Yoga for Lower Back Pain

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Yoga helps alleviating lower back pain. Yoga for back pain works organically and holistically; without taking the aid of medication and invasive interventions. More than 70% of all the physiotherapy exercises prescribed for lower and complete back, are yoga asana and its variations.

Amongst all the back pains, lower back pain is the commonest type of pain. 85% of people have had a lower back pain, one time or the other.

Lower back pain (LBP) is a common disorder involving muscles and bones of the low back (starts below the rib cage). Low back pain causes more disability than any other condition worldwide and accounts for almost 50% of all work related disability.

Classification of lower back pain:

LBP can be classified by duration as-

Acute (< 6 weeks)
Subacute (6-12 weeks)
Chronic (>12 weeks)

Causes of lower back pain

Malignancy
Infections – Abscess, Osteomyelitis
Inflammatory – Ankylosis spondylitis, psoriatic arthritis, reactive arthritis
Musculoskeletal – Mechanical (muscle spasm, muscle strain, spondylitis), herniated disc, spinal canal stenosis and fracture

Red flags…

The indications of impending back pain problem are following-

Leg weakness
Fever with chills
Continuous abdominal pain
Weight loss that is unexplained
Pain with coughing/ sneezing/ urinating
Sudden loss of bowel and bladder control
You should immediately seek a doctor if you have pain with following symptoms:

Symptoms of lower back pain

	Possible cause	Pain type	Radiation	Aggravating factors	Relieving factors
1	Muscle Strain	Dull and achy	Around groin, buttock and upper thigh	Movement of injured area	Rest, Medication
2	Disc Herniation	Severe burning, tingling	Travels to Buttock, leg and foot	Prolonged standing, sitting	Walking
3	Degenerative Disc Disease	Nagging to severe	–	Prolonged sitting	Walking, Changing position
4	Spondylolisthesis	Muscle spasm, numbness &tingling	Buttocks, back of thigh	Bending backwards	Sitting
5	SI Joint Disease	Nagging to severe	Low back, hip, groin, thigh	Prolonged sitting	Lying, Reclining
6	Facet Joint Arthritis	Pain + stiffness	–	Extended activity	Rest
7	Lumbar Spinal Stenosis	Mild to severe	Leg pain with walking	walking	Sitting
8	Spinal Compression Fracture	Sudden onset, sharp	–	Standing, walking	Lying

Who is at the risk of low back pain?

Overweight individuals
Persons with sedentary lifestyle
Jobs requiring heavy weight lifting

Treatment for lower back pain

Treatment of low back pain depends on cause, history, type and severity of pain. Main aims of treatment are:

To reduce inflammation
To improve flexibility of spine
To correct postural alignment
To relieve pain and stiffness associated with pain
To improve strength of lumbar spine musculature

Yoga Asanas or Poses for back pain

Yoga asana for lower back pain can be both preventive and curative. If low back pain is caused by structural defect then it is always better to consult a doctor before you go further with asana.

1. Yoga poses for lower back relaxation

Many times Lower Back Pain is caused by tension in muscles which can be relieved by:

Advasana
Shavasana
Makarasana

2. Yoga poses for strengthening low back musculature

Marjariasana
Bhujangasana
Shashakasana
Ardha-matsyendrasana
After these backward bending asanas can be done
Chakrasana
Dhanurasana
Ushtranasana
Ardha chakrasana

3. Yoga poses to reduce sciatica pain

It is advisable to start the session with supine lying with your calves resting on the seat of chair. Take a few deep breaths, go slow with all asanas, do the poses for 5-10 breaths on each side and end the session by resting your caves on chair. Few of the yoga asana to reduce sciatica pain are:

Apanasana (Knee to chest pose)
Sucirandhrasana (Eye of the needle pose)
Sputa padangusthasana (Reclining hand to big toe pose)
Eka pada rajakapotasana (One legged king pigeon pose)

4. Yoga poses for muscle strain

Acute muscle strain – Yoga is not recommended
Chronic pain- Move into yoga poses gently, use long hold times in poses, perform deep breathing in poses and end with shavasana with bolster under knees and folded blanket under low back to support. Spinal lengthening, forward folding and back bending poses are recommended

5. Yoga poses to relieve compression in low back

It is done by lengthening of back extensor muscles. Iyyengar yoga is noteworthy because it relies on external support through the use of props which enables the students to rest the injured area and achieve correct postural alignment. Therein teachers assist transit from passive/ supported poses to active poses without support. Iyyengar yoga specialist recommends following sequence to relieve compression in low back:

Dandasana
Shavasana II
Janu-shirshasana
Urdhva-dandasana
Pashcimottanasana
Adho-mukha-virasana
Sputa-pavanamuktasana
Pavanmuktasana on the bench
Supported garbha-pindasana (with ropes)
Ardha-uttanasana over halasana box and stool
Adho-mukha-shavasana (With upper wall ropes for traction)

6. Yoga for Lumber Disc Herniation or Slip Disc

There are three levels for the treatment of lumbar disc herniation. Start with level 1 and slowly progress to level 3. You should move from 1^st level to 2^nd only if you are comfortable doing this.

Level 1

Aadvasana
Shavasana
Makarasan (Crocodile pose)
Jyestikasana (Superior pose)

Level 2

Marjariasana
Bhujangasana
Ardha chakrasana
Ardha shalabhasana

Level 3

Ushtrasana
Shalabhasana
Dhanurasana

In all levels advasana, shavaasana, jyestikasana and makarasana can be used as resting poses.

Note: any forward bending asanas are avoided till the symptoms resolved completely

7. Yoga for Lumbar Spondylosis

Here aim of yoga asana is to improve spinal mobility and to strengthen lumbar musculature. Some of the yoga poses to improve lumbar spondylosis are:

Cobra pose
Child pose
Locust pose
Bridge pose
Cat and cow pose
Yoga poses to improve strength

8. Yoga for Spondylosis

Main aim of yoga is to reduce pain, which can be reduced by forward bending posture such as sasankasana breathing, tiger breathing, pavanmuktasana.

Note: Avoid acute backward bending postures i.e. chakrasana, ardhasana, bhujangasana also kapalbhati should be avoided for few days.

9. Yoga for Ankylosis Spondylosis

Here the aim of yoga is to…

Improve spinal mobility
Improve chest expansion
Correct postural alignment
Improve flexibility and strength of spinal musculature and hip flexors.

Some other treatment options for back pain available are-

1. Heat/ cold packs :can be used to reduce inflammation

2. Massage: massage combined with medication and exercise can help to reduce muscle spasm

3. Bed Rest: these days doctor recommends active bed rest than complete bed rest i.e. bed rest with returning to normal activities as soon as possible as studies suggest that rest any more than a day or two can actually make pain worse.

4. Medication: medicines are used to reduce pain and inflammation, some medicines inhibits transmission of pain signals to brain. Commonly used medicines are acetaminophen, ibuprofen, pain relieving creams can be useful

5. Manipulation: osteopathic doctors use manipulation to treat low back pain by applying pressure with hands to bones of low back region.

6. Surgery: preferred for long lasting pain interfering with activities of daily living and if conservative treatment doesn’t help much

7. How Does Yoga Help In Back Pain?

Improve Spinal Mobility
Improve Muscle Strength
Yoga therapy aims at relieving pain and functional limitation
It minimizes, heal and ultimately correct underlying physical malfunctions through a series of postures

Apart from yoga for lower back pain, one should also perform pranayama and practices to improve prana in body, as proper flow of prana itself relieves pain and stiffness.

Writers Note: Back pain, specifically the lower back pain, has become the single biggest cause of disability and reason of missed work, worldwide. I wish I could put all the the information in the article BUT it is important to consult a wellness expert, to get the back and the body, back into shape.

I see a few yoga and wellness studios offering specialised classes, lectures and workshops, to help correct the back issues. Yoga asana and related modalities work to help overcome this debilitating health issue.