Is yoga good for back pain?

The short answer to this question is yes.

Feel free to stop reading right here, because, unfortunately, the longer answer is more nuanced.

That’s because each person with back pain is completely different from any other. And every yoga teacher or class is different. What that means is that there’s no universal answer about yoga and back pain. It all depends.

What I believe is that any type of movement you do that you’re paying attention to is almost invariably beneficial. Yoga, when it’s properly taught, is a prime example of this attitude toward movement. Your attention is focused on your body’s experience as you’re moving.

you engage in yoga (or any movement experience) with this attitude, you practically can’t go wrong. If you’re paying attention to your own bodily experience, it’s much harder to do yourself harm.

It’s not impossible to mess yourself up, though, so I’ve listed a few precautions later in this article.

Favorable research results on yoga postures for back pain

A research study from the Annals of Internal Medicine in December, 2005 showed how effective yoga could be for back pain patients. The researchers enrolled one third of the patients in yoga classes (viniyoga). A second group was enrolled in “standard physical therapy” exercise classes for back pain, and a third group was handed a book on low back self care.

The group taking yoga fared better than the other two groups.

Here are my recommendations:

• If you have back pain, consider finding a top notch yoga teacher in your area.
• Take a private lesson or two to acquaint yourself with the teacher’s approach and to give her or him a chance to understand your body and its limitations too.
• Your teacher can then suggest a class that will be appropriate for your spine and your level of yoga experience.

Potential injury precautions

In 2009, the International Journal of Yoga Therapy published the results of a yoga-teacher survey about yoga-related injuries. Though the injury rate from yoga was quite low, low back injuries were among the most common types of injury.

Yoga teachers felt that some of the most important contributors to injury were:

• Overzealous, too-intense practice
• Poor body alignment
• Improper or insufficient instruction

Low back injuries in particular were associated with forward bending poses, especially poses that combined forward-bending with rotation.

My recommendations:

These are based on my own experiences with patients, my understanding of body mechanics, and my biases.

• Don’t work too hard to try to achieve an external standard of achievement. Pay attention to your own body, accept its limitations, and experience the challenges of each pose as it relates to you. A good teacher will reinforce this appropriate attitude.
• Poses that involve repeated or prolonged forward bending can put a strain on the intervertebral disks. If your low back is aching, don’t assume that stretching it will help. That can backfire.
• A lot of yoga classes emphasize repeatedly assuming a downward dog posture. That’s not necessarily a problem (some of my best friends are downward-facing dogs.) But supporting your body weight on your hands can place a strain on your wrists. Pay attention.
• I’ve seen some yoga classes in which there was an undue emphasis on pulling your shoulder blades back as if they could touch together behind you. I suppose this constitutes a well-meaning attempt to compensate for poor posture. But in my opinion it’s the wrong way to go about it.
• I’m not keen on bikram yoga, or other yoga classes taught in a heated room. Maybe if you’re under thirty.
• Every good yoga teacher should have the capacity to accommodate to an individual student’s limitations on the fly. This could mean providing appropriate props or supports, giving individualized instruction on a particular pose, or suggesting alternative poses.

The core principles of yoga – balance, core support, spinal flexibility, strength, relaxation, and body awareness – are all valuable goals for anyone seeking relief from low back pain and a healthier life.  Yoga classes can be a key part of your pathway to improved health.

Dr. Lavine has been an innovator in the use of movement and touch to promote health since 1981. He practices in New York City and Princeton, NJ.