Author: Katrin Koehler
Ref: Yogacharya Vishwas Mandlik (2008): Yoga Sopan. Nashik: Yoga Chaitanya Prakashan.
Yoga Therapy for Simple Back Pain
Back pain is a very common complaint, especially in Western countries. In the United Kingdom research has shown that between 50 and 60 % of the population suffer from back pain (either acute or more long-term) sometime during their life – men and women equally. Most of the persons affected are over 50 years old. Especially smokers and persons whose profession includes driving and/or lifting heavy items are prone to suffering from backache. The most common backache is pain in the lower back which is very often not related to any specific organic problem such as arthritis, slipped disc, tumor etc. Medical research has shown that only a very small percentage of the known and treated backache cases can be attributed to these causes. Four out of five persons suffering from back pain simply have weak back muscles and/or inflexible muscles and tendons. Particularly in these cases of so called “simple back pain” Yoga practice has proven to be especially helpful and efficient.
Acute back pain is severe pain that appears very suddenly and usually aggravates with every movement up to an extent where the affected person is sometimes not even able to move any more.
Chronic backache is pain experienced less intensively but over a longer period of time, causing daily discomfort in the person affected. This kind of pain is often experienced in the lower back and is often aggravated by physical or emotional stress.
Poor posture is the main cause for backache: most people sit, stand, sleep and bend in an inefficient and unhealthy way because of weakened back muscles. These are weak due to the modern lifestyle which is characterized by lack of exercise and generally a sedentary life. Poor posture itself can cause pain and is often aggravated by wearing improper shoes (e.g. high heels). Furthermore, poor posture makes the back more prone to spraining while performing activities like lifting heavy items, bending or driving. Poor posture leads to the holding of the muscles surrounding and supporting the spinal column in an uncomfortable and rigid way. If this is continued over a longer period of time, pain arises and the muscles will eventually go into a state of tight spasm. When this becomes semi-permanent, hardened bands and nodules will start forming in the tender back muscles. Another major factor in poor posture is weakness of the abdominal muscles. These are essential for maintaining a correct, healthy body posture as they keep all the abdominal organs in place. Weakness of the abdominal muscles causes the organs to fall forward – this creates a pull on the vertebrae. Especially in persons with overweight or digestive problems the back muscles have to compensate the excess pull on the spine and therefore start hurting. Women often lose their muscle tone after pregnancy. In the cases described above, strengthening of the abdominal muscles is required and will in many cases bring complete relief of the pain.
Referred pain: sometimes the actual root of the backache is found in another body part, very often the abdominal or reproductive organs. Particularly constipation and pain from gases can cause a dull backache or aggravate pre-existing pain in the back. In women, backache can also be related to retroverted or prolapsed uterus.
Congestion of the pelvis can appear due to intestinal or other infections. In women back pain sometimes occurs in connection with vaginal infection and bladder infection. Often backache is also related with the menstrual cycle and is experienced some days before menstruation. The reason for this many times is a congestion of the reproductive system. In this case practicing Asanas can relieve the congestion of the reproductive system and, if performed on a regular basis, can balance the hormone levels.
Emotional factors: emotional imbalance often creates tension in the back muscles and always has to be considered in the treatment of backaches.
Although back pain is very common and wide spread, there is no simple effective cure in modern medicine. Very often doctors are not sure how to treat this complaint effectively and so many people suffering from chronic back pain end up adopting a resigned attitude towards their suffering.
Practicing Yoga has proven to be very helpful in curing simple back pain. By strengthening and stretching the body and calming the mind we can address all the common causes of backache mentioned above.
In acute cases of back pain it is initially most essential to rest the body, ideally lying on the stomach in makarasana or advasana on a hard mattress. A gentle massage and alternating hot and cold compresses can bring immediate relief. Yoga Nidra is very helpful in relaxing body and mind in order to facilitate the healing process. Once the acute pain has reduced we can slowly start with a simple and gentle Yoga program.
The practice of Asanas is very important to strengthen, stretch and relax the abdominal and back muscles supporting the spine. This helps in supporting the ligaments and thereby keeps the spinal discs healthy. Stretching removes stiffness from the body, makes the spine becomes more flexible and realigns the vertebrae. As mentioned above strengthening the abdominal muscles is essential for a healthy body posture.
Backward bending Asanas often relieve back pain and congestions of the reproductive system. In these positions the abdominal muscles are stretched and the muscles controlling the spine are strengthened and toned. The nerves that emerge between the vertebrae are decompressed and therefore the practitioner experiences pain relief. Furthermore neuro-muscular imbalances of the vertebral column can be corrected. In general the supply of fresh blood to the back region is increased. Backward bends also restore the hormonal balance - this is important for women suffering from back pain related to their menstrual cycle. On an emotional level, these Asanas are associated with extroversion and the attitude of embracing life.
Spinal twisting Asanas generally make the spine more flexible, stimulate the spinal nerves and strengthen the abdominal muscles. Psychologically, twisting and untwisting the body symbolizes managing the knots and problems we encounter in life.
For the first 10 days it is recommended to practice the Vajrasana Series (Yoga Sopan book), Tadagasana, Pavanmuktasana, Ardha Chakrasana, Anantasana
According to the condition of the patient we can slowly start to practice the following Asanas: Bhujangasana, Shalabhasana, Dhanurasana, Ardhamatsynendrasana, Tadagasana, Kati Chakrasana, Trikonasana, Veerasana,
Optional Asanas are: Vakrasana, Uttanpadasana, Sulabh Ushtrasana, Uhstrasana, Marjarasana – Sankatasana, Chakki Chalanasana
For the lower back muscles the following Asanas are especially important: (Ardha-) Shalabhasana, Ushtrasana, Makrasana, and Bhujangasana
Shoulders and upper back muscles: Dwikonasana, Sarpasana, Bhujangasana, Marjari-asana, Kandharasana
It is most important to teach all the movements very slowly as it is most important to ensure that the patient is aware of his/her body to see which positions feel comfortable and prevent further injury.
Uddyian Bhanda (3 rounds, 30 seconds each) Jalaneti (once a week)
Laghoo Shankhaprakshalana can be helpful if back pain is correlated with digestive problems such as gas or constipation. However, in case of severe back pain this cleansing technique is not recommended as the strong contractions of the abdomen might be harmful.
Anulom Vilom deep breathing for 15 min. (balances sympathetic and parasympathetic nervous system), Sheetali Purak combined with Bhramari Rechak for 21 rounds
Optional practices: right nostril breathing, Bhramari without Kumbhak
Yoga nidra is especially useful for persons suffering from back pain, because meditation in sitting positions is often impossible in these cases. Yoga nidra helps to calm the mind and release emotional tensions which can cause back pain.
Relaxation and Meditation
As mentioned above, sitting in a meditative position might not be possible for many persons suffering from back pain. Therefore relaxation in shavasana or advasana is recommended. Here, different visualization techniques can be helpful e.g. the imaginations of tight, congested back muscles relaxing, letting go of tension and flushing the area with fresh blood. Pranic energy can be visualized flowing into the back muscles in conjunction with the breath.
All forward bending asanas are to be completely avoided until the backache is gone. Persons with excessive lower back curve (lumbar lordosis) should avoid backward bends, but can practice Saral Bhujangasana, Ardha Shalabhasana and Gomukasana. The following Asanas should not be practiced: Sarvangasana, Halasana, Shirshasana and its variations. Furthermore fast breathing, left nostril breathing, Bhastrika Pranayama and any Pranayama with Kumbhak have to be avoided. Vaman dhouti and Shankha Prakshalana should not be practiced as the severe contractions of the abdomen might increase the back pain.
The diet should consist of light vegetarian food. For many persons suffering from backache, overweight is a major factor so the removal of excess weight is desirable. If the backache is related to constipation, it is especially important to eat high quantities of fibers (vegetables, fruits, whole grains).
Excessive sugar, dairy products and milk, excessive oil and salt, meat, spices, processed and preserved foods should be avoided.
As explained above, the modern day inactive lifestyle is found to be the main cause for the great number of persons suffering from backache. Therefore, in preventing back pain, the practice of Yoga and regular exercise are most important. In general adopting a more active and conscious lifestyle will contribute to a healthy posture. (E.g. walking / riding a bike instead of driving a car, taking the stairs instead of the elevator etc.) A balanced, light diet and avoiding smoking and alcohol also play a major role here.
|Omkar Chanting, 11 times, Initial Prayer||2|
|Shavasana, guided relaxation||5|
|All basic movements (Yoga Sopan), performed very slowly, necessary for new Yoga practitioner||15|
|Vajrasana Series (Yoga Sopan)||15|
|Bhujangasana / Ardha Bhujangasana||1|
|Chakki Chalanasana (if not painful)||2|
|Brahmari inhalation & exhalation||5|
|Anulom Vilom, deep breathing||5|
|Ujjayi breathing without Kumbhak||5|
|Prayer & Omkar Chanting||4|
|Jala Neti - once a week|
|Yoga Nidra for stress relief – once a day|
|Listen to Omkar chanting while sleeping – as often as desired|
A study done by Padmini Tekur et al. in 2008 proves and analyzes the positive effects of a short term intensive Yoga program for persons suffering from chronic lower back pain. The research shows that the persons practicing Yoga (asanas, pranayama, meditation etc.) experienced considerably faster healing than patients receiving physiotherapeutic treatment.
“The views expressed above are solely those of the author. Yogapoint.com may or may not agree with all views presented.”
Swami Karmananda (1983): Yogic Management of Common Diseases. Bihar: Yoga Publications Trust.
Swami Satyananda Saraswati (1969): Asana Pranayama Mudra Bandha. Bihar: Yoga Publications Trust
Swami Muktananda (1977): Nawa Yogini Tantra. Yoga for Women. Bihar: Yoga Publications Trust
Tekur, Padmini et al. (2008): effect of Short-Term Intensive Yoga Program on Pain, Functional Disability, and Spinal Flexibility in Chronic Low Back Pain: A Randomized Control Study. In: The Journal of Alternative and Complementary Medicine, Vol. 14, No. 6, pp. 637 - 644
Yogacharya Vishwas Mandlik (2008): Yoga Sopan. Nashik: Yoga Chaitanya Prakashan.
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