More Teaching Notes: Yoga for Low Back Pain

Ensure Optimum Approach with Abdominals

The abdominals are one of your only significant lines of defense against wear on the lumbar disks. They offer protection in two ways: by limiting excessive rotation of the lumbar spine and by controlling the tilt of the pelvis and, thus, the curve of the spine… Most of the popular ab exercises—curls, crunches, and sit-ups—target the rectus abdominis, but this does little to support and stabilize the spine. When overdeveloped, this pair of muscles pulls down on the rib cage, rounding the upper back and creating tension in the shoulders, upper back and neck. This imbalance can compromise the action of the other abdominal muscles—the ones we need in order to maintain a healthy back. – Doug Keller

Encourage Movement

Independent of the effect on individual muscles, asana movements help back pain by improving the circulation that brings nutrients to the intervertebral disks while removing toxins. Gelatinous shock absorbers that cushion vertebrae that are adjacent to each other, the disks don’t have their own independent blood supply, and thus depend on movement of surrounding structures to aid in the delivery of nutrients. Movement causes the disks to be compressed, which squeezes out stale disk fluid, and then to expand, bringing a fresh supply. – Timothy McCall, MD

Be Mindful of Release Valves

Both the upper back and the pelvis can function as release valves for the lower back. It is important to remember that, when we work to flatten the lumbar curve in forward bending, there is a tendency to increase the thoracic curve. If we keep the chest lifted and the upper back flat, we must then watch for the tendency to move from the hips, increasing stress to the lumbar/sacral junction. If the hips are loose, we have to block the forward rotation of the pelvis to assure the low back will be stretched. – Gary Kraftsow

Encourage Addressing Cause of Pain

This is written for the student:

Keep in mind when evaluating your therapeutic options that most cases resolve in six to eight weeks, pretty much no matter what you do. Even with herniated disks, the overwhelming majority of people recover without an operation… A yoga therapist or bodyworker may be able to figure out what set you up for back trouble in the first place, by examining factors like posture, your emotions, and your work and living environment. Failure to address these issues is another reason back surgery is less successful than it might be and why many surgical patients wind up needing a second or third operation to address problems that develop at another level of the spine. – Timothy McCall