The ancient practice of yoga originated in India, before becoming popular in the West late in the 19th century. To the West, yoga became focused on positive thinking and meditation, and more recently has been accepted as an effective therapeutic approach for a number of musculoskeletal conditions, including chronic back and neck pain.
This week’s article is provided by Sarah Jane Wilson, the editor of Spectrum, the official magazine of the British Wheel of Yoga. Last year, Sarah provided us with a blog on the effectiveness of yoga for easing stress (you can find a link to this blog below) and the positive effect that it can have on the body and mind. This week she looks at the role that yoga can play in easing back pain.
In the UK it is estimated that around 8 out of 10 people are affected by back pain at some point in their lives.
It states on the NHS Website that regular yoga practice is beneficial for people with high blood pressure, heart disease, depression and stress, aches and pains, including low back pain.
How you sit, stand, lie and lift can all affect the health of your back.
Back pain may be triggered by bad posture while sitting or standing, bending awkwardly, or lifting incorrectly. It is not generally caused by a serious condition.
In most cases, back pain will improve in a few weeks or months, although some people experience long-term pain or pain that keeps coming back. Backache is most common in the lower back (‘lumbago’), although it can be felt anywhere along your spine, from your neck down to your hips.
Activities such as walking and swimming are great for increasing strength and suppleness in your back, while yoga can improve flexibility and strengthen your back muscles.
Although it can be difficult, it’s also important to stay optimistic and recognise that your pain should get better because people who manage to stay positive despite their pain tend to recover quicker.
One of the key benefits of yoga is that can help you to relax and remain positive. In terms of back pain, this will help ease it – worrying about your back pain will create muscle tension and make things worse.
How Does Yoga Work? A Yoga Practice
Many people are rightly drawn towards yoga and its associated practices when feeling stressed and/or in pain but it can be hard to gain both motivation and perspective then. Having an established yoga practice can give you a toolbox to deal with pain and stress when it emerges in life.
Yoga classes offer students postures and movements to stretch, strengthen and flex the body, to develop breath awareness, to relax and sometimes to meditate.
As well as toning muscles and extending the range of movement in the joints, the postures also benefit the body internally; stimulating organs, glands and nerves as well, keeping all systems in radiant health.
Yoga lowers stress by developing relaxation and breathing techniques. As physical well-being and bodily awareness improve, together with deeper breathing and an ability to relax more easily, there is an increase in energy levels, greater mental clarity and a general feeling of calmness and control.
GP Dr Tom Margham, a yoga enthusiast and spokesperson for the charity Arthritis Research UK, says:
“Yoga is a good first aid remedy for an episode of mild back pain, but done regularly, it also re-engages the muscles of the back and prevents recurrence of pain.
Yoga poses take the joints through the full range of movement, which stops them getting stiff and keeps them working effectively.
This is particularly important for the hips, as when people get older they tend to just use the hips for walking. That means the muscles around the joints waste away, the joints lose stability and joint pain gets worse.”
Practising yoga encourages awareness of your body – using it comfortably and efficiently throughout your day by paying attention to your postural habits, which can help prevent or ease back pain.
Anna Semlyen, a BWY teacher who specializes in yoga for backs, says:
“You learn to change your attitude to your back pain episodes and also to the experience of occasional pain itself with self-observation and by targeting the neurological pathways from the site of pain to the brain.
You learn to gently bring mobility to stiff parts of your body and to keep them flexible which encourages future health in those areas. You learn to exercise, strengthen and relax your body and also your mind, with beneficial effects to your body, your mind and your whole being.
Because everyone has a back, everyone can benefit from practising yoga designed to focus on the health of the lower back. Even if you are not suffering from low back pain, it can act as an educative and preventative technique.”
BWY teacher Barbara Ives has written a great article on yoga for lower backs too (Yoga for Healthy Lower Backs), she says:
“Conventionally, GPs do not tend to examine the role of stress in back pain and this doesn’t make sense. Many professional body workers believe there is a connection between the body’s stress response system and psychological tension.”
Yoga is excellent for promoting healthy joints, and reducing joint and back pain.
Research shows that people with low back pain are less depressed after 3 months of being offered yoga and also after practising yoga at home a year after beginning. Two trials (K. Williams et al 2009 and E. Groessl et al 2008) suggested that depression in low back pain sufferers decreases with yoga and that yoga’s benefits are long-term. It can be depressing to have back pain and yoga helps to bring about positive mental changes.
In this trial (K. Williams et al), 75% said that yoga had “significant importance” and the remaining 25% said that yoga had “some importance” on their low back health. In the same trial, yoga was found to lead to less medication usage (88% less).
Yoga – an Evidence-Based Treatment for Back Pain
In 2007 Arthritis Research UK began a collaboration with the University of York and a number of experienced yoga teachers. It set up a clinical trial with the aim of establishing a solid evidence base that yoga could help people with low back pain lead more active lives and manage their condition more effectively.
The trial involved two groups of people who were both receiving GP care for chronic or recurrent back pain. A 156-strong group were offered group yoga classes specially designed to improve back function, while a second control group of 157 people were offered GP care alone. The results of the study, published in the Annals of Internal Medicine, showed that yoga can provide more effective treatment for chronic low back pain than the usual care provided by GPs.
There was a 30 per cent difference at three months between the two groups, favouring those offered yoga, in people’s ability to do a range of everyday tasks. Specifically, people offered the specially designed 12-week yoga programme experienced greater improvement in back ‘function’ and had more confidence in performing everyday tasks than those offered the usual forms of GP care.
Function means people’s ability to undertake activities without being limited by back pain. Although improvements in back function were more pronounced at three months, there was still an improvement in people’s ability to walk more quickly, get dressed without help or stand up for longer periods of time even nine months after the classes had finished.
People had far fewer days ‘out of action’/off work for the year (approx. 3 versus 12) after beginning attendance on a ‘Yoga for Healthy Lower Backs’ 12-week course.
The yoga programme, which involved 20 experienced yoga teachers, was designed and delivered by Iyengar yoga teacher Alison Trewhela, in collaboration with Anna Semlyen, a BWY teacher.
The Yoga for Healthy Lower Backs programme aims are to: bring awareness to, and strengthen weak areas or loosen stiff segments due to past injuries; rebalance posture and strengthen musculature; improve and maintain improvements in strength, mobility, circulation and the health of the nerves.
The classes were designed for complete beginners, with yoga teachers given extra training in back care. Classes were held in Cornwall, London, York and Manchester. Those attending the specially-designed programme, which involved step-by-step gentle classes, were encouraged to become self-sufficient in the long-term. Classes were supported with four home practice sheets, a manual, and a four-track audio CD teaching how to relax physically and mentally.
Research scientist Dr Robin Monro says:
“While mild back pain is commonly associated with over-tense muscles and responds very well to yoga, forms of back pain that involve structural damage or degeneration can be worsened by some postures.
For instance, people over 60 often have osteoarthritis in some of their spinal joints,” he says.
“These joints may have grown bone spurs which can damage other tissues. It is important to stay in your pain-free range.”
Follow Dr Monro’s rules to help stay injury free:
- Tell the teacher if you have any underlying medical condition, or if any part of your body is in pain.
- Don’t be competitive and struggle into poses that aren’t comfortable.
- Don’t allow a teacher to adjust you into a position if it doesn’t feel good.
- Be wary of yoga taught in gyms by under-qualified fitness instructors.
- Ask the teacher for an easier pose if one the others are doing is too hard.
- Warm up with easy stretching before a yoga session.
- Take yoga seriously.
If you have a health condition you should seek medical advice from your GP before coming to the class. In the majority of instances you can still attend and practise safely. Certain movements and asanas may not be suitable for you but you will be advised what these are and an alternative option offered.
You may also find that some things need to be modified by using various props to ensure it is safe for your individual body.
Finding a class
Whatever type or level of class you choose, make sure to check the teacher’s qualifications before you sign up. British Wheel of Yoga teachers have trained for 2-3 years and are up to date on safety guidelines and best practises.
If you’re just starting to exercise or have a health problem, look for a gentle or beginner’s hatha yoga class. If you have a reasonable level of fitness and a strong, healthy back, opt for a middle-level class. Those with a good level of fitness who want something challenging should opt for an advanced class or more strenuous ashtanga yoga.
Appropriate yoga, such as the ‘Yoga for Healthy Lower Backs’ programme aims to address the past, present and future of the issue.
A yoga practice can help both prevent back problems and ease them directly, both through its physical and mental benefits. Supplementing it with a healthy body, as encouraged by Cytoplan practitioners, can help address this all-too common problem.
Sarah Jane Wilson is the editor of Spectrum, the official magazine of the British Wheel of Yoga (BWY). The BWY is a voice in the UK, dedicated to promoting yoga teachers, students and members within a professional and inspiring union. The BWY is recognised by Sport England as the National Governing Body for Yoga. For over 50 years it has promoted the practice and enjoyment of yoga for all those who are interested, whether they are students or teachers.
With many thanks to Sarah for this article, if you have any questions regarding the health topics raised in this article then please do get in touch via phone (01684 310099) or e-mail ([email protected])
Amanda Williams & The Cytoplan Editorial Team: Joseph Forsyth, Clare Daley and Simon Holdcroft