by Ellen Tousaw
Low back pain is one of the most common reasons people seek medical attention – in fact, up to 80% of individuals suffer from it at some point. Back pain, whether acute or chronic, can be extremely debilitating. It can interfere with our sleep, our work, and our day-to-day activities. The trickle-down effects of back pain can be even more incapacitating; chronic pain is linked to anxiety, depression, interference with relationships, and an overall decreased quality of life.
The spine and the structures that surround it are extremely complex. The causes of low back pain are highly variable from person to person; there is no one-size-fits-all explanation, and there is therefore no one-size-fits-all fix. In the neighborhood of the lumbar spine is the spinal cord itself; spinal roots that branch off to provide motor and sensory function to the legs; autonomic nerves that supply the pelvis for bowel, bladder, and sexual function; the bony vertebrae and their infamous intervertebral discs; numerous supporting ligaments; and muscles ranging from the paperclip-sized interspinales lumborum to the longissimus thoracis which run from the sacrum all the way up to the level of the shoulder blades. With all of these moving parts, there’s a lot of potential for dysfunction.
Chronic poor posture sets the stage for developing low back pain. Everyone is susceptible to this. With our society’s penchant for desk jobs and our ever-present phones, we’re a pretty hunch-y bunch. Poor postures results in spinal structures that are ill-prepared to handle loads, big or small.
Pharmacotherapy (NSAIDs, opioids, etc.) may play a role in the treatment of back pain. However, most lumbar pain that is mechanical in nature benefits most from physical exercise. Many clinical trials have demonstrated the efficacy of yoga in treating low back pain. In one study, participants reported a 64% decrease in back pain after just 4 months of regular practice. This therapeutic benefit is also shown to last longer than the effect of medication. Below are just a few examples of how yoga helps.
1. Yoga strengthens the core
Strengthening all the muscles of the trunk contributes to stabilizing the spine. Postures with the best bang-for-buck are those that both stretch and strengthen the back, such as downward facing dog, dolphin pose, and extended triangle. Even simple halfway lift pose fires up the muscles that run parallel to the spine. Improving back strength and flexibility helps prevent injury from occurring in the first place. Stronger muscles may also help relieve existing lower back pain by correcting imbalances and asymmetries in the lumbar region contributing to mechanical back pain.
Strengthening the abdominal muscles is another important element of back pain relief. Many of us have an exaggerated curve of the lumbar spine, which puts pressure on the lumbar vertebrae, ligaments and muscles, leading to pain. Strong abdominal muscles hold the pelvis in a neutral position, preventing this over-extension of the low back, and thereby decreasing pain. It’s a good idea to practice a variety of poses and techniques that target the core at different levels. For example, plank and chaturanga are especially great for the serratus anterior and external obliques, low boat pose for the rectus abdominis, and bridge lifts for the deep pelvic floor muscles.
2. Yoga improves posture
Strong back muscles act as a brace on either side of the spine, helping to keep it erect. Yoga strengthens this brace, but also helps to undo the effects of many of our habits that lead to unhealthy posture. Backbends such as cobra or locust pose are the antidote to slumping over a desk all day, for example, while standing poses like mountain pose re-train our body and minds to stand correctly: shoulders back, crown of the head reaching up, core engaged.
Yoga makes us more aware of our posture, but also of our bodies in general. Improved body-awareness helps us move through our everyday activities with purpose and strength, which can help us avoid undue stress on vulnerable areas like the low back.
3. Yoga helps maintain the integrity of lumbar structures
It makes sense that improving muscles’ strength and flexibility helps maintains their ability to keep our low back safe. But yoga benefits other structures too. One example is the intervertebral discs. They need to stay healthy in order to withstand weight-bearing and multi-directional forces, while staying firmly in place. Discs are maintained in large part by their nutrition, which they receive in an interesting way. Discs are like sponges. When we twist our spine, they’re wrung out, and the fluid they contain is forced away. Upon relaxation, a disc draws in fluid and nutrients from its surroundings. Yoga postures involving spinal twisting therefore literally wring older, stale fluid out of the spine, and promote the uptake of beneficial nutrients once the pose is released. Maintenance of the intervertebral discs through any twisted asana helps them avoid slipping (deviation from their normal alignment) and degeneration.
4. Yoga builds mental resilience
While physical exercise is one of the most important treatments, pain is multifactorial. It must be treated from physical but also psychological, spiritual, social, and cultural perspectives. Mindful practices like breath work and meditation provide psychological and spiritual tools which help people cope with difficult circumstances, including pain. Yoga is likely greater at treating low back pain than physical activity-only regimes, as yoga combines exercise with mental focus, posture training, self-awareness, self-care, and relaxation.
Lumbar pain is something we’re all likely to experience at some point in our lives. Yoga is perhaps one of the most important tools we can employ to keep our finicky low backs healthy and happy in the long term.
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Ni M, Mooney K, et al. Core muscle function during specific yoga poses. Complementary Therapies in Medicine. 2014; 22:235-243. DOI: 10.2016/j.ctim.2014.01.007
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