Chronic back pain affects as many as 70 million people in the United States alone—and, chances are, you have known at least one of them. Whether it is a friend, family member, loved one or perhaps, yourself there is some good news on the horizon. Just read on.

The solution to preventing and treating this insidious problem may be just one breath away—quite literally. Yoga is quickly becoming the elixir of choice in warding off back pain and chronic pain of all kinds. The practice of yoga can gently elongate and align the spine, correcting posture issues as well as teaching patients essential calming techniques.

What is Yoga?

Yoga is an ancient system of healing that combines physical postures with the breath.  It improves circulation, strength, balance, and flexibility.   Yoga philosophy has the back at its center. In fact, yogis believe that the health of a person’s spine determines his or her age as well as quality of life, not the number of years that person has been alive. Its curative work is unavoidable.

Spinal health depends on many parts of the body. The spine doesn’t operate on its own. It needs the legs to be aligned and it needs the strength of the legs, the buttocks, and the abdominal wall as well as the positioning of the pelvis. The position of the pelvis, the openness of the hips, the flexibility and natural curves of the lower and upper back, as well as the natural shape of the cervical curve also affect spine alignments. Shoulder and head positioning, as most physicians will agree, contribute to alignment issues. In addition, the strength of the back muscles can also help with back pain.

Teachers will often tell their clients to imagine the spine as a long strand of pearls. To keep the spacing even, they need to rely on the whole body and the strength of the muscles. If there is a lack of full range of motion in both the arms and legs, the negative forces on the spine will increase. Most often, the spine must compensate with extra bending and twisting.  And just as any physical therapist will tell you, weaknesses and strengths in any one or groups of muscles can affect the delicate nodules of the spine.

Yoga postures strengthen and increase the flexibility of muscle groups associated with spinal health, such as: the psoas major, hamstrings, shoulders, and abdominals.  For example, in a back bend, such as bridge pose, the muscles of the entire body (back, shoulders, legs, hips, etc.) are both strengthened and stretched.

• Alignment. One of the main focuses of yoga postures is keeping length in the spine, which creates good posture and alignment of the vertebrae. When the spine is aligned, proper blood flow and space between the vertebrae assure a healthy back. In fact, the alignment of yoga postures and the stretching quality that they provide increase the blood flow to all the tissues and muscles that support the spine. This increase of blood flow helps maintain the health of both the inter-vertebral disks and muscles.
• Strength. Yoga also increases strength in all the muscle groups that support the spine.
• Flexibility. These postures also create greater flexibility in the shoulders and hips, which lessens the demands, made on the back and allows the spine to rotate properly.

The majority of new yoga practitioners that I see have the inclination to slump the shoulders, that action tends to lead to shoulder, neck, and back pain.  By moving the shoulders up and back, which is emphasized in all yoga postures, increased strength and flexibility in these areas begins to alleviate pain and discomfort.

• Breathing. In the practice of yoga, the focus of connecting breath with movement makes us more aware and conscious of the way we align our bodies. You are probably already aware of this—as the sufferer may explain of a particularly stressful time when their back pain seemed to flair up. Yoga’s breathing and meditation aspects induce a calming response that has been found in many studies to assist people in decreasing their pain.

Interestingly enough, yoga has also been helpful in treating depression and anxiety, which often accompany pain problems (Barr, 2003)

Studies have shown that those who practice yoga as little as twice a week for eight weeks make significant gains in strength, flexibility, and endurance which is a basic goal of most rehabilitation programs for back or neck pain” (Barr, 2003, p.1).

Raub (2002) indicates that over the last ten years, a growing number of research studies have shown that the practice of hatha yoga can improve strength and flexibility and may help control such physiological variables as blood pressure, respiration and heart rate, and metabolic rate to improve overall exercise capacity.

What to Recommend

Even with the many documented benefits of yoga, patients with chronic back pain need to be discriminating. Various schools and types of yoga can provide boundless options, but patients need to make sure they are practicing a type of yoga that fits with their own personal preferences and physical ailments.  Patients should ask the teacher beforehand if he or she has experience working with that condition or if there is another more experienced instructor who could be recommended.

Most recently, therapeutic yoga has emerged as a new paradigm to this practice.  The schools of yoga most reputed for therapeutic knowledge and aiding in relieving chronic pain have challenging levels of accreditation.

For example, Iyengar yoga, is a physical yoga practice that focuses on precise alignment and understanding of how the body works. Iyengar yoga also advocates using props, such as blocks, straps and blankets, personalizing the posture to each student.  Maintaining proper alignment is always emphasized in this school of yoga.  Rather than moving quickly through a series of postures, the use of props assists in making alignment possible.  Props also aid students who lack strength and flexibility to take the basic form of the posture.  If a student’s lack of flexibility in the hamstrings will prohibit him or her from achieving a seated posture, sitting on a blanket or a block will aid in keeping the natural curve of the spine.

Yoga Instruction

Because yoga is so popular in America today, finding a teacher may almost be too easy. Thus, students should take time exploring studios and teachers. Patients with back pain should inquire about a teacher’s training and certification.  At a minimum, a yoga teacher should be Yoga Alliance certified and, preferably, trained and experienced in a therapeutic method, such as Iyengar.  I emphasize that people with chronic pain of any type never practice with an inexperienced or uncertified teacher.

Because the patient is in pain, he or she should ask whether the teacher has dealt with specific injuries.  Anytime the pain intensifies, this is an indication to back up and realign.  If the teacher tells a student it should hurt or if the teacher is vague about an adjustment, it is not acceptable. Though Iyengar teachers are not the only highly educated and alignment based teachers out there, the instructor’s hours of education are lengthy and required, even at an entry level.  They also receive a thorough understanding of subjects, such as anatomy and physiology, hands-on adjustments, therapeutics, and expertise in teaching. In general, this takes a minimum of four years.

In addition to seeking people with the right credentials and training, students and patients should be able to relate well with their instructors. Certain personalities seem to go better with others, so patients should make an effort to find an instructor who fits their unique personalities. Practicing yoga for an hour with someone with a soothing voice who goes at an ideal pace for the patient can be invaluable in practice. In addition, a patient who likes the instructor will be that much more inclined to keep coming back to classes.

Luckily, the yoga community is an embracing one—with many studios offering special introductory classes to test out the grounds and offering instructors to teach various types and levels of yoga. The allure of yoga is that it encourages practitioners to spend less time competing with the world around them and more time getting to know the world inside. By exploring this inner world, many patients discover a restorative power that heals.