic low back pain,” Medscape Medical News, October 27, 2011 (Archives of Internal Medicine, October 27, 2011).
Fred Busch, “How yoga helps the back,” spine-health.com.
Kai Engbert, Ph.D., and Michaela Weber, “The effects of therapeutic climbing in patients with chronic low back pain,” Spine, 2011;36(11):842-849.
Deborah Kotz, “Using yoga to relieve low back pain: what to do, what to avoid,” Boston Globe, July 24, 2012.
Amanda MacMillan, “Yoga, stretching may ease chronic back pain,” CNN Health, October 24, 2011.
Jennifer Warner, “Yoga, stretching may ease lower back pain,” WebMD Health News, October 25, 2011.
06/12/2013
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