Elena Jutai, ND
Pesky low back pain is one of the most common reasons to visit a primary care doctor. All too often we reach into the cabinet for our quick fix pain killers. While these may help with pain in the short term, it is important to consider that the root cause of low back pain is often much deeper.
Why yoga can help
We need to remember that our body is designed to move. The spine moves in 4 main ways: forward bending (flexion), backward bending (extension), twisting (rotation), and side bending (lateral flexion). Yoga utilizes all 4 movements of the spine and provides an opportunity to prevent and help heal low back pain by stabilizing the spine through active muscle contraction and passive stretches for tight muscles. As a yoga teacher, I often see students with what I call “slumpasana” – poor posture, weak abdominal and back muscles, and an overall lack of body awareness. All of which contributes to the perfect conditions for low back pain.
Review of literature
The Clinical Journal of Pain published a systematic review in 2013 that showed strong evidence for short-term and moderate evidence for long-term reduction of low back pain and back-specific disability after yoga interventions’.1
Yoga therapy is a specifically designed yoga practice for individuals and their specific health concerns.
The Journal of Back and Musculoskeletal Rehabilitation compared yoga therapy and normal medical treatment of disc extrusions and bulges in nonspecific low back pain and sciatica. The randomized controlled trial was made up of 61 adults aged 20-45 with nonspecific low back pain or sciatica, and disc protrusions or bulges. 30 participants were randomised to yoga and 31 to normal medical care- in most cases this consisted of advice to take pain killers and non-steroidal anti-inflammatory drugs. Yoga entailed a 3 month course of group classes and home practice, specifically designed to ensure safety. The end results concluded that yoga therapy can benefit both sciatica and nonspecific low back pain, provided that precautions are taken.2
Precautions: Before choosing to include yoga as a complementary therapy for your low back pain, it is important to consult a proper healthcare professional about your health concerns and to clarify contraindications. Not all yoga asanas are meant for everyone. Notably back bending and forward bending must be modified or avoided altogether if you have disk disease, spinal stenosis, sacroiliac dysfunction, spondylolysis, spondylolisthesis, and sciatica. For a safer yoga practice communicate with your yoga teacher so they are aware of your health concerns. Ultimately, it is the student’s responsibility for what they choose to do in their yoga practice. Remember to listen to your body and modify where necessary.
The tension, soreness, and stiffness experienced with low back pain can be relieved through a simple yoga practice.
Here are 5 asanas that combat low back pain
Click the arrows to move through the slideshow.
Chakravakasana - Cat/Cow pose
How to do it: (Cat)Rest on all fours with the tops of the feet on the mat. Ensure your knees are under the hips, and that the wrists are below the shoulders. Gently curl the spine upwards and bring the head towards the chest as you EXHALE. Return to a neutral spine. (Cow) Let the belly drop and the hips tilt forwards as you INHALE. While rolling your shoulder backwards as you look straight ahead
The benefits: Chakravakasana is a simple way to warm up the whole length of the spine.
Modifications:If you have sensitive knees fold the mat or use a towel for extra cushioning to increase comfort. If you have wrist pain, bend the elbows and place them on the floor.
Parivrtta Janu Sirsasana- Revolved Head-to-knee pose
How to do it:From seated extend the RIGHT leg 45 degrees while bending the LEFT knee so it is open and out to the side. Keep the sides of the body long as you lift the left hand and gently place it behind your head. Arch towards the RIGHT foot leading with the right side body, being mindful that the chest stays open and place the forearm along the floor in front of the leg .
*Ensure that both sit bones are making contact with the floor throughout the pose and
The benefits:This is my favourite pose for low back pain because it stretches the small muscle that connect vertebrae to vertebrae in the low back while giving an awesome stretch to the side body which extends into the upper arm allowing for more movement in the shoulder joint. It also gives a stretch to the back of the extended leg in the hamstrings.
Modifications:If you have the space, without collapsing the chest, you can reach further to grasp the calf, ankle or big toe. Make sure your sit bones stay evenly grounded. Never sacrifice alignment and form to reach further.
Bhujangasana- Cobra/Serpent pose
How to do it:Lie on your front side and place your hands just under the shoulders. Squeeze your shoulder blades together and down the spine while you INHALE and lift your chest a few inches off the mat. Remember to keep the legs active by pressing them towards the toes. Look forward and slight ahead of the mat. Do NOT use your hands and arms to push yourself up.
The benefits: Bhujangasana is my favourite active pose for low back pain because it strengthens the length of the spine. In fact Bhujangasana is a variation of the Mackenzie press-up in physical therapy an exercise recommended to patients suffering low back pain because it helps realign displaced intervertebral discs. In comparisonBhujangasana is a more active and challenging pose.
Modifications:If too difficult the arms can be used slightly for support. To make more challenging, let the heels fall outwards to help relax the bum muscles and make the spinal muscles do more of the work.
Marichyasana-Ray of Light pose
How to do it:Sit with the legs extended and bend the RIGHT knee so the foot is just beside the thigh of the extended leg. Place the LEFT hand on the floor with the arm against the spine and the finger tips facing away Bend the RIGHT elbow and press into the inside of the bent knee. Use this as your anchor to twist from the base of the spine, one vertebra at a time, followed by the chest and lastly the head.
The benefits:This spinal twist helps realign the spine while engaging the core muscles and opening the shoulders.
Modifications: To accommodate low back weakness place a blanket under the hips.
Balasana- Child’s pose
How to do it:Kneel and sit on the heels with the tops of the feet resting on the ground. Relax your chest onto your thighs and allow the forehead to rest on the floor. Bring the arms along the side of the body, palms facing upward.
The benefits: Child’s pose mimics the primary curvature of an unborn child, where the spin is a C-shape. Having the knees together gives an extra low back release.
Modifications:If you need to relax the knees, place them wider than hip width apart. If you experience foot discomfort, curl the toes under.
How to find a qualified yoga teacher: It is important that your yoga teacher has the proper training credentials. Are they accredited from the Canadian Yoga Alliance, Yoga Alliance, or other institution? Are they aware of your injuries or limitations to your yoga practice? You should always feel safe in a yoga class, where the teacher is able to provide modifications and assists where necessary. If you have the extra funds it is definitely worth while having a yoga teacher design a private yoga class to meet your individual health needs.
References:
- Cramer H, Lauche R, Haller H, Dobos G. A systematic review and meta-analysis of yoga for low back pain. Clin J Pain.2013 May;29(5):450-60. doi: 10.1097/AJP.0b013e31825e1492.
- Monro R, Bhardwaj AK, Gupta RK, Telles S, Allen B, Little P. Disc extrusions and bulges in nonspecific low back pain and sciatica: Exploratory randomised controlled trial comparing yoga therapy and normal medical treatment. J Back Musculoskelet Rehabil.2015;28(2):383-92. doi: 10.3233/BMR-140531.
