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Yoga and Low Back Pain

Zen in the morning sunJennifer Kurz, MD

Yoga, interpreted from a Sanskrit phrase originally meaning “to yoke together” or “to add/ unite,” is a mind body belief and practice system that encompasses both Hindu and Buddhist philosophies. Its philosophy dates back to pre-Vedic Indian traditions and has origins in multiple spiritual and religious roots. Gurus from India first introduced yoga to the West in the 19th-20th centuries, advocating “hatha yoga” postures for strength and balance, and in the 1980s, it became a popular form of physical exercise throughout the Western world. While yoga will not cure many diagnoses, it is used as a complementary alternative medicine therapy for numerous conditions, including cardiovascular disease, diabetes, cancer, mood disorders, low back and musculoskeletal pain, and even AIDS. Now there is a huge variety of different yoga practices, exercise classes and instruction throughout the world. From bikram (hot yoga) to gentle Yin Yoga and all in between.

  • According to the philosophy of yoga, humans exist as three bodies; energy flows through channels and is concentrated in the chakras.
  • Emphasis on relationship of thought and breath, control of mind, control of body and senses, and mindful awareness.
  • Three main focuses of Hatha yoga: exercise, breathing, meditation.
  • In modern wellness, yoga postures have been used as physical exercise to reduce stress, increased spine mobility, meditate, and alleviate health problems.
  • Clinical trials have shown evidence that yoga (particularly “Viniyoga” in one study) is effective for chronic low back pain. Hatha yoga may be effective for chronic, but not acute, low back pain, with statistical improvement at 24 weeks compared to standard medical care, with 80% decreased need for analgesic medications.
  • Injuries have been reported, with controversy. Most recently, William Broad’s New York Times Magazine article in January 2012 created negative press, after he suffered a back injury from a yoga pose. Torn muscles/hip labral tears, knee injuries, and neck pain have been reported; with headstands, handstands, shoulder stands, backward bends, lotus positions (seated cross-legged positions) producing the greatest reported injuries; however, this may be associated with beginners’ competitiveness, lack of instructors’ qualification to guide appropriate level classes, and lack of knowledge about which poses may be more or less injurious to the beginner yogi.

In general, yoga is a very safe and beneficial practice that I recommend to most of my spine patients; there are yoga exercises and practices that can certainly help both men and woman, young and old. It promotes balance in mind and body, decreases back and chronic pain, increasing muscle tone and core strength, improves motor control and flexibility, and allows patients a new mindset of health and fitness in a world besieged by unhealthy lifestyle patterns, excessive sedentary behaviors and imbalance, and reliance on medical interventions to resolve pain.

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