Yoga and Back Pain

Dr. Swami Karmananda Saraswati, MB, BS (Syd)

Backache is one of the most common disorders in our communities today. Every year in the United States alone an estimated two million new members join the ranks of the multitude of sufferers from chronic back pain, while in the United Kingdom the syndrome is second only to bouts of respiratory disease (colds, flu, bronchitis, etc.) as the leading cause of lost man hours in trade and industry. It is estimated that between 50 and 60% of the population will suffer from an incident of acute or more long term back pain at some stage of life.

In spite of the magnitude of the problem, a simple, effective cure for backache has proved elusive to modern medical science. For this reason, most doctors lack confidence in treating backache patients effectively with therapy often becoming a long, drawn out and frustrating affair for doctor and patient alike. As a result, the attitude of the chronic back sufferer is commonly a fatalistic and resigned acceptance of this painful condition - 'till death do us part'.

However, our experience is that this need not be the case, for yoga offers a simple, effective and permanent cure for this troublesome condition. Many chronic back pain sufferers who have resigned themselves to a life of pain after a diagnosis of incurable spinal degeneration or osteoarthritis can be readily liberated from their problem, and from later recurrences, after a few days or weeks upon adopting a simple daily yoga program. Furthermore, the small percentage of patients (perhaps 5%), who are actually found upon X-ray examination to be suffering from prolapse of an intervertebral disc, prove equally amenable to yoga therapy.

What causes backache?

This question is hotly debated in therapeutic circles. However, recent studies have shown that the vast majority of backaches are caused simply by muscular insufficiency and inadequate flexibility of muscles and tendons. This contradicts the popular prevailing belief that a high percentage of backache is caused by slipped disc, arthritis and degenerative joint disease, or organic conditions such as bone cancer, Paget's disease and rickets.

Research studies

In one study, conducted jointly by researchers from New York University and Columbia University, USA, an unselected sample of 5000 consecutive patients presenting complaints of backache to hospital casualty departments were followed up. It was found that in 8% of the cases, the back pain had no connection with herniated intervertebral disc, tumours or organic conditions of any kind. For over 4000 of the patients investigated, back pain arose simply from muscular strain as well as tendinous inflexibility.

A similar study, again of 5000 patients, conducted by Dr. W.D. Friedman of the LCD. Rehabilitation and Research Centre, USA, obtained almost identical results, concluding that in 4 out of 5 patients, acute back pain occurs simply because functional demand upon the back muscles exceeds their capacity.

Failure to recognise this is probably the major reason why back pain is so poorly treated at the present time.

The mechanism of common backache

The most common site for backache is the lower back, followed by the neck and the region between the shoulder blades. This pain arises when the muscles surrounding and supporting the spinal column are held rigidly and uncomfortably contracted over a long period of time. This situation commonly arises from long hours in uncomfortable car seats and office chairs. When this goes on day after day, the muscles gradually go into a state of tight painful spasm which becomes semi-permanent, as fibroblasts infiltrate the troublesome region, laying down fibrous tissues. These spasmed or fibrosed areas can be readily felt as deep hardened bands and nodules within the tender back muscles.

Chronic backache tends to be worse at days end and is relieved by massage, heat, relaxation and bed rest. It responds readily and permanently to a program of yoga asanas and relaxation aimed at increasing the functional capacity of the weak muscles.

Acute backache

Acute backache is usually a variation upon this theme. This is back pain of sudden onset and agonising severity, which renders the victim completely immobile and helpless. This pain can strike at any time, especially in those leading a sedentary lifestyle characterised by lack of exercise and overweight, both of which contribute to functional inadequacy of the back muscles. Acute back pain commonly arises after a trivial jolt or insignificant movement such as a cough or sneeze. Agonising pain accompanies every subsequent back movement, to such an extent that movement becomes almost impossible.

This is by no means a rare occurrence, for statistics suggest that between 50 and 60% of the population will suffer just such an incident at some time in their life.

When one is in this predicament, the first thing to do is to get into bed as soon as possible. The muscles surrounding the injured area quickly go into spasm to provide a protective immobilising splint, preventing all further movement of the area. By immediately getting into bed, the body demands are reduced and the muscles can safely relax a little.

In the acute situation this severe pain can be effectively relieved by aspirin. The bed should have a solid wooden supporting base underneath the mattress.

Application of heat to the affected area by fomentation or hot water bottle also brings relief. Stiffness can be avoided by gradually moving the position in bed from time to time. Alternatively, relief may be gained by applying a cold compress (ice blocks in a cloth are ideal) and some patients obtain best relief from alternating hot and cold compresses every few minutes. Gentle massage several times a day also facilitates recovery.

Ninety percent of cases of acute back pain will fully recover with a week of bed rest, with vast relief after a day or two. The problem then becomes one of preventing a recurrence and it is here that yoga proves of great benefit.

Yoga program to eliminate simple backache

These asanas should be practised for 15 to 20 minutes each morning without fail, followed by 10 or 15 minutes in shavasana. This program is specifically designed to increase the functional efficiency of the various muscle groups responsible for back pain, and should be learned under expert guidance:

  1. For lower back muscles: ardha shalabhasana, shalabhasana (locust posture), ushtrasana (camel posture), makarasana (crocodile posture).
  2. For shoulders and upper back muscles: dwikonasana (double angle pose), sarpasana, bhujangasana (cobra posture), majariasana (cat posture).
  3. Relaxation in shavasana or advasana with visualisation of tight congested back muscles relaxing, letting go and flushing with fresh blood, as pranic energy is visualised flowing into the back muscles in conjunction with breath.

(Note: Full details and illustrations of these postures are contained in Asana Pranayama Mudra Bandha, a Bihar School of Yoga publication).

Dietary recommendations

Correction of back pain is facilitated when a light vegetarian diet is consumed and excess weight is removed. Correction of chronic constipation often brings spontaneous remission of back pain. In this respect the optimal diet consists of whole grains, roti or wholemeal bread, pulses, vegetables (steamed, boiled or salad), fruits, nuts and juices.

Avoid excessive sugar, milk and dairy products, oil, meat and spices.

Follow this program regularly for One month and then reassess the state of your back and general health. You will not recognise yourself- body and mind.