Yoga for Back Pain

Yoga practice is a form of mind-body practice involving a combination of muscular activity and poses, which promote strength, endurance, and flexibility; and facilitates self-control and a sense of calmness. The origin of yoga comes from a Sanskrit root “yuj” meaning union, alluding to the practice of joining and concentrating one’s attention while practicing yoga. There is evidence to support that yoga practice improves multiple aspects of health (i.e., physical, mental, spiritual) and in particular, stress-related illnesses. 

Yoga and physical therapy may be beneficial for individuals with subacute and chronic low back pain. Back pain is a common complaint and can be potentially debilitating in some individuals. Based on the duration of symptoms, it can be classified as acute (i.e., less than four weeks), subacute (i.e., 4 to 12 weeks), or chronic (i.e., greater than 12 weeks). Signs and symptoms include increasing pain when lifting and bending forward; pain when resting, sitting, or standing; and pain that radiates down the back into the buttocks, leg, or hips. Yoga is thought to improve low back pain by stretching and strengthening the muscles and connective tissues surrounding the spine and hip joints. It can also improve an individual’s posture and flexibility. 

Yoga, when practiced correctly, helps stretch the muscles and connective tissues that could be contributing to an individual’s back pain. Yoga also helps to build muscle mass and strength, improve balance and coordination, and increase blood flow to different parts of the body. Of note, if performed too quickly or incorrectly, individuals may be at risk for further injury and muscle strain. 

Several yoga poses that help to loosen the hip muscles and improve back pain include child’s pose and cat-cow stretch. To perform child's pose, start by kneeling on the floor with knees hip-width apart and both feet pointing backward. While leaning back on your knees and feet, lean forward and keep your buttocks on your heels. Then, rest your head toward the floor and stretch your arms out in front of you with the palms facing the floor. This position helps stretch the shoulders, back, and hips, providing pain relief.

To perform cat-cow pose, you start on your hands and knees and your head facing down, with both palms of the hands on the ground and both knees bent. It is important to ensure both arms are directly under your shoulder blades and your knees are flat on the floor directly below your hips. Inhale deeply while curving your lower back (i.e., spinal flexion) and tilting your pelvis up like a “cow” while allowing your chin to rest on the chest. Then, exhale deeply as you draw your stomach upward towards the ground (i.e., spinal extension) while lifting your head upwards. Cat-cow pose helps to release tension from the upper back and neck while strengthening the spine.

Another widely recognized yoga pose is downward-facing dog, which helps to stretch and strengthen the upper arms, shoulders, hamstrings, and back. Begin by positioning your body on all fours on your hands and knees. Then, spread your hands so that the shoulders are over the wrists and both legs and feet are hip-width apart. Slowly walk the palms out in front of the shoulders. Raise your knees off the ground and lift your hips upward, allowing the legs to straighten. With the legs straightened and hips raised, continue to walk your heels toward the front of the yoga mat, bending the left leg while the right leg is straightened and vice versa. This posture lengthens the spine and counteracts the effects of prolonged sitting.

Finally, the supine spinal twist can also help alleviate back pain by improving spinal mobility and posture. Start by lying on your back with the arms out to the sides with palms facing down in a T-position. As you inhale, bend your left leg and draw the knee to the chest, shifting your body weight onto your shoulders and arms. As you exhale, draw the left knee across the right side of your body. Gently allow the spine to rotate to the right and place your right hand on top of your left knee to help support this motion. Then, rest your bent knee on the ground and repeat this exercise with the right leg. 

While yoga can be a beneficial exercise to individuals with back pain, there are certain poses that are not recommended, especially for those with a known history of back injury. For example, in individuals with spinal stenosis (i.e., narrowing of the spinal canal) positions that tend to overextend the spine, can potentially overstretch the back and worsen the pain. Some of these poses include the camel pose and upward-facing dog. Additionally, advanced positions that put pressure on the neck, sacrum, or spine typically require more experience and muscle recruitment. While some of these poses (i.e., boat pose, upward bow, or wheel) can be done safely in more experienced individuals, it is not recommended for beginners as they may compromise their form instead of maintaining good posture, thereby placing further strain onto the lower back. It is important to consult a healthcare professional to have one’s body mechanics evaluated prior to starting a yoga exercise regimen to understand your body’s limitations.

Yoga practice is a form of mind-body practice that involves a combination of muscular activity and poses to promote strength, endurance, and flexibility. Tight hips from prolonged sitting are one of the most common causes of low back pain. Several yoga poses that can help alleviate lower back pain include the child’s pose, cat-cow stretch, downward-facing dog, and spinal twist. These yoga positions help lengthen and stabilize the spine and ultimately provide pain relief. While yoga and physical therapy may help with back pain, there are certain exercises that should be avoided, particularly in individuals with a history of back injury. Poses that have the ability to overextend the spine or place excess pressure on the sacrum and/or spine may worsen back pain. Therefore, it is important to consult a healthcare professional for a comprehensive evaluation before starting a yoga exercise regimen.