Backache

Dr. Swami Shankardevananda Saraswati

Backache and slipped disc are major problems in today's world, and as yet modern medicine can do very little to alleviate them. Many people are turning to yoga for an amazingly simple, yet effective, way to remove the intense and crippling pain of backache and sciatica, and to prevent their recurrence.

Backache

Probably the most important cause of backache is tension. In today's fast moving world most people find that they are being threatened by their environment and job situations. This tense state of mind causes tightness in the neck, shoulders and back muscles. When we are threatened, we clench our teeth and raise our shoulders in a defensive manner. We close ourselves off from the environment, and this involves hunching our back and shoulders. This unconscious reflex must be corrected by awareness and relaxation.

Another reason for so many back problems in our modern world is the advent of furniture. Chairs and spring mattresses promote poor posture and induce weakness of the back muscles so that slipped disc and sciatica can occur. When you sit in a chair you cannot maintain a straight and strong back for any period of time. This causes our neck and shoulder muscles to compensate for the poor posture by tightening up to prevent us from slouching excessively.

A strong spine is necessary for health. Yoga postures promote a straight and relaxed spinal cord. This allows the prana to flow freely and the nerve currents to move unhindered. Yogasanas such as makrasana, bhujangasana and dhanurasana strengthen the spine and back. Sitting in a cross-legged pose, such as sukhasana, siddhasna or padmasana, keeps the back straight and is of great benefit to all those suffering from back pain and sciatica.

Cause of backache

The major causes of backache today are:

  1. Injury from twisting, lifting or crushing.
  2. Degeneration of the back resulting from congenital or acquired causes or to lumbar spondylosis.
  3. Spinal disease in the form of inflammation, tumours or Paget's disease of the bone.
  4. Fevers such as influenza or abdominal disorders of the stomach, duodenum, pancreas or urogenital tract.
  5. Idiopathic (unknown cause) such as fibrositis, myofasciitis, sacroiliac strain, etc.

Slipped disc

This common occurrence is the main cause of backache. The disc lies between the bony spinal vertebrae and is composed of a fibrous ring of tissue called the annulus which contains a fluid called the nucleus pulposus. The disc supports the vertebrae and allows movement of the spine to take place. Slipped disc is caused by prolapse of the disc substance. Either the annulus or the nucleus slips out of its normal position. It can then press on the spinal cord causing backache, or on the nerve roots causing backache and/or sciatica (pain starting in the buttocks and shooting down into the back of the legs). Prolapse is usually below or above the fifth lumbar vertebra, at the level of the waist. It is accompanied by swelling which makes the symptoms worse; this generally subsides with time, allowing the disc to slip back into place. If the swelling is severe, the disc many remain prolapsed, interfering with the functions of the spinal cord and the mechanics of the joints of the vertebrae. This causes permanent weakening of the disc and if it has gone back into place, it may slip again due to the slightest strain or provocation, unless strengthened through yoga and revitalised with prana.

Slipped disc is usually due to strain caused by lifting with the back bent, thus tearing a ligament along the vertebrae. Incorrect movement is therefore the main cause. When you lift anything, the back should be straight with the knees bent. Use the power of the legs and hips rather than the back. Slipped disc is also caused by an increase in pressure inside the annulus from the absorption of fluid, or the degeneration of the ligaments due to old age or ill health.

The first symptom of slipped disc is a sudden onset of intense pain, though the pain may be slight at first and increase with time. The patient may be fixed in the forward bending posture with backache and/or sciatica. Subsequent attacks can also come suddenly and often follow a trivial event such as coughing or slight straining. The pain is made worse by straining or stooping.

Medical treatment

Medical treatment consists of applying heat to the area, analgesics for the pain, and exercise to strengthen the muscles. To treat the prolapse itself, medical science has three possibilities.

  1. Rest on a hard bed, made by placing boards beneath a thin mattress. (This is the type of bed used in the ashram.) If it is a severe attack, the patient should stay in bed for three weeks. For less severe attacks a special corset can be made, and for minor attacks the patient is asked to avoid stooping or lifting.
  2. Reduction by traction or manipulation can be applied to open the disc space allowing the prolapse to move back into place. This also lessens pain. Manipulation is a valuable tool in the right hands, but is usually avoided if there is sciatica. Alternatively, to reduce pain, local anaesthetic can be injected.
  3. Removal by operative techniques has an eighty per cent success rate. It is only suggested by the doctor if the attacks are severe, recurrent, disabling and persistent despite other forms of treatment. This may leave the patient permanently disabled, perhaps with a fused spine, and should be avoided unless other treatment has proved ineffective.

After medical treatment, rehabilitation involves education in lifting from the hips rather than the spine, and exercises (backward bending) to strengthen the muscles. These exercises are similar in many ways to yoga and restore suppleness and muscle power. Patients are advised to continue sleeping on a hard mattress.

Yoga treatment

Through the practice of yoga combined with medical expertise, the strength of your back will return, thus preventing further trouble. This is true preventative medicine. Backward bending asanas aid in the treatment of slipped disc and sciatica by exerting traction on the area, strengthening and loosening the muscles, releasing muscle spasm and freeing nerves which have been constricted. At the same time they supply prana to the affected area.

The following three postures should be practiced regularly with awareness and relaxation for the relief and cure of all back problems: makrasanna, the crocodile pose; bhujangasana, the cobra pose; and dhanurasana, the bow pose. There are many other backward bending asanas which can also be used to strengthen the back, for example: sarpasana, the snake pose; shalabhasana, the locust pose; ushtrasana, the camel pose; supta vajrasana, the sleeping thunderbolt pose; chakrasana, the wheel pose; and ardha matsyendrasana, the half spinal twist. All these postures offer the same benefits for back problems. However, a few poses done well and practised regularly are far better than many poses performed quickly without awareness and relaxation. All the above-mentioned asanas can be found in Asana Pranayama Mudra Bandha, published by the Bihar School of Yoga.

While you have back pain or sciatica do not bend forward or do any forward bending poses. These will come later when your back is stronger and free of pain. In order to strengthen your back as quickly as possible, use makrasana whenever you have a chance- while you are reading a book, watching TV, etc. This pose relaxes the whole body and eliminates pain. In this position be aware of those parts where you have felt pain and try to direct prana into that area. Imagine this prana as a golden, warm, tingling, flowing stream of force that revitalises and removes all dis-ease.

While doing any of the backward bending asanas, remember to feel into the spinal cord. Feel the vertebrae and discs moving, massaging the annulus and making it strong and firm. When these postures are practised as a supplement to medical treatment, the speed of cure and removal of symptoms is increased. In this way you will benefit from the best of both sciences- yoga and medicine.

Physical benefits of backward bending asanas

The vertebral column and the discs between the vertebrae are made strong and flexible. This ensures that the discs are maintained in the best possible health and do not become squashed or weakened, thus preventing slipped disc. Spinal deformities can be straightened out and posture corrected, e.g. rounded shoulders are eliminated.

The spinal cord is massaged. The nerves which emerge from the spinal canal can pass through the vertebrae unimpeded. If regular exercise is not done, it is possible for the vertebrae or a disc to move out of position and impinge on a spinal nerve, thus preventing the flow of vital nerve currents. Backward bending asanas also increase the blood flow into the spinal cord ensuring a good supply of nutrients. This is done by squeezing the blood out during the asana, so that on relaxing the pose, new blood washes the impurities from a usually sluggish venous system. This encourages maximal function in the nerves and thus affects the health of the whole body.

The autonomic nervous system is rebalanced and toned up by the action of the blood supply and the massaging effects.

The back muscles are strengthened and nourished by the increased flow of blood. Backache is quickly and easily removed. Posture is readjusted and corrected, removing spinal deformities. Backache will be removed by relaxing tense muscles, releasing compression of the spinal nerves and removing general body fatigue.

Slipped disc can be eliminated by the traction created, but it is preferable to have a teacher to help you with these asanas, at least the first few times.

Rheumatism and other causes of backache are prevented and removed by the action of these asanas on the joints of the spine and the rest of the body. This maintains flexibility and efficiency in the whole musculo-skeletal system.

The whole body is made healthy through these powerful asanas. The abdominal organs are massaged and manipura chakra, the pranic centre of the body, is stimulated and rebalanced. The lungs are fully inflated and massaged, cleaned and stretched. The heart is stimulated and cleansed. The blood is purified more efficiently by the lungs, kidneys and liver. The brain benefits from an increased amount of blood. Massage of the spinal cord also improves brain function. When the spinal cord and brain are relaxed and the whole body is toned up, back problems are eliminated.

Effects on Prana

Backward bending asanas increase prana by acting on the spinal cord and the solar plexus. These physical manifestations of the most important areas of prana are revitalised, unclogged and cleaned out. The spinal cord is the vehicle for sushumna, the central nadi of the body. It is the vehicle for the autonomic nervous system, the physical manifestation of the ida and pingala nadis. The solar plexus is the physical manifestation of the manipura chakra where prana is generated, stored and distributed. When prana is generated from the solar plexus, the back remains naturally straight as the flow of energy in the spine is like a rod, supporting the vertebrae and flowing into all parts of the body, maintaining good health and preventing disease. Thus it can be seen how valuable a tool yoga is in co-operation with modern medicine and healing systems in general.

The spiritual side

When you are crippled by back pain or slipped disc, how can you help your fellow man? Instead you must be helped to regain your health and vitality. When the body and mind function as a harmonious unit and prana flows freely, psychic centres open up. These are the chakras located in the spinal cord. But if you have spinal trouble or back pain, it is not possible to open these centres in a healthy manner. First the spine must become strong and straight, and the mind healthy. Only then can you reach the higher levels of awareness that are the birthright of everyone.