Yoga for Low Back Pain

Yoga can be very effective for low back pain, but to get good results it is important to understand some basic things about yoga anatomy, posture, and movement.

 

Many people including yoga teachers think that forward bends are beneficial for lumbar pain, but in many cases this can make the pain worse.

 

The problem with forward bends is that they tend to create more rounding in the low back, rather than strengthen the back muscles and support the natural curvature and arch in the low back. 

Lordosis in the lumbar spine.

Natural

lordotic curve

Notice how in the pictures below the low back is rounding out and up.
Standing forward bends can injure the low back.
Cobbler pose stretches the hips, groin, and low back.
Too much forward bending can increase or even cause low back pain.

What causes Low Back Pain, and how can I fix it with yoga?

Herniated discs are a common cause of low back pain

We've all heard the old adage about bending your knees when you pick up something heavy. Doing this protects your back. If you don't bend your knees and pick up something heavy, it places extra strain on the back. This can pull muscles, damage soft tissues, and even injure the discs. Similarly, chronic bending forward such as can occur with excessive sitting and working can weaken, strain, and damage the low back.

Low back pain may also result from injuries, trauma, degeneration, poor posture, stenosis, herniated discs, pinched nerves, arthritis, inflammation, and more. 

Bridge pose for Low back Pain

Bridge pose is a fantastic asana for many cases of low back pain because it's a gentle backbend that strengthens the back and supports the lordotic curve.

 

I use bridge as one of the primary poses I teach to my clients. I even suggest it to most of my patients with severe conditions like herniated discs and sciatica.  

The bridge pose is a gentle back bend.

Cat cow pose & Low Back Pain

Flexing and Extending the Spine in Cat Cow

Cat cow pose is good for older adults.

In cat pose the spine

is in flexion.

Cat cow pose is often suggested in yoga as a good exercise for low back pain. This can be a great pose for lumbar pain because it takes the spine through movements known as flexion and extension. When you do cat, such as seen in the image, it flexes the spine. However, when you do cow it moves the spine through extension. Doing these movements together creates good balance between flexion and extension of the back and spine.  

Since the knees are bent in this pose it also reduces strain in the low back. Forward bends with straight knees such as the standing or seated forward bends can place a lot of strain in the low back.​ For this reason, I often don't suggest forward bends for low back pain, unless it's a pose with bent knees. Bending the knees protects the back.

Pelvic Tilts and Low Back Pain

Anterior and posterior pelvic tilts may cause low back pain.

When you have low back pain it is important to consider the pelvis and hips. Many cases of lumbar pain result from problems in the pelvis such as anterior or posterior pelvic tilts. Lateral tilts in the pelvis can also contribute to back pain.   

With anterior pelvic tilts the arch of the low back will move forward and make the lordotic curve more pronounced. This will also tighten the erector spinae, rectus femoris, and iliopsoas muscles. 

In posterior pelvic tilts the glutes, hamstrings and abdominal muscles will get tight, and the low back will look flat. The image of the X-ray shows a flat back resulting from a posterior tilt. 

Both anterior and posterior pelvic tilts can cause low back pain, but different yoga poses will be necessary depending on what condition the person has. A simple pose like cat cow that moves through both flexion and extension can benefit both of these conditions. Bridge pose is also good for both disorders because of the way it moves the pelvis.

Myofascial lines and Pressure Points

The images show the myofascial line in the back of the body known as the Superficial Back Line (SBL), and the bladder meridian from Chinese medicine. The points in the ankles and calf are pressure points that can help low back and neck pain.

In my online classes I teach how to use various pressure points for low back pain, and how to stimulate the points in yoga poses. For instance, in down dog these points get stretched, as does the whole SBL and bladder meridian. Down dog is also a very good pose for low back pain because it stretches the SBL, but does not strain the back like forward bends do. Down dog can also be useful for decompressing the discs between the vertebrae, and can help with pinched nerves and sciatica.  

Acupuncture meridians are similar to myofascial lines. The urinary bladder meridian is similar to the superficial back line.

Pressure points may be stimulated through poses, acupressure, modifications, movements, and more.

Myofascial Lines, Meridians, and Yin Yoga

The superfical front line looks like the stomach meridian. The lateral line is like the gallbladder meridian.

The above images show three of the myofascial lines. On the left is the Superficial Back Line (SBL), in the middle the Superficial Front Line (SFL), and on the right the Lateral Line (LL). A myofascial line consists of muscles and fascia that have similar structural and functional roles. These are essential to know about for yoga therapy, yin yoga, manual therapies, acupressure, and acupuncture. These lines also look very similar to the bladder meridian, stomach meridian, and gallbladder meridian.

 

Each of these lines or meridians also contain many pressure points that we can use in our yoga practice.  

Points in the achilles tendon, calves, and hamstrings can be very effective for getting rid of low back pain, but simply stretching these points is usually not enough. Applying pressure and pose modifications can greatly assist in working with the acupressure points. 

When yoga is combined with self-massage and acupressure very effective results can be realized. 

Side bends, the Lateral Line & GB Meridian
SIde bends are good for older adults with low back pain.

Lateral bends are very important to include in a yoga practice for back pain. They stretch the lateral line from the neck muscles, to the ribcage, glutes, and IT band. 

One function of the lateral line is to integrative and harmonize the actions of the back and front lines. Since the LL is in the middle of the SBL and SFL it helps coordinate activity between the forward movements of the front line, and the extensions in the hips, back and neck. 

Points on the IT band are often good for back and hip pain. The IT band is also a popular place to use myofascial release rollers in yoga practice. By massaging the upper thigh and IT band with foam rollers, it can help to release tension that builds up in this line from the low back. 

 

Pressure points on the IT band and Lateral Line
LL Final Red Tung & Fascia Lines_edited.jpg

 When back and hip pain occur together it is very common that the points shown in the image get very tight and painful. Massage, acupuncture, and foam rollers can all help to reduce tension here and stop lumbar-hip pain. 

Yoga poses for the IT band, and lateral line in general, are also beneficial for releasing tension from the back and hips. By doing self-massage in yoga poses we can see additional benefits. While many people like to use foam rollers, I often prefer to use my own hands, since you can't use rollers in all the yoga poses. However, every pose allows us the opportunity to apply acupressure, modifications, and movements.

 

Since the whole lateral line is affected by pressure anywhere within it, points on the legs are even beneficial for the head and neck. In my classes I go into great detail about how to stimulate these points in a variety of ways for neck, shoulder, and back pain.

Masgter Tung's points - Thigh Nine Miles Three is related to the acupuncture points GB 31.

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