26 May Yoga to relieve lower back pain?
So what’s all this fuss about, and is there evidence to support the practice of Yoga? And better yet, could Yoga benefit people if they have back pain or other conditions? Exercise Right explores the value of Yoga in an exercise plan to treat Lower Back Pain.
If you check out the latest class timetables at your local gyms these days, it is common to see a variety of Yoga classes being run. And you might even have friends who keep encouraging you to try one of these classes, and swear by their regular practice. Yet, you’re hesitant and possibly quite doubtful that they are even beneficial forms of exercise! How could all those “Om’s”, downward dogs, and deep breathing be good for us, you ask!?
Take a trip back in time with your mind, and you’ll remember that Yoga studios were rarely seen in most cities and towns, let alone Yoga classes at your local gym. And there certainly weren’t people walking around town in Yoga apparel on their weekends!
So what’s all this fuss about, and is there evidence to support the practice of Yoga? And better yet, could Yoga benefit people if they have back pain or other conditions?
Yoga and Lower Back Pain – what’s the research?
Despite the challenges of researching the health benefits of yoga, many good-quality studies are beginning to emerge on the benefits of Yoga, for Chronic Lower Back Pain in particular, and the results are interesting.
For example, a randomized controlled trial (RCT) involving 101 patients with chronic low-back pain compared a Viniyoga practice with conventional back exercise classes and with use of a self-help book. At the end of the 12 week study, the yoga group showed more improvement in back function than the two control groups, who either participated in the conventional exercise classes or were given the self-help book.
And, in 2013, a meta-analysis of randomised controlled trials (in other words, the most reliable evidence possible for the effects of medical treatment) showed that after Yoga participation, which varied in duration from 1 to 24 weeks, had a medium to large effect on functional disability and pain.
In 2009, an evaluation of Iyengar yoga therapy on chronic low back pain was carried out in the United States. This study required participants to complete Yoga over a 24 week period, and also reviewed their pain 6-months after the Yoga intervention. Their results showed clinical improvements at 12 and 24 weeks into the Yoga therapy, and participants also reported a lowering of their back pain induced depression.
So what does all this mean? A regular practice of specific Yoga poses has been shown to improve certain symptoms of back pain. Functional disability, pain intensity and even symptoms of depression can all be lowered from completing regular Yoga exercises.
And the reason for these impressive results? Yoga appears to address imbalanced in the muscles and associated soft tissue that affects the spine and neck, and improves spinal alignment and posture. Specifically, studies have found increased hip flexion and hamstring flexibility from regular Yoga practice (4,7).
Yoga is generally believed to improve flexibility, strength, balance, and agility. For patients with Lower Back Pain, yoga appears to address imbalances in the musculoskeletal system affecting spinal alignment and posture. For example, yoga targets many muscle groups with the aim of lengthening tightened muscles and strengthening often underutilized core muscles. In fact, in studies of patients with Lower Back Pain, yoga has been found to increase hip flexion as well as spinal and hamstring flexibility [4, 7].
As discussed above, however, the practice of yoga places as much emphasis on relaxation and meditation as on physical movement. The mental focus induced by yoga likely helps people increase their awareness of how they position and move their body in maladaptive ways and relax tense muscles. In addition, yoga is generally believed to reduce stress and improve mood and overall well-being; these effects are likely enhanced by the breathing techniques taught as part of the yoga practice.
Lower Back Pain is a significant public health problem and one of the most commonly reported reasons for the use of Complementary Alternative Medicine. Combining ancient wisdom, tried and tested exercises, as well as modern exercise science evaluation and research, Yoga when executed correctly, in the right technique and in the right dose, can have a positive effect on people’s chronic lower back pain. And these exercises can be completed in the comfort of your own home, or during the day at your work space!
The following yoga postures (called Asanas in Yoga) are just some of the postures that have been tested in studies, and found to reduce lower back pain in participants. Remember, if CLBP has been plaguing you, it would still be recommended to have an assessment with your Accredited Exercise Physiologist (AEP0, to ensure these exercises are going to be therapeutic for your body. And if Yoga is something you are wishing to continue and expand into, you could find a Yoga teacher who is also an Accredited Exercise Physiologist (AEP)! Click here to find your local Accredited Exercise Physiologist.
Top 5 Yoga Poses for Lower Back Pain
1. Savasana – Tadasana
Organising the pose:
- Stand with your feet together. Line up your heels behind your second and third toes. (Most people will have to turn out their heels a little.) Face your kneecaps over your toes.
- The weight should be even on each foot,
from front to back and side to side. To do this, ground down, lift your kneecaps, and engage your quadriceps muscles. Then isometrically press the backs of your knees forward—but don’t actually bend them—engaging your quads and hamstring muscles equally. Hug your upper thighs together, then isometrically press them away from one another to activate both your adductors (inner thighs) and abductors (outer thighs).
- With your arms alongside your body, turn your biceps and palms to face forward. Align your neck so it feels long and even on all sides.
- Take a big inhale and lift your rib cage evenly away from your pelvis; exhale and hug in the sides of your waist to create lumbar (low-back) stability.
- Stay here for a good 10 breaths—or make this your whole practice!
– Don’t flatten your lumbar spinal curve by tucking your tailbone. This will push your hips forward and prevent you from forming a long line from your feet through the crown of your head.
– Don’t roll to the outside edges of your feet or distribute your weight unevenly. This will interfere with the structural stability of every joint above your feet.
2. Supta Padangusthasana I (aka. Reclining hand to big toe pose)
Organising the pose:
- Lie supine on the floor, legs strongly extended. If your head doesn’t rest comfortably on the floor, support it on a folded blanket. Exhale, bend the left knee, and draw the thigh into your torso. Hug the thigh to your belly. Press the front of the right thigh heavily to the floor, and push actively through the right heel.
- Loop a strap around the arch of the left foot and hold the strap in both hands. Inhale and straighten the knee, pressing the left heel up toward the ceiling. Walk your hands up the strap until the elbows are fully extended. Broaden the shoulder blades across your back. Keeping the hands as high on the strap as possible, press the shoulder blades lightly into the floor. Widen the collarbones away from the sternum.
- Extend up first through the back of the left heel, and once the back of the leg between the heel and sitting bone is fully lengthened, lift through the ball of the big toe. Begin with the raised leg perpendicular to the floor. Release the head of the thigh bone more deeply into the pelvis and, as you do, draw the foot a little closer to your head, increasing the stretch on the back of the leg.
- You can stay here in this stretch, or turn the leg outward from the hip joint, so the knee and toes look to the left. Pinning the top of the right thigh to the floor, exhale and swing the left leg out to the left and hold it a few inches off the floor. Continue rotating the leg. As you feel the outer thigh move away from the left side of the torso, try to bring the left foot in line with the left shoulder joint. Inhale to bring the leg back to vertical. Lighten your grip on the strap as you do, so that you challenge the muscles of the inner thigh and hip to do the work.
– Hold the vertical position of the leg anywhere from 1 to 3 minutes, and the side position for an equal length of time. Once you have returned to vertical release the strap, hold the leg in place for 30 seconds or so, then slowly release as you exhale. Repeat on the right for the same length of time.
What does it do?:
- Stretches hips, thighs, hamstrings, groins, and calves
- Strengthens the muscles supporting the knees
- Relieves backache, sciatica
- Therapeutic for high blood pressure
3. Urdhva Prasarita Padasana (Upward Extended Feet Pose)
Level: All levels
Urdhva = up. Prasarita = extended or spread. Pada = foot.
Organizing the Pose:
- Lie on your side with the hips at the wall and swing the legs up so that the buttocks, backs of the legs and heels can be at the wall. If it is not possible to do this and keep the lower back and pelvis on the floor, then slide away from the wall until you can get your pelvis down.
- Reach the arms up alongside the ears to reach long on the floor behind you.
- Hold this position for a few breaths.
- Keeping the hips on the floor and the backs of the thighs pressing into the wall, exhale and lift the heels an inch or so off the wall. Hold this position for several breaths.
- Exhale and release the heels back into the wall.
- Change the interlock of the fingers and repeat the pose.
- Use the thigh muscles to press the backs of the thighs into the wall.
- Spread through the feet and toes and stretch the legs up towards the ceiling.
- Link the thumbs and pull them away from the thighs.
- Stretch the sides away from the wall.
- Move the sides of the waist down towards the floor.
- Soften the groins.
- Broaden the top of the chest.
4. Utthita Hasta Padangusthasana I (Extended Hand to Big Toe Pose I)
Level – intermediate
Organising the Pose:
- From Tadasana (Mountain Pose).
- Lift the right foot up and grab hold of the big toe with the first two fingers and thumb of the right hand. Bring the left hand to the hip.
- Exhale and stretch the leg out and up in front of you, pulling the toes back, exhale and come into Utthita Hasta Padangusthasana I (Extended Hand to Big Toe Pose I).
- Inhale, extend both legs, lift and open the chest.
- Exhale and take the leg out to the side, keeping the gaze forward.
- Hold the position for several breaths.
- Bring the leg back to centre.
- Come back to Tadasana (Mountain Pose).
- Repeat on the other side.
- You can hold this pose longer by supporting the raised-leg foot on the top edge of a chair back (padded with a blanket). Set the chair an inch or two from a wall and press your raised heel firmly to the wall.
5. Bharadwajasana in chair 1 (Bharadwaja’s Pose)
Level: All levels
Bharadwaja = an ancient sage with an insatiable desire for learning.
Organizing the Pose:
- Sit sideways in the chair with the chair back to your right.
- Link the thumbs and pull the arms up alongside the ears, lengthening the sides of the trunk and widening the chest.
- Exhale and turn the trunk to the right, bringing the hands to the chair back.
- Inhale, draw the sides up.
- Exhale and turn.
- Hold the pose for several breaths before repeating on the other side.
- Keep the hips and knees even. Place a block between the thighs to help.
- Soften the lower abdomen and broaden the back.
- Lift and lengthen both sides of the trunk evenly.
- Turn the upper abdomen and chest.
- Widen and drop the shoulder blades down the back.
- Soften the neck.
- Keep the head centered over the chest to not over-crank the neck.
May these exercises be of benefit to you or your family, and bring about better spinal health and enjoyment of life! Remember, if you’re experiencing Lower Back Pain or a Musculoskeletal pain, Yoga should be a part of an exercise program prescribed by an Accredited Exercise Physiologist.