Therapeutic Yoga for Back Pain by Cody Drasser
Back pain is one of humanity's most frequent complaints. Back pain can originate from the muscles, nerves, bones, joints and can feel like a dull ache or a sharp, piercing or burning sensation. Experts estimate that as many as 80% of the population will experience a back problem at some time in our lives. In the United States, acute low back pain (also called lumbago) is the fifth most common reason for physician visits. One of the most common reasons for missed work, back pain costs us at least $50 billion each year. Personal Struggles
I’ve experienced back pain in one form or another for many years, beginning when I was a teenager. But the major blow came when I was in a car accident at age 27, which resulted in significant injuries that still persist in one way or another today: a herniated disc, severe whiplash and concussion as well as a broken left foot and torn right ACL, which caused me to walk with a limp for many months, favoring one leg and foot over the other. I lived with the imbalances and pain caused by this accident for many years, enduring the pain because I didn’t know what to do about it.
I now have a strong sense from my experience, research and dialogue with people with back pain that many simply endure the pain for lack of real knowledge as to what can be done about it. How many suffer in silence without knowing that even the simplest stretches and Yoga postures can offer respite?
From my personal experience, I can’t recommend a better prescription for the relief of back pain than Yoga. Done safely and properly, Yoga works all areas of the physical body ad can get the spine back to working order.
Yoga postures isolate specific muscle groups and the six movements of the spine: Flexion, Extension, and Lateral Movements on both sides and Twists on both sides. These movements create (or at least move towards) optimal health of the spine by stretching the spinal muscles and adjoining muscle groups.
Physical State Reflects the Mental State
The physical practice of Yoga postures is much deeper than just moving the body. The physical body mirrors the mind. Therefore, by affecting the physical state in beneficial ways – with movement and breathing practices – we can begin to self-soothe not just physical blockages but mental, emotional and energetic blockages.
I’ve often felt at times of mental stress and contraction that my body will feel similarly stressed and tight. Manic thoughts or confusion in the mind often lead to an imbalance in the physical body. Tense muscles, joint inflammation and general stiffness and achiness are often signs of something similar happening within the mind.
How we uniquely practice our own Yoga is dependent on how deeply connected we are to our bodies. Knowing what type of practice would benefit you the most is not always an easy track to navigate. Focusing on the back, if you feel quite a bit of tenderness or tightness in any area of the spine, begin the practice slowly to safely open up the affected area.
As the breath deepens and leads you into a deeper state of connection with various sensations in the spine, you will be able to more accurately guide yourself into a posture flow that works to heal and nourish the spine, rather than one that depletes and causes further injury. What we practice on one day might be more slow-moving and gentle while another practice another day would be more active and flowing, as the spine allows. A combination of the two is usually what works best in terms of stretching the affected area (gentle practice) and then challenging the area to build strength (active flow). Understand that a posture that worked one day may need to be practiced differently (or not at all) the next practice.
Using Breath to Relax the Body
"Life is in the breath. He who half breathes half lives." - Chinese proverb
The quality of breathing in any Yoga practice cannot be overstated. Inhalation allows you to take in the life-enriching oxygen the body needs to sustain life and health. Exhalation allows you to rid the body of carbon dioxide and prepare for the next full, deep inhalation. Symbolically, with each breath in comes the possibility of deepening into the moment and the posture. Likewise, with each breath out comes the possibility of shedding old layers and opening up to something new, with each moment of the posture being different than the last.
By consciously altering the breath, you begin to positively affect the nervous system and influence the types of thoughts in the mind and how the body carries itself. Many people go about their days with very little thought or care as to how the breath is supporting the body. When it comes to healing the body, releasing stress and healing injury (back pain, in this case) there couldn’t be a better remedy than consciously directing and controlling the breath.
These two breathing techniques described below can relieve pain and heal the back while bringing balance to the nervous system. They can take place in almost any posture or situation and are a terrific way to self-soothe.
Start by sitting down (or lying on the spine if more comfortable and necessary, given your pain level) and taking a few deep breaths. I like the ‘Cleansing Breath’ technique myself: Simply inhale deeply through the nostrils and then exhale through the open mouth with a sigh. This breath can transition you from whatever tasks you were engaged in beforehand and allow a deeper movement into stillness and the present moment.
After a few Cleansing Breaths, begin the transition into Victorious Breath, which you should work to comfortably sustain during practice. You might also find it meaningful to bring the hands together in front of the heart or some other position to signify openness and acceptance. Perhaps allow the chin to slightly drop in honor of the practice you are about to begin and say a silent prayer of gratitude and thankfulness for spine and all that it can and cannot do. Whatever way you begin your practice, do it in a way that holds meaning for you.
Poses to Alleviate Back Pain
The poses listed below will generally work all areas of the back but the therapeutic focus has been directed to a specific area. The breath is crucial to connecting to the body and listening to the messages it is sending, so use the breath to enter into the pose. Explore if staying in a milder version is right for you or if going deeper will allow you to open further. Once the proper pose is discovered, take anywhere from 5 to 10 full cycles of breath (a cycle is one inhalation and one exhalation), depending on the intensity of the pose or the opening desired. Never stay in a pose that creates an immediate sense of discomfort.
While it may seem redundant to speak about not wanting to further injure yourself while practicing Yoga, I believe it bears repeating. Essentially, I’d like to dispel the myth that one should endure pain in Yoga in order to achieve the perfect posture. The old adage ‘no pain, no gain’ bears no meaning to healing back pain through Yoga.
Suggested Poses for the Cervical Spine
Neck Rolls/Ear-to-Shoulder Stretch
Simple movements of the cervical spine while the body remains in a neutral, cross-legged seated pose such as Easy Pose. Keep the entire spine erect and draw one ear gently to the shoulder. Don’t strain the neck down to the shoulder and don’t lift the shoulder up to the ear, as this will only increase tension in the neck and shoulder. For additional stretch, bring your hand to the side of the face for gentle intensification of the stretch.
Slow and gentle movements that flex (round) and extend (lengthen) the entire spine from a hands and knees position, this pose can be modified and accessed by just about any practitioner. Practice on the fists or forearms if the wrists are sensitive. Place a blanket under the knees for cushioning if there is sensitivity or discomfort. Inhale into spinal flexion (Cat – spine arched upwards like an angry Halloween cat) and exhale into spinal extension (Cow – spine bowed in the opposite direction, yet with some engagement, not hanging like a hammock).s
Suggested Poses for the Thoracic Spine
This is a very popular Yoga pose where the focus is primarily in the lengthening of the entire spine. It can be particularly useful for practitioners experiencing mid-back pain as well as low-back pain because it creates the potential for opening and release in these areas. It strengthens the arms and neck while it engages the abdominal muscles and lengthens the muscles of the back of the leg. Palms can be placed on blocks or a blanket can be placed underneath heels for reduction in hamstring or calf sensitivity if the stretch is too intense at first. Down Dog can also be done with forearms on the floor in the presence of wrist/palm sensitivity.
Lateral stretch for the spine that can be performed in table-top position (hands and knees) by pressing side ribs towards one side while looking over opposite shoulder.
Suggested Poses for the Lumbar Spine
This is a supine pose in which the spine is brought into extension by pressing into the feet to lift the hips towards the ceiling. Bridge strengthens and stretches the back as well as the front of the body. Lifting into and lowering out of the pose can create a sense of ease and safety in the body before sustaining the pose for a longer period of time. This is important especially in the case of extreme sensitivity in the low back. If extreme discomfort is felt in any part of the back, slowly release out of the pose and rest.
Legs Up The Wall
This pose can be done in place of Restorative/Supported Half Shoulder Stand. A lightly rolled towel or blanket can be placed beneath the neck if the stretch in the cervical spinal muscles is too great. Of course, if any sort of persistent discomfort is felt, slowly come out of the pose by lowering the knees into the chest and rolling off to one side.
Strengthening the Abdominal Muscles
Supportive abdominal muscles play an important role in increasing awareness of how to engage your body to stand upright properly – a major factor in spinal health – and general maintain a healthy back. The following poses may aid the development and training of strong and supportive abdominal muscles:
Intense standing pose – hence the name ‘Fierce’ – that engages abdominal, leg and spinal muscles. Bending the knees in a standing position, you lower the hips and upper body down, as if sitting back into an imaginary chair. This pose asks quite a great deal from the legs and feet in order to remain firmly connected to the floor. Abdominal muscles and spine must be engaged as well as to keep the torso from slouching or drooping forward. The arms can be in any number of positions here – raised above shoulders, hands on hips, hands in prayer, etc. You may want to leave the hands on the hips to focus more intently on abdominal and spinal muscle engagement. A block can be placed in between the thighs to bring awareness about hugging the inner legs towards one another to keep the knees and femur bones in alignment with the hip points.
This balancing posture is done on the buttocks/’sitz’ bones (ischial tuberosities). The abdominal and spinal muscles must work together to keep the torso aloft and balanced. The Iliopsoas muscles are worked – those muscles that draw the legs closer towards the torso and abdomen. With all of these muscles engaged, attempt to bring your body into a ‘V’ shape. You can access the posture more easily at first by bringing the hands to catch behind the kneed for support in both upper and lower body and then gradually work to release the hands from this position and extend them upwards (reminiscent of Chair) while keeping the upper and lower body as engaged as before, attempting to lift the legs and the torso upwards and closer towards one another. A strap can be looped around the soles of the feet and grasped with the hands if the abdominals are weak or if there is tightness in the hamstring muscles.
Preventative Back Care
In addition to the specific poses listed above, the following poses can be added as regular maintenance for spinal health.
Named after a famous sage believed to have contributed hymns to the Vedas, this seated pose twists and opens the entire spine and can be easily modified in the presence of certain ailments of the spine. The posture is also believed to massage the internal organs. You can come into the twist from a seated pose simply by bending the knees and placing the feet on the floor. From there, drop the knees and thighs over towards the right as you also move the torso and heart in that direction. The most common leg placement is for the inner left shin and calf to rest within the inner edge of the right foot. As the legs move into this position, allow the torso to follow, twisting from the low spine, through the mid spine and shoulder and finally turning the neck and head to gaze over the right shoulder. You can access the pose more easily by placing a folded blanket underneath the buttocks; this will allow ease in keeping the entire back lengthened, instead of slouching and diminishing the elongation you are looking for. Also consider placing your hands on two blocks instead of straining to reach the floor, which can also diminish the length in the spine.
Camel is a back extension pose that strengthens the muscles of the back and legs while stretching the entire front of the body. One of the reasons that I love this pose so much and recommend it to those suffering from most sorts of back pain is that the pose can be accessed in a variety of different ways. It is mostly a strengthening pose for the back with the front of the body being the area stretched and opened, stimulating the vagus nerve. Essentially, there’s no one right way to go about it and is a great pose to use as a gauge in terms of how open or tight/sensitive your back might be feeling. Place a blanket underneath the standing knees. Blocks can be brought alongside the feet and heels if connecting the hands and feet are not possible. Keep hands on hips in the presence of extreme low back pain, extending back only slightly. Posture is to be avoided if pain is present, regardless of modification. The stretch can be accessed in a much easier and safer way by sitting on a chair and reaching the hands behind you onto the seat and extending the back and lifting the chest while keeping the chin softly tucked into the throat.
Closing the Practice and Reintegration
Upon the completion of your Yoga practice, always allow some space for relaxation (Savasana or Corpse Pose) for complete integration of the physical postures and the opening and healing that they’ve hopefully brought about, as well as any energetic shifts that might have occurred before reintegration and emergence back into daily tasks. Even a brief Yoga practice can sometimes greatly alter the energy and mental state and it is important to realize that one should never go directly from a practice back into regular duties and demands without first creating a transition. Relax for at least five minutes and then close the practice in some way that is meaningful to you. Chanting, meditation, bringing the hands together in prayer position at the heart or silently thanking your body and your spine for all that it can do for you are effective ways to close the practice and allow a safe transition back into your daily life.
Exploring the Right Postures
The more you experiment with postures and breathing techniques and their effects on your spine, the more adept you will become in targeting specific back pain using Yoga and the breath, and the more you will be able to heal yourself from whatever condition you may be faced with. You may be living with back pain for a number of reasons, but it does not have to be a cage that locks you up and restricts you from feeling healthy and vital in all that you do (and wish to do in the future). Right now, today, you can take your back health into your own hands! Use Yoga alone or in conjunction with other healing modalities, such as massage and other movement-based activities, that will bring breath, stretch and strengthening to the spine in order to free you from restriction.