by Angélique Poulain and Emily Stewart
The information provided in this blog post is for guidance purposes only and does not substitute for professional medical advice. You should always consult a medical professional or healthcare provider if you’re seeking medical advice.
Chronic back pain is the leading cause of disability worldwide.(1) Acute back pain caused by sports injuries and unexpected events can cause physical, emotional, and social problems.
Finding relief and long-term care is pivotal to overall health, regardless of where pain occurs (lower, middle, or upper back). Can yoga help with chronic back pain? Here we investigate the causes of back pain and the relief certain yoga poses can provide.
Table of Contents
Practice doesn’t make perfect; practice makes flow.
And that’s what the new Discover Yoga Series on the adidas Training app is all about: bringing you to your flow state. Perfection doesn’t matter: whether you’re new to the practice or a seasoned yogi, our 8-week series puts you on the path to grace, mobility, and bliss. From pranayama to vinyasa, OM to namaste, our professional yoga instructor leads you through every pose. All you need is a mat, a sense of curiosity, and a desire to get stronger, from the inside out. Get your flow on!
What is Chronic Pain?
The experience of pain differs from person to person. When someone is injured, the pain is called “acute,” meaning that it happens at a particular moment in time to a specific region (and typically, quickly). Acute pain can also refer to severe pain.
Chronic pain is different from acute pain: it is uncomfortable daily irritation that might be difficult to “place” within the body. Chronic pain is also called “non-specific pain” or CP.
How Can I Identify My Back Pain?
“The back” is a general term that typically applies to the space from the base of the cervical spine (the neck) to the posterior superior iliac crest (the upper edge of the pelvis, where the spine inserts). Understanding and communicating where your pain occurs is key to determining the best yoga poses and styles.
Upper, Middle, and Lower Back Pain
Because all back muscles work together to keep you upright, pain in one region often extends to the other areas. Finding the original site of the pain can often help diagnose the cause.
Upper back pain typically occurs underneath the base of the neck to the mid or lower rib region. Pain can radiate up the neck and shoulders. Major muscles here include the trapezius, rhomboids, posterior deltoids, and scalene muscles.
Painful movements often include:
- Trunk rotation
- Spinal rotation
- Spinal extension (backbends)
- Spinal flexion (forward folds).
Middle back pain is usually experienced near the spine (medially), around the space where the lower ribs and diaphragm connect to the spine.
Muscles here include the spinal extensors, latissimus dorsi, and serratus anterior. Pain is often felt when breathing, reaching, and rotating.
Pain can radiate around the
- Rib cage
- Along the sides of the torso
- The heart (due to restricted breathing)
Lower back pain, also known as lumbago, is the most common type of chronic back pain. The lower back is the connection point between the upper and lower body, and the only structure supporting it is the spine. That’s a lot of work for one section of bone!
Muscles in this region include the quadratus lumborum, spinal extensors, iliopsoas (often called psoas), and obliques. Because the sartorius muscle originates in the lower back, it can also cause lower back pain.
Pain is usually felt during:
- Spinal flexion and extension
- While seated for long periods
- While moving (like walking)
Sciatica occurs when the sciatic nerve experiences pressure from nearby muscles and bones. Sciatica causes a pain that “shoots” from the lower back, through the hips, and into the lower extremities.
One other type of pain is unique to the back: herniated discs (also referred to as “slipped discs”). A herniated disc can occur over time due to daily spinal compression or patterned movement. It can also occur in an injury or accident. The initial pain could be chronic or acute; many people walk around with a herniated disc and don’t realize it!
Because bulging discs typically rupture on the back of the spine (i.e., they usually rupture outward and not inward), forward-folding yoga poses are contraindicated. Even if the disc ruptures inward, any disc compression could cause fluid to leak toward the organs. If you have a herniated disc, ask your doctor for approval and advice regarding a yoga practice.
The Victim Is Not The Criminal
Movement therapists often say, “the victim is not the criminal.” Meaning that where you feel pain is probably not what’s causing the pain. It’s likely related to an issue further down the kinetic chain that affects movement at the point where pain occurs.
For instance, ankle issues can cause knee pain. When one part of the body isn’t moving well, the rest has to compensate. If it can’t adapt or has to keep adapting for long periods of time, then pain can occur.
“Patterns of movement” refers to how we move subconsciously every day. When specific movement patterns are limited or restricted, then other parts of the body will suffer.
If you have lower back pain, watch how your knees move when walking and exercising. If they seem to be insecure, rotating, or asymmetrical, they could be affecting your sartorius muscle. The sartorius wraps around the pelvis and begins at the lower back. If your knees aren’t moving optimally, they could be causing pain deep in your lower back!
For this reason, mindfulness, patience, and non-judgment are vital in treating pain. Trying to “work out” an injury is useless if it’s related to an entirely different muscle. If you can treat the pain at the moment; that’s great! But unless the source of the pain is found, it will likely keep returning to different parts of the body.
Don’t just treat the symptoms, look to the cause!
What Causes Back Pain?
That IS the question! No, seriously, it’s tough to diagnose the cause of lower back pain because it is so often related to one’s general posture, patterns of movement, and lifestyle. Plus, pain is in the eye of the beholder; it’s difficult to explain!
Many people with chronic pain first notice it when exercising, like back pain when running. Unfortunately, this usually causes them to cease the exercise, creating less vitality, energy, and stiffness.
No one is immune from back pain. One study of German elite athletes revealed that 81% of them suffered back pain in any regular competition year.(2)
Unfortunately, back pain is often chronic. Most people who experience lower back pain say that the pain “comes and goes.” Even when they think the pain is gone, 20% of people have recurrent flare-ups at unexpected times. Therefore, most people with lower back pain cannot “cure it” but, rather, must manage it.(3)
Even in cases of acute back injury, like taking a brutal hit in a rugby game, the pain seems to last. That’s because back pain affects every part of life and movement. The spine is the body’s highway: it delivers the messages and fluids that keep us running, literally and figuratively. So many muscles originate within and attach to the spinal walls, ribs, and pelvis.
When the back is injured, the entire body has to find new movement patterns to compensate. Residual and related pain can occur for months, and even years, later. For this reason, holistic mind-body care is key. Like yoga!
Back Pain is Social
Chronic back pain is scientifically linked to one’s home life and workplace, which is one reason why scientists think that yoga for back pain relief helps. While the intricacies home-work-back connection is still under investigation, it is shown to affect back pain in two basic ways.
First, the stressors in families and workplaces seem to cause back pain in the individuals who experience them, especially if they are not practicing stress resiliency, self-management, and self-care.
Second, any treatment provided to sufferers in the clinical setting unravels when they return to the same emotional triggers in their home and work life. No matter how many hours of physical therapy, the symptoms may continue unless the emotional causes of back pain are addressed.
The truth is: To make your back feel better, you must make your life feel better.
Why Yoga For Back Pain Relief Works
Scientifically speaking, there’s still a lot of research to be done about why some people experience back pain relief when undertaking a regular yoga practice. Some studies show that yoga has no discernable physical impact on the actual sites of pain.
And yet, study after study shows that the perception of pain decreases when people practice yoga, and often more than people who practice other sports, educate themselves on their condition, and do nothing at all.
It seems that yoga is magic! There’s minimal quantifiable evidence of what changes, but participants express that something does significantly change for the better. Why? How?
The Mind-Body Connection
Scientists are intrigued by these questions: how does yoga build resiliency, and how does yoga impact mental health related to pain? Musculoskeletal pain (like back pain near the spine) is the leading contributor to disability globally(4). However, many people suffer from chronic back pain and are not registered as disabled.
Yoga decreases disability among those with severe lower back pain, and the hypothesis is that yoga builds resilience by teaching participants to tolerate discomfort without judgment or anger.(5)
It seems that yoga makes people feel better even when the point of pain remains unchanged. One study analyzed people with degenerative intervertebral discs. After 12 weeks of yoga, that group reported significantly less pain and anxiety. But only a few participants showed any physical change.(6)
Research demonstrates that yoga relaxes the sympathetic nervous system and the adrenal glands.(7) A calm nervous system causes pain to feel less intense (an aroused nervous system has the opposite effect).(8) So, yoga has a positive impact on mental health which contributes to decreased sensations of physical pain.
Yoga is also proven to mitigate pain within the physical body. One study compared people with chronic arm pain. They were asked to do yoga stretches with one arm only. The result? The “yoga arm” experienced less pain than the non-yoga arm!(9) Another study by the same authors compared yoga to basic stretching to eliminate back pain. They found no difference between the two types of intervention.
So, it’s not yoga that helps with back pain but stretching in general.(10) That’s great if you know stretches and don’t get bored doing them. Most people enjoy the mind-body connection offered in yoga flows, yoga classes, and under the tutelage of professional yoga instructors.
The Enjoyment Factor
Here’s the thing: while yoga isn’t proven to help with the physical symptoms of back pain more than other kinds of exercise, it is proven to be a more sustainable form of movement.
Participants in one study were more likely to adhere to their recommended yoga workouts than strength training workouts. And yoga participants were less likely to take off work for lower back pain than strength-training participants. Yoga feels good on more than one level, so participants are more likely to keep up their practice.(11)
When it comes to low back pain, movement is medicine. Whichever movement is the most enjoyable and sustainable is the ticket to relief!
The Psychology of Pain
Even the most athletic or anatomy-focused yoga classes usually feature small bits of philosophy: the interconnectedness of people, the bridging of mind and body, and the importance of self-reflection. Effective chronic pain interventions usually feature “education” on pain and self-management. They influence beliefs, help end catastrophic thoughts, encourage honesty around fear, and help those in pain pursue self-efficacy. Yoga naturally integrates these ideas into practice, which is why so many doctors recommend yoga for back pain relief.(12)
When Yoga Doesn’t Help
It’s important to note that yoga may be dangerous for some participants, like all types of exercise. One study showed that yoga increased lower back pain in some participants after six months of regular practice. However, increased back pain due to yoga was the same risk as other exercises.(13)
The takeaway: listen to your body! The participants in this study were required to continue practicing, no matter what, for scientific investigation. The participants should have been allowed to stop when their pain increased.
You are entitled to stop your practice when it doesn’t serve you. And since yoga teaches you to listen to your internal cues, it will tell you when you’ve had enough.(14)
Yoga Exercises for Back Pain
Now that you’re educated about back pain and why yoga helps, it’s time to dive into your practice! Below is a brief list of helpful yoga poses curated by Angélique Poulain. She’s the professional yogi you’ll see leading the adidas Training yoga program. Angélique offers even more yoga stretches for lower back on the adidas Training app. Get it here:
- Sphinx: a pose for upper back pain where the elbows are located under the shoulders and the torso is gently lifted. The ribs and hips are kept on the ground. It also helps lower back pain if lifting high off the ground hurts.
- Cobra pose: an intense version of sphinx pose, cobra involves laying on the ground and slightly contracting the belly button helps to not “fall” into an arch but brings some relief, especially in the lower spine.
- Spinal twists: spinal rotations conducted while laying down, sitting, or standing. Be sure to lengthen the spine before rotating so it’s an opening (rather than compression). Stand or sit tall, then twist!
Puppy: like child’s pose but easier on the knees and more stimulating for the thoracic spine. Keep the hips over the knees and reach the arms straight overhead with your chin resting on the ground.
- Happy baby: a lengthening pose for the lower back muscles. Lie on your back, with knees wide apart and hovering over your armpits. Holding onto the knees or toes, try to get the entire spine from tailbone to back of neck against the ground.
Angelique says: “To get some power to support your healthy posture, there is strength needed too!” Here are her favorite back-strengthening exercises:
- Superman: lay on the ground, lift your arms and legs like you’re gliding valiantly through the air! Whether you are a Superwoman, Superman, or Superperson, this will strengthen all your spinal erectors.
Swimmer: swim on your yoga mat! “Try to paddle your arms and legs up and down to activate the smaller muscle groups,” advises Angelique.
- Chair: the key to this pose is keeping any curvature out of the back by actively engaging the core muscles and hinging at the hips. For extra credit, lengthen your elbows in a straight line alongside your ears.
- Bridge: activates the glutes and lower spine to support a straight standing and sitting position.
If you ultimately decide that yoga isn’t helping with lower back pain, or if you’d like to strengthen your back muscles more, try these bodyweight exercises for back pain.
Should I Do Yoga With Lower Back Pain?
The answer: you should do whatever feels best in your body. Yoga has been proven to decrease back pain. It relaxes the mind, teaches resiliency, and mobilizes stiff joints. Whether you practice alone or with a guide, yoga for back pain might help you feel more connected with and comfortable in your spine. Remember: if you’re at all unsure of your health or have any pre-existing conditions, the first step to a new practice is to consult your doctor or physical therapist about the best types of movement for you.
About the Authors
Angélique Poulain is a Yoga Coach with a background in Yoga Therapy and Pilates. Her holistic approach always focuses on alignment, injuries, and support. You can find her on Instagram: Angeli.que_Poulain and on her website: www.YogaRebel.de. Take yoga classes with Angelique on the adidas Training app!
Emily Stewart is a freelance writer at Runtastic. She’s a 200-Hour and nearly 500-Hour certified Vinyasa Yoga Instructor. She is also a certified Trauma-Informed Yoga Instructor. She’s taught in the USA, England, Malta and is currently teaching yoga in Austria. She’s attended and hosted yoga retreats around the world. She spent 6 months studying abroad in India, where she attended an inner-city Sivananda Vedanta Yoga ashram at least twice weekly. She also spent three days at their forest ashram in Tamil Nadu, India. She has served as a Mentor and Teacher Trainee with The Kaivalya Yoga Method Teacher Training.