What Really Works for Back Pain

It is easy to prescribe a given set of asanas for back pain. In reality there is practically no one sequence or given set of asanas that works for everyone. There is no one cause for back pain and every body is different. There may be some conditions, such as spinal fractures, that will be aggravated by yoga. Here are some practical and realistic steps for back pain that I share when consulted by yoga teachers and therapists.

Back pain is probably the most common issue I have encountered in teaching yoga and yoga therapy. First, it helps to know what is causing the back pain. Yoga may be indicated as possible therapy. Then we go through some asanas that may be helpful after taking into account the person’s physical limitations and medical history.

However, even after numerous tests, often the cause for pain is not determined. The pain can be debilitating. In this case, it is helpful to first go through various movements to help determine where the pain is located, what movements and angles make it worse or act as triggers, and then how it radiates into other parts of the body.

People that I encounter are in no position to do sirshasana (head stand), sarvangasana (shoulder stand), dhanurasana (bow), shalabhasana (locust), bhujanagasana (cobra), or matsyasana (fish). They cannot even walk or sit without pain. In fact, if the pain is due to a compression of the discs/vertebrae in the small of the back, many of these asanas aggravate the pain as they seem to cause further compression because of the pelvic tilt in those bodies. They need forward bends.

What is helpful is relaxing the body and muscles that have often become tense in response to the pain. A short breathing practice is very useful. Then begin with range-of-motion type asana movements, doing several repetitions with the breath to loosen the joints and muscles. Some suggestions are leg lifts (one leg keeping the other leg bent and never with both legs together), arm lifts, cycling (one leg at a time, keeping the other leg bent), rowing, grinding, titali also known as baddhakonasana (butterfly or bound angle pose), simple abdominal twists, nose-to-knee pose (keeping the opposite leg bent), and side bends. Many of these simple movements can be found on www.mahasriyoga.com/asana/index. Once the body gets comfortable with repetitions, then try holding positions.

After several days of the range-of-motion movements, move on to  tadasana (known as both tree and mountain pose), marjariasana (cat), shashankhasana also known as balasana (hare’s or child’s pose), followed by modified bhujangasana (cobra) often called the sphinx, and parvatasana also known as adhomukh svanasana  (mountain pose also known as downward dog), and setu bandha (bridge pose). Many of these can be easily modified for the chair. Add vyagharasana (tiger pose) to strengthen the back.

Once a comfort level has been achieved with those asanas, move on to surya namaskars (sun salutations).  For chair sun salutations visit www.mahasriyoga.com/asana/chair. Forward bends such as janusirshasana (figure 4 pose) can also be added.

A gentle and steady progression is suggested as I have found that to be the most effective. If there is a sharp pain, a pulling or any burning sensation, stop that movement. Often, many adjustments are necessary to deal with the pain and to accommodate various medical conditions. A good yoga therapist is necessary for those who require modifications.

Yoga Nidras can be very helpful in managing pain.