How Yoga can help prevent and reduce lower back pain
There are a number of ways Yoga can help with easing back pain. Both on a physical and psychological level. It all comes down to what the back pain is, and how it was caused.
In this blog, I specifically talk about non-specific lower back pain.
According to Spine-Health.com, exercise of the spine is important for its healing and when done in a controlled, gradual, and progressive manner, active back exercises distribute nutrients into the disc space and soft tissues in the back to keep the discs, muscles, ligaments, and joints healthy. Consequently, a regular routine of lower back exercises helps patients avoid stiffness and weakness, minimize recurrences of lower back pain, and reduce the severity and duration of possible future episodes of lower back pain.
But it is very important to speak with a doctor to identify exactly what the issue is before beginning a practice.
Causes of non-specific lower back pain
Non-specific lower back pain is the most common type of back pain. It is called non-specific because usually it is not clear what is actually causing the pain and the pain can vary from mild to severe.
A major misconception with non-specific lower back pain is to limit movement, where actually, it is the complete opposite.
Types of non-specific low back pain include:
- slipped disc
- herniated discs
The back pain associated with these types of problems normally come on all of sudden.
So what causes non-specific lower back pain?
- Structural: joints, discs, muscles, tendons and ligaments.
- Muscle weakness: struggle to hold the spine up caused by injury and/ or inflammation.
- Chronic stress
- Tight hamstrings
- Fear of pain: Psychological and emotional factors caused by a physical change. The Pain Cycle.
Problems with the structures in the back such as joints, discs, muscles, tendons, and or ligaments and can take a number of months to bring the spine back to normal.
Muscle weakness can occur when the facet joints or certain other structures in the spine become injured or inflamed, causing the large back muscles to spasm and cause low back pain and limitation in motion.
If this limitation in motion lasts for more than two weeks, it can lead to muscle weakness because the use of the muscles is painful, movement is avoided to reduce this pain. This can then lead to muscle wasting or weakening and then cause even more back pain.
There are a variety of theories about the causes of stress-related back pain. Chronic stress leads to muscle weakness (see above), the stress causes back muscles to tighten in a fight or flight response, depriving muscles of energy needed to support the spine. And as stated above, because it becomes painful to move, the movement is limited and then muscles continue to weaken.
Your hamstrings are the large muscles in the back of the thighs. Tight hamstrings can sometimes lead to low back pain, and those with lower back pain tend to develop tight hamstrings. According to spine-health.com, one theory is that tight hamstrings limit motion in the pelvis, so the motion gets transferred to the bottom lumbar motion segments and increases the stress in the low back.
The Pain Cycle
One of the main themes with all back pain theories is that psychological and emotional factors cause some type of physical change resulting in the back pain. This can lead to what is called ‘the pain cycle’.
The Pain Cycle can lead to the person who is suffering from the pain becoming anxious and fearsome about movement just in case they feel that pain again.
The Pain Cycle is characterized by the following:
- The patient becomes unnecessarily limited in many functions of daily life, as well as leisure activities.
- This decrease in activities is due to the patient’s fear of the pain and injury.
- This fear may be made worse by admonitions doctors and/or family and friends saying to “take it easy” due to some structural diagnosis (which may actually have nothing to do with the back pain).
- The limitations in movement and activity lead to physical de-conditioning and muscle weakening, which in turn leads to more back pain.
According to Spinal-Health.com, this cycle results in more pain, more fear, and more physical de-conditioning along with other reactions such as social isolation, depression, and anxiety.
In most cases, with non-specific lower back, getting on with daily life is most important. Yes, there are certain movements to avoid that will aggravate the injury, but keeping yourself walking and moving about is better for recovery.
Interesting fact: The Brain itself has no pain receptors. Pain is emotionally driven in most cases. It isn’t as simple as a two-way communication, for example, how you react to pain if you stand on a sharp object in the moment of celebrating some good news is different to how you’d react if it was in the middle of an argument with someone.
Why the core muscle group is so important
To maintain a healthy spine, you need to develop strong muscles around it to support its function. Particularly for the Lumbar Lordosis (lower back), as it doesn’t have the added strength of the rib cage.
When moving the body in certain ways it is important that the core muscles are engaged to help protect the spine and surrounding musculature from injury in static and dynamic movements.
For example, during a practice of yoga asanas, you will hear teachers say something about ‘engaging the core muscles’ before we move into the asana — this is because our core muscles most often act as a stabilizer and force transfer centre rather than a prime mover. It is also important to ensure these core muscles are engaged prior to lifting or moving heavy objects.
Muscles and ligaments support the spine, hold it upright and control movement during rest and activity. The core muscle group need to be strong to protect the lower back (Lumbar Lordosis) acting as dynamic stabilizers for movement as well as improving flexibility between the vertebrae.
The main muscles in the core muscle group include:
- Transverse Abdominis
- Pelvic Floor
- Lumbar Multifidus
Our core muscle group contributes to spine stability providing the ability to flex, side bend and rotate the trunk. These muscles serve to protect the abdominal organs and ensure the maintenance of good postural alignment.
Many of the muscles in the core muscle group are hidden under those that people would usually train for example the External Obliques and the Rectus Abdominis.
Yoga for lower back pain
A physical yoga practice can be useful in reducing lower back pain. Here are three Yoga Asanas that you could do to help to strengthen your core muscle group and keep your Lumbar Lordosis safe. These can be practiced to prevent lower back pain, or during a time where you need to rebuild strength and flexibility. Always practice with caution and speak with your medical practitioner before practicing.
- Marjariasana (Cat pose) helps the flexibility of the spine and build strength around the lower back and abdominals. This could be done, sitting on a chair, standing or on all fours, depending on what felt most comfortable for the student.
- Vyagrahasana (Tiger pose) would need to be practiced with caution and depending on the lower back issue, you may need to avoid bringing the knee in towards the head. However, the elongation of the stretch from the tip of the fingers to the tips of toes would help, as well as the engagement of the core muscle group. This asana is very good for the postural muscles and hips, so would really help you to build the muscular support needed for the lower back.
- Bhujangasana or Salamba Bhujangasana (Cobra or Sphinx) allows you to strengthen your deep Extensor muscles of the spine in addition to the Lumbar Multifidus muscles that would be engaged once the lower abdominals are activated. If you do this in four stages and slowly build you way into full cobra step-by-step and in their own time.
- Makarāsana (crocodile pose) is the main asana I would practice during the time I had a slipped disc in my L5 of my lower back. This was the main way I felt the most release and ease of any pain. You could even use this as your pose for relaxation instead of Savasana (corpse pose).
- Relaxation Allowing yourself at least 20 minutes for a full and deep relaxation will really help to release any unnecessary muscle tension around the spine. You may even find that lying in constructive rest pose with a bolster or pillow under the knees will help relieve pressure off the lower back. Or to lay on their side hugging a bolster or pillow.
Yoga and stress-related back pain
Yoga can also assist with stress-related back pain by taking a more integrated approach and looking at the four elements that may make up the affected areas for the stress-related back pain; physical, emotional, cognitive and environmental.
- Physical: including de-conditioned and weak muscles, nerve irritation, etc. — this could be combated by specific asanas, such as those listed above.
- Emotional: including depression, anxiety, anger, etc. — Through using specific sequences such as Earth sequence, along with relaxation.
- Pranayama: particularly alternate nostril breathing or even deep yogic breath.
- Cognitive: reducing negative thoughts, pessimism, hopelessness, etc. — by using positive mantras and affirmations during sequences, asanas, relaxation, and meditation.
- Environmental: stress could be caused by something like a loss of a job, or financial problems, etc. — this element is not something as a yoga teacher we can have control over, however, with the support provided by your yoga teacher, your medical practitioner and using the above techniques, you will find that you can develop the tools required to overcome difficult circumstances.
The human spine: Our shock absorber
Our spine is really a shock absorber; unique due to its ‘S’ shape and how each vertebra sits together. Since standing upright, the human spine has evolved to cope with different kinds of load and is essentially the supporting structure or our body. Often people argue that the ‘S’ shape of the modern human spine is caused by a sedentary lifestyle and that cultures who live far away from modern life, experience less non-specific lower back pain because they had a ‘J’ shaped spine—like those seen in Greek and Roman sculptures, where there is only one curve in the Lumbar Lordosis (lower back).
According to an article published on NPR.org, over a period of 10 years, acupuncturist Esther Gokhale visited a number of tribes in Ecuador, tiny fishing villages in Portugal and West Africa, to study their daily life and movements. Here she discovered the fascinating differences between the modern ‘S’ shaped spine and the ‘J’ shaped spine.
The human spine is structured in a way that it helps us to maintain balance and allows a range of motion throughout the spinal column. It is well sprung with resilient discs between each of the vertebrae.
Non-specific lower back pain can be caused from different experiences, from the physical like a slipped disc, to the mental, like stress.
Sections of the ‘S’ shaped Spine
There are four curves of the ‘S’ shaped spine. They help us with balance, stability and suspension.
- Cervical Lordosis (neck)
- Thoracic Kyphosis (in-between the shoulder blades)
- Lumbar Lordosis (lower back)
- Sacral Kyphosis (sacrum)
Finally, at the base of the spine is the Coccyx or tailbone, which are four fused coccygeal vertebrae. The Sacral Kyphosis and the Coccyx take the most weight impact and is a feature exclusive to humans.
Interesting fact: As children, the Sacral Kyphosis is actually five sacral vertebrae which fuse to become one sacrum after puberty.
Muscles of the back
Muscles can be categorized into two groups:
Our muscles layer through our body.
Stabiliser muscles: usually the ones that sit deeper within the body such as the postural muscles (Transverse Abdominus, the pelvic floor, and the deep back muscles, Multifidus etc). One of the major tasks for this muscle group is to support the spine.
Mobiliser muscles: usually closer to the surface and help us with big movements. They tend to work in phases and are usually long in their design, this includes the hamstrings and rectus femoris.
When both stabilizer and mobilizer muscles are working properly, they work in harmony with each other, helping to reduce the risk of injury to the body. If either has a weakness, they might overcompensate to make up for any muscle weakness, putting more strain on the stronger muscle. When this happens, it can cause more harm in the long run if not identified and treated.
Whilst there are many muscles in the back, the main three that help the function of the spine are Extensors, Flexors, and Oblique muscles.
The relationship among muscles, posture, and lower back pain
Muscle strength and flexibility are essential to maintaining the neutral spine position. Weak abdominal muscles cause hip flexor muscles to tighten causing an increase in the curve of the low back. An unhealthy posture results when the curve is overextended called lordosis or swayback. Proper posture corrects muscle imbalances that can lead to low back pain by evenly distributing weight on both sides of the body, and well-balanced through the vertebrae in the spine.
The relationship between the lower back and the hamstrings
The hamstrings run through the back of each thigh. Tightness in this muscle limits motion in the pelvis which can increase stress across the low back and corrupt correct posture. Stretching the hamstrings with these following exercises (or as part of a routine of back exercises) can gradually lengthen them and reduce the stress felt in the lower back.