15 March, 2021

A Healthy Back with Yoga

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Back pain is Australia’s second leading cause of disease burden.1 Around 8 in 10 Australians have back pain at some point in their lives.2

Several things can cause it, including your posture (especially from sitting long hours in an office chair), a sudden movement or fall, lack of physical activity, stress, an injury, or a medical condition. The pain is usually related to the way the bones, discs, tendons, muscles and ligaments work together, or inflammation.

Orthodox treatment includes physical therapy, education, and pain relief medication such as opioids. However, society finds itself in an opioid epidemic with escalating treatment costs and mortality rates. The health sector is under pressure to find alternative solutions.

Opioids harm more than help

Low back pain is one of the most common reasons for which patients are treated with opioids.3 Long-term opioid therapy is associated with poorer pain response, function, and quality-of-life outcomes and may be less effective among people with mood disorders, neurological disorders, neuropathic pain, and psychiatric disorders.3

Opioid therapy is also associated with numerous dose-related adverse effects, such as respiratory depression and overdose, as well as dependence, tolerance, worsened pain, depression, constipation, and confusion. Approximately 20% of individuals receiving long-term opioid therapy develop an opioid use disorder.3

What does the research show?

One study assessed the effects of either yoga practice or physical therapy over the course of one year. The participants had chronic back pain and showed similar improvement in pain and activity limitation. Both groups were less likely to use pain medications after three months.4

Another study found that people who practiced yoga showed small to moderate decreases in pain intensity in the short term. Practice was also found to slightly increase participants’ short- and long-term function.5

A recent literature review shows indicates that yoga can reduce pain and disability, can be practiced safely, and is well received by participants. Some studies also indicate that yoga may improve psychological symptoms, but these effects are currently not as well established.6

Despite these positive results there is a need for more high-quality studies to figure out which pain conditions yoga is most effective, as well as what styles of yoga are best suited to people in pain.

Can yoga hurt my back?

Yes, if not performed correctly. With many online streaming platforms available it is tempting for many beginners to try yoga unsupervised. However, if correct alignment is not sought then there is risk of injuring oneself.

Always consult with a medical professional first if suffering from back pain. Certain back problems, such as spinal fracture or a herniated disc, are not suitable for yoga.

Yoga as therapy

Many yoga therapists will tell you that they work with back health more than any other issue. Yoga addresses the whole person, connecting the mind and body. For example, emotional or cognitive responses to physical pain may lead to a disconnect between the mind and body, which may be addressed through regular yoga practice.7

The sense of the mind and body reconnecting through yoga may be associated with improved awareness of afferent (sensory) feedback allowing for more effective efferent (motor) commands to muscles, reducing muscle tension, spasms, and associated pain.

Regular yoga practice can also build body awareness that enables you to be more conscious of imbalances and tension being held in certain areas. This awareness can be used to improve your alignment.

Strength and stretch

Yoga aims to stretch and strengthen the important back muscles such as the paraspinal muscles that help you bend your spine, the multifidus muscles that stabilize your vertebrae, and the transverse abdominis in the abdomen, which also helps stabilize your spine.

Stretching can be great for alleviating tightness in back muscles but building core strength is critical for back health. To strengthen the back of a structure we must balance the support in the front. That is why poses that incorporate abdominal and back strength are important for back health and spinal alignment.

Caring for your back means developing healthy postural and movement habits and practicing postures and exercises that can build the muscle strength that will give your spine the support it needs.

Other pain relief aspects of yoga

Along with stretching and strengthening postures (asanas) yoga offers diaphragmatic breathing (pranayama); positive affirmations (mantras); and meditation (dhyana). As a whole, yoga practice may heal the physical body, address flexibility (often times cited as common issues for people with chronic pain) and may lead to changes in cognition or in emotional regulation.8,9 Yoga may also help people reduce pain interference, defined as the interference pain has on everyday life and functioning.10

While yoga is not a quick fix solution for chronic pain, the nature of movement, breathwork and meditation may help connect mind and body and release tight muscles, tendons and fascia that contribute to pain conditions.

For more information about Yoga and pain management or to find registered yoga teachers and therapists, visit Yoga Australia, the International Association of Yoga Therapists or the Australasian Association of Yoga Therapists. Alternatively, if you need to speak to your GP or health care professional, please seek further assistance.

Yoga does not just change the way we see things; it transforms the person who sees.

― B.K.S Iyengar

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