Oh, My Aching Back

Swami Mantramurti Saraswati

One of the most common physical problems today, especially in the West, is backache. Each year in the United States alone some two million people join the long list of chronic backache sufferers. If we project this figure on to the world's population, the enormity of the problem becomes staggering.

The attitude that 'once a sufferer always a sufferer'. This, however, is limply not true in the overwhelming majority of cases. It has come to the awareness of many that there are a number of ways to prevent, alleviate and cure backache complaint!, including yoga, manipulation, acupuncture, physical therapies, and simple exercise. Recent studies have shown that more often than not backaches are simply caused by muscular insufficiency and inadequate flexibility of muscles and tendons, The results of these studies have gone against the prevailing notion about the cause of backache. The medical profession has held that a large percentage of backache was caused by slipped disc, arthritis and organic conditions, but research carried out by a combined medical group from New York University and Columbia University has helped to change this view. The researchers studied five thousand consecutive patients with backache examining every back pain patient coming to these universities until the total reached five thousand. It was an unselected sample, which means that the results should apply to the general population rather than to any particular group. In eighty one percent of the cases the back pain was found to have nothing to do with herniated intervertebral disc, tumours or organic conditions of any kind. For over four thousand patients, suffering was related simply, if agonizingly, to muscular insufficiency and inadequate flexibility of muscles and tendons, Dr. W.D. Friedman of the I.C.D. Rehabilitation and Research Center makes the same claim based on his experience with another five thousand backache patients.

To those who have resigned themselves to being a backache victim, this is good news, as there are obvious ways to deal with the problem of muscular insufficiency and inflexibility. In many cases the benefits of yoga cannot be overemphasized. First, however, one must overcome acute backache and the crippling pain that so often accompanies it.

Treatment for Acute Backache

Acute backache may strike at any time. All that is needed is a sudden jolt or movement and immediately the back hurts every time you move - if you can move at all. In these eases what you need is professional help and if none is available the first thing to do is to get into bed as quickly as possible. The muscle spasm has provided a painful warning that something is wrong and movement should be limited. It is also meant to be protective, to splint the affected area and prevent aggravated motion. By getting into bed you reduce the demands on the body and the muscles can relax a bit. If the pain is extreme take two aspirins. Aspirin's pain relieving effect and anti-inflammatory qualities are often useful for back ache. Continued use, however, can have a harmful effect on one's kidneys.

Remember that the spasm which led to pain will increase at the pain increases. It becomes a vicious cycle as one increases the other, so the earlier this cycle is interrupted the better.

Apply heat for an hour, avoiding stiffness by gradually moving your position from time to time. Some people get quicker relief from cold compresses and others from alternating hot and cold every two minutes. Also have someone to gently massage you several times a day.

Once the back pain has been reduced, it is best to seek further professional advice and then start on a simple effective yoga program that can prevent any further occurrence of the backache as well as improving your general health.

Tests

Here are some simple tests for muscle weakness and inflexibility which you can perform to establish the best yoga program for you. Those people who do not meet the minimum test standards tend to have a high incidence of back pain. It it important to note that some who fail the tests may never have had back pain while others who pass the tests experience back pain. This stems from the fact that back pain due to muscular causes is a result of demand exceeding capacity. If there is little demand, extremely weak muscles may produce no trouble. On the other band, if the demand is great, the level of muscular strength must meet the demand and even someone with adequate strength for most occasions will experience pain if they cannot meet the demand. Therefore, caution should be exercised in any strenuous tasks.

In the tests, emphasis is placed on the stomach muscles. It has been found that in chronic backache, abdominal muscles are often less than one third as strong as back muscles. When abdominal muscles are weak, we change posture, leaning slightly forward and putting extra strain on our back muscles. Very often, strengthening the abdominal muscles has proved to be all that is necessary to eliminate backaches.

Before starting a yoga program for backache, it is important to find out where you have muscle weaknesses and what part of your body is inflexible. This knowledge should act as a guide to the type of yogic postures you should practice and also the ones you should avoid. The following tests will show you exactly where you need help. These tests meet minimum levels of muscular fitness. Follow the instructions exactly.

  • Test 1: hip flexing muscles
    Lie on the back, hands clasped behind the neck.
    Keeping the knees straight, legs together, lift the feet ten inches above the floor.
    Hold for ten seconds.
    If you can hold the position easily, then your hip flexing muscles have adequate strength. If not, then these muscles need to be strengthened and you have failed the test.
  • Test 2: abdominal and hip flexing muscles
    Lie on the back, hands clasped behind the neck. Have the feet held down and slowly sit up. If you can sit up, your abdominal muscles and hip flexing muscles have sufficient strength to handle your body weight. If not, you have failed the test.
  • Test 3: abdominal muscles
    Lie on the back, hands clasped behind the neck.
    With the knees bent and the feet held down to the floor, slowly sit up.
    In this test you eliminate the action of the hip flexing muscles and can therefore determine the strength of the abdominal muscles alone.
  • Test 4: upper back muscles
    Lie on the stomach with a pillow under the hips.
    Have the feet and buttocks held down.
    Clasp the hands behind the head and raise the elbows, then chin, then trunk off the floor.
    Hold for ten seconds to pass the test.
  • Test 5: lower back muscles
    Lie on the stomach with a pillow under the hips. Have the upper back and waist held down. Lift both legs, keeping the knees straight. Hold for ten seconds to pass the test.
  • Test 6: flexibility of back and hamstring muscles
    Keeping the legs straight, touch the fingertips to the floor. Failure to do so means inflexibility and tension of the back and hamstring muscles.

Remember: These tests meet minimum levels of muscular fitness only.

Yogic Treatment

Certain yogic postures are indicated according to the tests you may have failed. If these are practiced slowly with awareness and relaxation, the strength of your back is bound to return, thus preventing further backache. These practices result in true preventive medicine.

  • Test 1
    Failure indicates weak hip flexor muscles.
    Corrective practices: pawanmuktasana part II, variation to leg lock posture - do not interlock the fingers around the knees but keep the hands at the sides.
  • Tests 2 and 3
    Failure indicates weak hip flexor and abdominal muscles. Corrective postures: pawanmuktasana part II, naukasana, chakki chalana, dynamic form of paschimottanasana (done slowly), shashankasana, marjariasana, sit ups with knees bent and with knees straight.
  • Test 4
    Failure indicates weak upper back muscles.
    Corrective postures: Lie prone with a pillow under the hips.
    Raise one arm and then the other as high as possible. Raise both arms together.
    Makrasana, bhujangasana, sarpasana, tiryaka bhujangasana, marjariasana, Utthan prishthasana.
  • Test 5
    Failure indicates weak lower back muscles. Corrective postures: makrasana, ardha shalabhasana, shalabhasana, tiryaka bhujangasana, dwi konasana, marjariasana, Utthan prishthasana.
  • Test 6
    Failure indicates lack of flexibility of hamstring, back muscles and other structures.
    Corrective postures: knee bending and knee crank, straight leg raising, ankle bending and ankle rotation (stretch achilles tendon), leg lock posture, shashankasana, trikonasana series, samakonasana, utthita lolasana (done slowly).
Note: All these postures are fully described in Asana Pranayama Mudra Bandha, a BSY publication.