by Dr. Jeffery O’Guin
Consumer reports found that yoga was the most helpful and preferred option for treating back pain (Real Relief From Back Pain, June 2017). Additionally, a published study in the Annals of Internal Medicine found yoga to be equally as effective as physical therapy for back pain.
As a chiropractor and spine health specialist, I am not surprised by these findings. Extensive research is regularly showing that active therapies are usually the best option for managing back pain. I have been an advocate for yoga and have recommended it to my patients for many years. Therapies such as myofascial release and spinal manipulation were right behind yoga in effectiveness, and are additional measures to create optimal alignment, balance and symmetry. However, it is in actively being involved that has the greatest outcomes in regard to spinal health. In this post, I am going to outline all of the reasons why yoga is so incredible for helping to manage back pain.
First, and most importantly, yoga emphasizes a relaxed mind and body. Through breathing and mindfulness, it is easier to become in tune with the body. This level of body awareness helps to achieve more relaxed and coordinated movements. Essentially, when the mind is relaxed, the body can more easily relax, making movements more fluid. This self-exploration equates to safer and more pain free ranges of motion.
Another interesting component of relaxation and the breath is their relationship to core stability. When people think about core stability, they immediately think of butts and guts. Although, the glutes and abbs are important muscles to consider, the diaphragm is frequently underestimated. The inner core is the most foundational / deepest level of core stability. It is made up of the diaphragm (muscle used mostly for breathing), transverse abdominals (side stomach muscles extremely important in rehabilitation), multifidus (deep muscles along the spine), and pelvic floor muscles (muscles that control your private parts). This inner core often needs to be awoken in people with spine pain. Diaphragmatic breathing, such as in yoga, is an excellent way to wake up this entire area. This is because of the overlapping neurological connections between the diaphragm and the rest of these important muscles.
In addition to this inner core, yoga incorporates many levels of strengthening muscles and increasing core stability. This is important because many cases of chronic and recurring back pain are due to unstable joints of the spine. Ultimately, it is the muscles that protect the spine and keep the body upright. Without muscles, we’re all just a bag of bones with no support. The muscles of the core are especially important because the ‘Core’ is the center of gravity and foundation for all movements. Every step taken and every reach made, should begin with core muscles firing to stabilize. Then, orchestrated movements begin to ripple out to the limbs. If the core muscles do not initiate movement, or if they do it poorly, pain becomes a natural consequence.
During a typical yoga class, poses are maintained that enhance the endurance of the most important muscles for core stability. Breathing with the diaphragm is also emphasized, facilitating a deeper level of core awakening. Positions and poses are also held while muscles are stretched and lengthened. This means that the muscles are being strengthened and lengthened at the same time. This is important because it strengthens the muscles in a variety of ranges. This adds another level of stability and coordination, important for managing back pain.
Next, the slow and gentle stretches done in yoga are a great way to balance the pelvis and spine. Having tighter muscles on one side of the body than the other, creates asymmetries. Imbalances like these usually cause uncoordinated movements and sensations of ‘being out of alignment’. Also, having a misaligned pelvis can eventually cause excessive wear and tear on joints which can lead to pain. Additionally, stretching improves the ability to move throughout the day without restrictions, minimizing strains on muscles.
Finally, a group of benefits often overlooked are stress reduction and social support. Near the beginning and end of most yoga classes, a short meditation session encouraging relaxation is emphasized. Additionally, social support and building relationships is paramount for overall health. Consider that the newest model of health care is called the biopsychosocial model. This can be important because with any form of chronic pain; stress, anxiety and even depression are common. All of this makes yoga an excellent choice on multiple levels.
Although yoga is incredible for helping with back pain, a few key points should be emphasized. As a spinal health specialist, I would be negligent if I didn’t mention these. First, there are a variety of yoga classes and instructors. In the study that showed yoga to be equally as effective as physical therapy, there was a specific protocol used for helping people with back pain. In choosing a yoga class, you should always speak to someone at the studio, and let them know your interests and needs.
Next, if you have back pain that is not responding, you should absolutely see a spine health specialist. Find a chiropractor or DPT who will take the time to do a full exam and explain what’s causing your pain. Once an accurate diagnosis is made, guidelines can be given in regards to management. This should include specific stretches or exercises to focus on, but more importantly what might need to be avoided. For example, there might be one particular stretch that is actually aggravating a condition. Additionally, other therapies such as traction, spinal manipulation, or myofascial release might be necessary. Finally, managing back pain is usually multidimensional, requiring several strategies. A good physician can be a great resource, helping to evaluate and give advice every step of the way.
Originally published February 27, 2018 by Dr. Jeffery O’Guin D.C. Republished with permission.