How to fix your chronic lower back pain
Or lower back pain 101: Learn to manage it before it manages you
(Post one of eight)
As a traveling physical therapist, I tend to see many patients with complicated issues related to their pain. Furthermore, those issues tends to be chronic in nature. If you think of chronic complex pain you’re probably picturing someone with lower back pain, amirite?
Sure you are, because lower back pain is the quintessential hallmark of chronic and complex pain. If you have dealt with lower back pain, then you are part of the 3 million that suffer from it each year. In fact, half of all working Americans have reported a case of lower back pain. So, how can we avoid this ailment so many people stricken by?
A VERY short list of treatments that may help (incredibly non-comprehensive because even I learn new ways to manage this pain almost daily)
- Physical Therapy
- Trigger point inj. from a Physiatrist, Orthopedist, Pain mgmt., or Neurologist
- Chiropractic manipulation
- Massage Therapy
Today’s post will focus on yoga. Yoga has been around for anywhere between 5,000 to 10,000 years, but has built up quite a bit of a following for some time. Nowadays you can’t throw a rock without hitting a yoga studio, a gym that offers yoga, or a park where people are participating in the practice that promotes healthy stretching.
Of course yoga is much more than stretching. Yes, some yogis tie themselves up into pretzels- but there is much more to it than that.
In the case of lower back pain, yoga is great because of the three benefits that are paramount with this ancient Indian practice. We already covered stretching, but that is definitely a big number one. Being less active nowadays than humankind had been in the past leaves us with certain predictable patterns of tightness that has been linked to problems such as lower back pain (see lower cross syndrome picture below) Yoga focuses on stretching your joints in a safe manner to remove these impairments. What would be an unsafe manner? Ballistic stretching. This means bouncing into a stretch. Was there a gym teacher that didn’t teach this?
The second big (huge) benefit to lower back pain with yoga is the static stability gain in performing the poses. When we have lower back pain, our stabilizing muscles shut down causing sheering at our spine and compensation with other muscle groups. The trick to bringing back the stability is by starting with a safe static position and maintaining balance. Balance is going to be grouped into the category of stability for this reason. By balancing, you are forcing your body to wake up the muscles that keep your spine strong and rigid (as in not sheering as opposed to inflexible). If balancing is painful, you’re doing it wrong. Find a way to make it easier and go from there.
Lastly, and possibly my favorite reason yoga is a home-run in the back pain management world, is the importance it places on breathing. Deep breathing promotes relaxation of increased muscle tone (see: knots and trigger points), releases natural waste like carbon dioxide while increasing oxygen to cells, slows your heart rate and lowers your blood pressure, better blood flow to muscles, and the list goes on and on. Breathing is a necessary for life- but we usually do it incorrectly. Or at the very least, we do it inefficiently.
The diaphragm is a primary muscle responsible for breathing, but is rarely used for it. When we diaphragmatically breathe, we are expanding our belly with air through our nose and out through our mouth. The importance of this beyond yoga is that the diaphragm is also one of the key players in lumbar spinal stability. The diaphragm (along with the pelvic floor, transversus abdominus, and lumbar multifidii) makes up a portion of our intraabdominal pressure creators causing spinal stability. Here is a simple trick to help you breath properly.
- Lie on the floor with both knees bent and your feet flat. Place one hand over your chest and the other on your belly. Take a breath in. Which hand moved first? Was it the one over your belly? Congrats! If not, try it again and imagine inflating a balloon in your belly. Did you get it this time? Of course you did! Repeat this 5 more times- don’t you already feel a little better?
Ok, so now you know the first thing about yoga and how it helps your back. A little addendum, I wouldn’t wait until you have pain to start, the long term and short term benefits can be made starting right now. Right now? Yep! Right now. Some yoga classes could last an hour, but I love my yoga quickies. Here’s a list of some good youtube videos for yoga in a rush.
5 minute yoga with Tara Stiles: https://www.youtube.com/watch?v=khDyWeZGb4w
10 minute yoga from BoHo Beautiful: https://www.youtube.com/watch?v=LnIC7dFeGO0
15 minute yoga from PsycheTruth: https://www.youtube.com/watch?v=2_SE2gQwXoo
30 minute yoga from Yoga by Candace: https://www.youtube.com/watch?v=gQqE3tm7TjI
60 minute yoga from Yoga Upload: https://www.youtube.com/watch?v=d9SpulbEJmU
Yoga for lower back pain from YogaTX: https://www.youtube.com/watch?v=pyFNz8zJSdw
On a side note, these videos are good and the people seem to know what they’re talking about- however, nothing beats having someone trained observing you and how you perform to make sure you do minimal damage in your downward facing dog. There are many skilled healthcare workers and yoga trainers who run classes to help you in your journey to a pain-free existence.
Well, that’s one topic down- any questions or comments? Did I skip an important complimentary/alternative treatment to lower back pain mgmt.?
Dr. Daniel Davids PT