27 Oct Should You Try Yoga for Back Pain?

You have friends that have done yoga for back pain.

Not only is their back pain better, but they smile more!

Let’s talk about you.

Your back pain has been around for a while now. Maybe the back pain comes, lasts 5-10 days, til it finally goes away for months at a time before you feel it again. But now, it’s worse than it’s ever been before. When you look in the mirror, your hips might be shifted off to the side.

Or perhaps it’s an always-present nuisance that you’ve learned to ignore. You feel stiff in the mornings when getting out of bed or after any period of time sitting more than 10 minutes.  Once you’re walking, the stiffness has completely resolved, leading you to think there’s nothing serious going on.

You’ve tried:

• Chiropractors with their adjustments
• Massage therapists with their hands-on-your-muscles techniques
• Physical therapists with their electronic stimulation, ultrasound, dry needling and strengthening
• Medical Doctors with their pills or shots filled with relief-promising steroids
• Orthopedic Doctors who want to operate …

… And none of it has worked as promised.

Now you’re wondering, maybe yoga can help your back pain like it did for your friends?

If You Had a Magic Wand, What Are You Wishing For?

If you had a magic wand that you could wave and get exactly what you wished for, what would it be?

Many of the patients who enter our practice at Barefoot Rehab tried yoga previously, not really knowing what they were trying it for.

Is your wish to:

• Relax and de-stress from life?
• Stay active and exercise in a gentler way than you’ve been doing?
• Throw spaghetti at the wall and try something different to address your pain or stiffness in the long run?
• Have less pain or stiffness, ASAP, and for the rest of your time above the dirt on this planet?

All of the above wishes are entirely acceptable and valid wishes.

But …

If you want back pain relief, you need to be really clear what your wish is.

We’re talking about your back here. Your body.

Without your health, what do you really have?

Think of the people who you see on a daily basis.  Go through your mental Rolodex and remember all of the times you’ve seen them hobble around the office or your home or witnessed them complain about their stubborn back pain.

Back pain can suck the life out of you and it’s not something to mess around with.

You just have to know what your magic wand wish is.

And know that if your answer is for back pain relief, let’s substitute spaghetti-throwing with hope that real relief is on the horizon with a little more self-knowledge.

Yoga for Relaxation and Gentleness – YES!

We Americans like to move and to move fast.

Listen to rush-hour traffic near any major city or in any suburb to observe the frustrated honking that takes the place of people’s need to go as fast as they want to go.

Our workouts have tended to be pretty fast too.  There’s CrossFit, running, spinning, and other types of weight-lifting.

Good thing is, more and more of us are turning to gentler forms of movement, such as yoga, that puts less stress on and prevents faster degeneration (or wear-and-tear) of our joints and causes less pain.

Yoga is one of my favorite recommendations for those who need another way to relax, de-stress, and be gentler on the body. Using yoga blocks can make your practice even easier and safer.

There’s something about meditating while moving, focusing on the breath, that puts us in a different mental state to deal with all of life’s difficulties.

If your magic wand wish is to relax, de-stress, and move more gently, yoga is an amazing option.

Before you choose yoga for this wish, are you clear that this is your reason for choosing yoga?

Yoga for Back Pain – Maybe?

There’s a cultural phenomenon of living in fixable pain due to losing hope and not trusting doctors.  One of the symptoms of this problem is when someone says:

I’m going to try _______ for my pain.

The keyword being “try”.

I put zero blame on those who suffer in pain for making this statement.

My finger gets pointed at multiple parties:

• Individual doctors/therapists who get paid to fix pain, but don’t focus on their sweet-spot and fail to deliver to 100% of the patients who walk through their doors. Don’t get me wrong, there are patients who I can’t help at all. But, doctors can be honest about the reasons why and not string patients along for more than 5 visits without relief. Some physical therapists and chiropractors sometimes see people for 20-30 visits with 0% improvement! This makes my blood boil.

• Insurance companies whose goal it is to save money (and not do what’s necessary set someone up to be pain-free).

• Healthcare, more generally, for not being open to exploring pain-relief options that work more effectively than other options.

Before I get all fired up about injustice, I digress.

It’s helpful to point the finger, though, so that you, as the consumer and person suffering in pain, can align yourself with a choice and a possible exercise/therapeutic intervention that balances the odds in your favor, whatever the wish may be.

Sure, yoga can help your back pain.

So can CrossFit, chiropractic, massage, acupuncture, steroids, or any other treatment. Heck, if a surgeon cut your body in half, severing the lower back and legs, you’d have no pain after the healing process finished. If an intervention truly didn’t work for any individuals, you would’ve never heard of it. It wouldn’t exist any more.

We are NOT talking about ‘Maybe yoga can help me, so I’ll try it.’

We are talking about ‘If my goal is to get out of pain NOW, ASAP, and stay pain-free, what’s the best way to do it?’

With that said, there are situations where yoga is a really good solution for back pain.

When Is Yoga the Best Solution for Back Pain?

You can do yoga safely …

… with minimal risk of further permanent damage …

… and a good chance of back pain relief …

… When as many of the following data points are true (in bold below):

You’ve been inactive for most of your life with no significant trauma such as car accidents.

You likely have minimal serious joint degeneration.

Your pain is mild.

There’s probably nothing serious going on.

Moderate to severe pain = Moderate to severe problems (or pathologies).

Your pain occurs at the end of any range of motion.

You likely have muscle pain, not disc or joint pain.

Pain in the middle of a range of motion, like the Forward fold, is almost 100% positive for a disc problem.

If you’re older than 40-50 years of age AND …

You have stiffness getting out of bed in the morning or after getting up from sitting AND …

Both an x-ray AND MRI have confirmed that there’s bone arthritis, but no disc injury.

Bone arthritis responds really well to yoga. Disc damage does not.

If you have stiffness getting out of bed in the morning or after getting up from sitting, don’t do yoga without the MRI.  These symptoms are NOT muscular. The question is, is it bone, facet joints, or disc?

If it’s bone or facet joints, you can try yoga without too much risk of injury.

If it’s anything more than a mild disc injury, do not try yoga.  If you do, your pain will get worse as the months go by, even if you feel relief during your yoga practice. You’ll likely noticed increased stiffness the morning after a yoga day.

Choose Your Ranges of Motion in the Forward Fold and Up-Dog

If you decide to try yoga for back pain, empower yourself to move safely for years by choosing how far you move into each pose or movement.

Since most people’s back pain that has lasted more than months to years is caused by a disc problem, we will assume yours is too.

Your choice of range of motion can be the difference between:

• Doing the full movement – putting high stress on your back – and having to stop yoga in a few months due to increasing pain.
• Doing the movement into smaller ranges – putting less stress on your back – and continuing your yoga practice for years to come.

The very common Forward Fold movement puts stress on the hamstrings, sciatic nerves, and low back.

When you go to your end range of motion, you’re putting HIGH stress on the low back because your spine is rounded forward with your upper body weight pulling your spine forward and down.  That doesn’t make the movement good or bad. But, it DOES mean that if you have a bigger low back problem, putting HIGH stress on it means risking bigger pains now or in the future.

Like any investment, your choice of range of motion is:

• how much risk you’re comfortable with?
• does the movement feel safe and pain-free?

When you have a disc problem, your hamstrings and back stretch for the first 0-90% of the movement.  What stops your movement at the bottom IS NOT these muscles coming to their end ranges but your disc putting the brakes on the motion.

Simply, you can avoid the last 10% of your range of motion to avoid engaging the disc problem.

If you really want to play it safe, keep your spine neutral, like you would if you were doing a Good Morning exercise. Doing the forward fold like this has the added benefit of strengthening your low back much more than the Forward Fold will.

While the Forward Fold rounds (and flexes) the spine forward, Up-Dog does the opposite, arching (and extending) the spine backwards.

Up-Dog with full range of motion taxes the end range of hip and low back extension.

You can significantly lower the stress on your low back by doing Cobra Pose instead.

Or do a mini Cobra Pose to keep the stress in your butt and mid-to-upper back.

Rest assured. Sit or lay like a dog and the stress on your low back will be minimal.

When Will Yoga Make Your Back Pain Worse In The Future?

Yoga will make your joint problem and pains worse when as many of the following data points are true (in bold below):

You have a moderate-severe disc injury.

Evidence of disc injury includes:

• MRI confirmation.
• Low back stiffness getting out of bed in the morning or when getting up from sitting.
• At least one severe episode of LBP that lasted more than 7 days anytime in the past.
• Pain in the middle of the range of motion in the Touch Your Toes Test.
• Slowness (like the body is saying “Whoa, slow down buddy, I’m injured, be cautious”) in the Touch Your Toes Test.

If you have a mild disc injury and decide you want to try yoga for back pain, then avoid the end ranges of motion.

Avoid the last 10-20% of any low back rounding movements as shown in the images above.

Don’t get me wrong – any lumbar flexion or extension outside of a neutral spine has at least a small amount of stress to your low back.  Even keeping a neutral spine and leaning your torso over has a small risk of re-injury.  But, you can try it safely, a little bit at a time, if you’re mindful how you feel up to 3 days after your yoga session.

If you have any increased stiffness or pain outside of your baseline level of stiffness/pain up to 3 days, you know you overdid it.

You have tight hamstrings that have not gotten better with 30 days of stretching or yoga.

If your hamstrings haven’t gotten any more flexible as evidence by the Touch Your Toes Test, then you probably have a:

• sciatic nerve problem … or a …
• disc problem.

You can confirm that you have one of these problems with the Hamstring Stretch Test seen below.

Do not continue doing yoga if you have one of these problems unless you get it fixed by someone who knows what they’re doing.

Do You Want Pain Relief, Now?

Imagine you have a screw.

If someone said to you:

I’m going to grab whatever I find … A hammer… A wrench …  A level …. to screw the screw in.

You’d look at them like they’re crazy!

When it comes to back pain (or any pain really), it’s vital that you have a list of your diagnoses.

Without the list of your diagnoses, it’s like the crazy person choosing a random tool.  Sure, that crazy person might be able to figure out how to screw the screw with the hammer in some weird way, but it would take ridiculous effort and way more time. Wouldn’t you want to get a screwdriver, screw it in 10 seconds and be done with it?

Same problem – same solution – with the nail and the hammer!

The list looks like something under “Musculoskeletal Dx” in the video below, where each piece of the puzzle can be addressed separately and with the right tool.

A hammer for a nail. A screwdriver for a screw. A wrench for a nut.

If you’re not able to diagnose and provide the proper solutions for the problems in your diagnosis yourself, I recommend you find an Integrative Diagnosis provider. They’re the best in the world at fixing pain, conservatively.

If you live in North Jersey and want the best shot at fixing your back pain, with our without yoga, give us a call at Barefoot Rehab. 862 – 205 – 4847.

What has your experience been with yoga for back pain? Has yoga helped your back pain? Has it made your back pain worse?