Yoga for Your Back

If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

By Carol Ardman
WebMD Weight Loss Clinic - Live Events Transcript
Event Date: Wednesday, March 2, 2005

MODERATOR: Welcome to WebMD Live, Dr. Fishman and Carol Ardman. Why yoga for back pain?

FISHMAN: There are very few side effects, it's portable, it's free and there are basically no devices you need to carry with you. Yoga is thousands of years old and there are almost no other means that are as side-effect free. Maybe best of all, unlike medicine, which only takes you up to the state of normal and then says, 'Thank you very much, go about your business,' yoga continues to improve you even when you reach what most of us think of as normal.

In addition, yoga can be individually crafted for you and your problem, unlike medicines, with which all you can do is take more or less, often through the day. But you can't alter the medicine, which is what you do all the time with yoga.

There is even one further advantage: yoga makes you calm. To the extent that pain is not eliminated you are able to bear it better.

MODERATOR: There are many different types of yoga. How do you determine which is the best to do? Is it a matter of personal preference, or are there certain types which are better for certain problems?

FISHMAN: First, there are some that are generally better, they're better for everybody because they are more anatomically sophisticated, and therapeutically better. But when it's someone in pain, we don't want a yoga teacher; we want someone who has experience with the yoga and the illness to combine the two.

My favorite teacher is Mr. Iyengar. I studied in India with him for a year. His anatomy and focus is exactly right. Ananda, Integral yoga and other eclectic brands might be excellent, but I can't talk about them all.

There are two to stay away from if you have back pain. One is Bikram, which is not particularly adapted or focused on individual difficulties. Also, the power yoga such as Ashtanga, where it seems there are dual aims. One is to give a good workout, and the other is to seek the calm so famously reached in the East. But you can't have your heart beat fast and have it beat slowly at the same time, so they're difficult to understand from this point of view.

MODERATOR: Do certain types of yoga help with specific back pain problems?

FISHMAN: Something that arches your back, to improve the opening of the spaces that the nerve roots exist in. A herniated disk will be terrible for you if your disks and vertebrae are slipping.

Our book separates out nine different causes for low back pain, characterizes them so everyone will understand them, then gives postures for each specific one. There is also a difference between acute and chronic pain. This too is best treated according to its category.

ARDMAN: When choosing a type of yoga if you have back pain, it's important to tell your teacher that you have back pain, and discuss it thoroughly to make sure your teacher understands what it is so that you know what you have to avoid.

Also, when choosing a yoga teacher, it's a good idea to make sure that he/she practices yoga seriously at home and has a personal practice. That person will be more able to be responsive to your needs.

MODERATOR: In your book you talk about nine common causes of back pain. Could you please describe them?

FISHMAN:

1. Musculoskeletal pain, which is basically when muscles, joints or ligaments hurt, is the most common cause of back pain. (ARDMAN: That includes muscle spasm.)
2. Nerve pain from a herniated disk in the lumbar spine.
(ARDMAN: That's also called a pinched nerve root or slipped disk.)
3. Arthritis, which is a progressive condition of the joint. It can be any joint along the spine. There are five lumbar vertebrae with three real connections between bones at each level, which means 15 possible places where this can occur.
4. Sacroiliac arrangement, which is a single joint on each side of the body.
5. Pregnancy, where up to 70% of women who are pregnant have back pain. It's a self-curing condition like muscle spasm, but can be very uncomfortable. There is a lot of weight in front of you, your blood volume in the spinal cord itself can compromise it, and your ligaments are loosened from a hormone from the placenta. On top of all this, there's no comfortable way to sleep.
6. Spinal stenosis, where the openings in the spine are narrow. The opening from your brain down the spin is so narrow that the nerves get irritated.
7. Piriformis syndrome, where the sciatic nerve gets compressed by a muscle in the buttock.
8. Being overweight. We have a chapter on weight control. Being overweight makes back pain much worse.
9. After back surgery, usually the pain you went in for is gone, but you have new pain from the surgery. It will go away, but there are yoga exercises you can do to help the pain with weight, balance and strength.