Yoga for Back Pain Relief
Your spine is a complex structure of bones, joints, ligaments, discs and muscles, all of which can become irritated by improper posture (slumping at your desk for 8 hours?), imbalanced muscular strength, tight tissues and unsuspecting daily activities (all I did was tie my shoes!). And because of this complexity, it’s easy to get hurt. In fact, the National Institute of Neurological Disorders and Stroke estimate that 80% of Americans will experience low back pain at some point in their adult lives.
When it comes to treatment, there’s no one-stop shop; but increasingly, doctors, physical therapists and healthcare professionals are recommending yoga as initial treatment for back pain. In fact, in 2017 the American College of Physicians endorsed a new guideline outlining initial treatment for low back pain which includes exercise, mindfulness based stress reduction approaches and yoga over pharmacological interventions. Which means you can alleviate and even prevent back pain symptoms from the comfort of your own yoga mat; healing may be in your hands.
Why Yoga?
Yoga uses a double hitter approach to alleviate back pain: Breathing practices calm the nervous system and soothe your brain’s perception of pain; gentle stretches increase blood flow and hydration to injured tissues and strengthening poses help weak postural muscles do their job well again. “Yoga is a gentle way to explore different postures that help ease back pain. Simply moving your back in all different directions can help release tension and rebuild the protective muscles [around the spine] ” explains Erica Yeary, Yoga Medicine Therapeutic Specialist and Exercise Physiologist in Indianapolis, Indiana. “Furthermore, the benefits of yoga go beyond the muscles to address the emotional aspect of pain. The connection to breath, slow movements, and gaining body awareness help alleviate stress related to back pain.”
2 Types of Back Pain
Some cases of back pain are caused by an irritated spinal nerve; easily identified as sharp, shooting, tingling and periodic pain. Think: a herniated or hemorrhaging disc that’s zinging on a nerve. This acute pain should be treated by a your doctor or a neurologist and rest is important; however, gentle stretching targeting the surrounding tissues can definitely help alleviate overall pain and strengthen key muscles that contributed to the injury in the first place, explains Lisa Muehlenbein, Yoga Teacher and Health Coach in Spartanburg, South Carolina. She suggests restorative yoga, which focuses on lowering the body’s stress response through breathing and gentle movement. “I also suggest finding a teacher who understands anatomy and dysfunction, how to address these concerns and [how to] work alongside medical professionals as part of an overall health and wellness team,” she says. SHOULD WE PUT IN A RESTORATIVE YOGA Posture and a BREATHING EXERcISE? I gave one example below.
The second type of back pain is soft tissue-related which is noticeable as dull, achy and constant discomfort. Think: sore low back after a day of skiing. According to Yeary, what’s helpful here is a combination of stretching and strengthening the back that addresses postural issues, which are usually an underlying cause of pain. “Yoga's focus is not only on stretching, but also on putting the body in challenging positions that require the muscles to work and support the skeletal system. This combination helps re-balance the structure of the [soft tissues] reduce muscular tension, build flexibility and strength, improve balance, and increase mobility.”
Your Spine—In Curves Your spine doesn’t run straight up and down, like a stick. It consists of three main curved areas that provide for movement and help protect your organs.
Cervical Spine: The uppermost part of your spine is comprised of 7 cervical vertebra in your neck. This part of your spine is very mobile–it flexes, extends, turns, and bends—to see the world around you. As a result, the muscles and ligaments can become overworked and imbalanced. Chronic neck pain is often associated with “forward head carriage” (hello, text neck!) which can refer down to your shoulders and upper back. We also carry an immense amount of emotional stress and tension in our necks, which means breathing practices that relax your entire body can be really helpful in treating neck pain.
Thoracic Spine: Consisting of 12 vertebrae and a concave shape, your mid back is the least mobile part of your spine because it forms the foundation for your ribcage, which supports and protects vital organs. The biggest issue here is immobility: improper postural habits, sports-related injuries and repeated over-use with improper biomechanics all affect the thoracic spine and the muscles attached to your ribcage. Because of this, mid-back discomfort is intimately related to weak upper back muscles, tightness in the chest and shoulders, and immobility in your side body (think: lats and obliques.)
Lumbar Spine: With 5 large vertebrae, the lower back carries the weight of the body. There’s quite a bit of mobility here—twisting, bending, flexing, extending and twisting—but if there’s a problem in an area of the spine above it, it can stress the lumbar spine.“Muscles such as the erectors, psoas, quadratus lumborum, and the transverse abdominis all work together as pillars of support for the spine and are strengthened through yoga,” Yeary explains.
Stretches:
Thread the Needle (Optimizes shoulder mobility, reduces tightness between the shoulder blades and opens up the side body to reduce discomfort in the thoracic spine and upper body.) [do you want these little explanations included? I was just including the key muscle target areas for your info … to make sure it made sense you can delete them.]
Start in child’s pose with your knees wide and hips on heels.
Walk your hands over to the left side of your mat.
Thread your left arm under your right and look to your left hand, crossing one shoulder under the other.
Take 10 inhales and exhales to expand the side ribs
Repeat on the second side.
Kneeling Hip Flexor Stretch (Stretches and strengthens your iliopsoas group, which gets tight when you sit all day and can contribute to back pain by pulling your lumbar spine into incorrect alignment.)
From hands and knees, step your Right foot forward. Align knee over ankle.
Inhale: Bring your body upright and reach your left arm over head. Place your right hand on your front thigh.. Exhale, bend your left elbow and drop your hand behind your head.
Gently lean forward a few inches, until you feel a stretch in the front of your left hip crease and left side body.
Take 10 inhales and exhales.
Repeat on second side.
( we could always move this to the strengthening section… and up-level to crescent or something? Adding the arm makes it potent and it’s highly recommended by professional athletes?)
Reclined IT Band Twist with Strap (Tight hips play a huge role in lower back pain-- it’s all connected! Stretching your IT Band, compressing tissues across the back of your sacrum and gentle twisting in the low back can significantly increase mobility and decrease tightness.)
Lay down and place a yoga strap around the toe mound of your right foot. Hold both ends of the strap in your left hand.
Keeping a slight bend in the right knee, bring the right leg across your body to align the knee with your navel (right foot in line with your left shoulder).
Inhale: Point your toe. Exhale: Flex your foot. Repeat this action 10 times; then pause and hold for 10-15 inhales and exhales.
Then, let the Right leg fall all the way over to your left in a big twist. Stay for 10-15 inhales and exhales.
Repeat with the left leg.
Strengtheners:
Bird dog (Supports your spine by strengthening supporting tissues that hug the spine, supports proper posture by increasing 360 core strength.)
Start on hands and knees.
Inhale, extend your left leg back and press the toe into the ground. Actively support your spine with your belly, drawing navel upward and pointing tailbone down toward heel. Imagine a belt gently hugging in around your core.
Aim to keep a flat low back (not hollow and concave) as you lift the left foot off the floor 3 inches.
Reach your right arm forward by your ear, palm facing in.
On your inhale: reach a little further. On your exhale: mindfully tap left leg down. Inhale reach, and exhale tap down. Repeat 10 times and then switch to your second side.
Extended Triangle with Cactus Arm (Strengthens side body, obliques, and upper back. Also stretches lower back and chest.)
Step your feet as wide as your wingspan and point your right foot forward. Turn your left foot in 45 degrees for Triangle Pose.
Reach your arms out and lean forward. Place your right hand on your shin and your reach your left arm straight up.
Inhale: right your left arm over head for extended triangle and look forward.
Exhale: pull your left arm back and bend your elbow like the shape of a cactus arm. Look down to your right toe.
Repeat this pattern 10 times and then switch to your second side.
Don’t forget: Sensation is good, but pain isn’t. Muehlenbein the analogy of a stoplight with her clients. If you’re feeling stretching or strengthening but not pain, you are at a “green light,” and it’s ok to go further. If you feel some discomfort, that’s a sign to pause and re-evaluate your effort, like a “yellow light.” If you feel pain, especially sharp, shooting or burning, that’s a “red light” which definitely means back off. She suggests finding that “sweet spot” in the middle where you feel sensation in the targeted area, but not pain.
And of course, breathe. Yoga Therapists recommend a yogic breathing exercise, called “3 Part Breathing.
Breathing Exercise: 3 Part Breathing
· Three part breathing or “Complete Breath” helps tissues heal by releasing excess physical tension and reducing pain by calming brain pain receptors. Lay down on a blanket or pillow to prop up your back so you can access your diaphragm more easily. Visualize your breath being directed into 3 parts of your torso: your belly, chest and shoulders. In your inhale, consciously fill your body from bottom to top: belly, chest and shoulders. On your exhale, consciously empty your body from top to bottom, like you are pouring out a pitcher, completely releasing your attachment to pain and tension. Take 10 rounds total and end with this meditation intention: “I am open to full and complete healing. My tissues are safe and so am I.”
Visualize discomfort leaving your body with every exhale, stretch and strengthen with mindful awareness a few times a week, and these head-to -toe therapeutic yoga poses may keep your back healthy for the next few decades.
Lisa Ash Drackert is an educator and yoga studio owner and Yoga Medicine Yoga Therapeutic Specialist based in Kansas City, Missouri.
Seated Twist with Neck Stretch
From seated, bend your right knee and point it forward (bring your right heel toward your left hip.) Bend you left knee and place your left foot on the floor in front of your right knee.
Wrap your right arm around your left knee in a gentle twist. Set your left fingertips behind you.
Inhale: Drop your right ear to your right shoulder and press your left thumb into the floor. Exhale: Drop your left ear to your left shoulder.
Continue alternating the movement of the neck (yoga therapists call it “nerve flossing”) and then take a few shoulder rolls.
Hold the gentle twist for 10 inhales and exhales. Switch sides.