Yoga for Back Problems (cont.)

MEMBER QUESTION: My back pain seems to come from stress. Help!

"You should see your doctor if your back hurts for more than three weeks."

FISHMAN: Stress is a common cause of lower back pain, and work by Dr. John Sarno has pioneered a yoga-like method that is very successful by reducing anger and frustration. His books are out there and he teaches courses in New York. Yoga is an alternative method with no proven studies that I've seen regarding back pain, but many proven studies of reducing physiological correlates of stress, such as blood pressure and heart rate.

MEMBER QUESTION: I have a herniated disk that is manageable at this point, but I have to be very careful. I was injured by a personal trainer that had me doing things I should not be doing, which caused the damage. I've noticed that many yoga instructions ask you to do some really big moves that don't appear to be back friendly. How do you find someone you can trust?

FISHMAN: I wish I had a great answer. Yoga was taught in ancient times in only one way -- person to person. The students sought out the teacher and they worked together. The students got to know the ancient yogis. They were usually attached to wealthy families, but didn't care for wealth at all. In exchange, they were able to meditate and did not have to work, and they were really the family's doctor.

Our lives have changed, and we go to classes and read books about yoga, but the same criteria apply. The yogi should be in clean, quiet quarters. As best you can, you should be able to tell that he/she is not as interested in money as much as being interested in helping you. The person should have certification and should be available for questions before, during, or after a session. You might also ask for references just as you would with any other teacher.

ARDMAN: Look for a type of yoga called Vini yoga. It's a therapeutic yoga that is taught one on one. You can ask your teacher if he/she does Vini yoga or knows someone who does, because they may be more trained to help with the back. If you have a herniated disk, you should use a lot of caution when searching for a yoga teacher.

MEMBER QUESTION: I sit at a computer all day. I've done my best to make my work station back-friendly, but it never fails that my mid-back and upper neck ends up in spasm. What sort of yoga can I do for that, and better yet, is there anything I can do while at my desk?

FISHMAN: Posture is the most important thing here. One of the best ways to achieve good posture is through meditation, where you learn to sit straight and love it. Besides that, back bends (some adapted to do standing up if you are at work, against the wall) are helpful when it begins.

ARDMAN: Also -- take frequent breaks, walk around and use a pillow or even a rolled up towel in the small of your back for support while sitting at the computer.

FISHMAN: Your head weighs 14 or 15 pounds. You must support it by your shoulders or your neck is doing a lot of extra work. Imitate the beefeaters at the Tower of London. Keep your head on your shoulders and it will help a great deal. Yoga will help and there are many good photos in the book to help you see the positions.

MEMBER QUESTION: I've been practicing yoga regularly since getting a discectomy four years ago. Physicians have told me it could actually do more harm than good. It does help me with pain management so I would like to continue doing it. Are there any positions I should be avoiding altogether?

FISHMAN: Assuming the discectomy is L4-5 or S1, your biggest risk is in the twisting postures such as matsyendrasana or jathara parivartanasana.

MEMBER QUESTION: Is it OK to do yoga with a video? I live way out and cannot get to a class. Is there any video you recommend?

FISHMAN: If you have pain, you need more than the video can give you. You can use the video after classes or after you have read our book, but I wouldn't go straight to a video if you have pain because nothing they say is sensitive to you and your problem.

MEMBER QUESTION: Would you recommend yoga as a preventative? Gardening season is coming up and I'd like to avoid the usual spring backaches.

FISHMAN: What a good idea. Doing yoga is very much like cultivating small plants. I would practice forward bends especially.

ARDMAN: You should see your doctor if your back hurts for more than three weeks. You should talk to your doctor before practicing any strenuous yoga, and don't substitute yoga for seeing a doctor. Yoga can be tremendously helpful if you have back pain, but if misused it can cause back pain, and that's not a situation anyone wants.

You can be a very advanced yogi or a total beginner who has never done it before, and yoga can help you either way.

MODERATOR: Dr. Fishman, you have used yoga in your practice for 30 years to help patients with back pain. What kind of response do you get from patients when you suggest it?

FISHMAN: It's changed in the last ten years. I used to use yoga postures and sometimes wouldn't even identify them as yoga. But in the last ten years, yoga has become so respected in the general community that I openly embrace it with patients. When I do this now, their eyes light up. They're excited to be using yoga and have no difficulties with it. Ten years ago they might have said something different.

MEMBER QUESTION: I'm six weeks pregnant and I would like to know if stretching and ab exercises are OK for me.

FISHMAN: We have a chapter in our book that is devoted to pregnancy and what is safe. I happened to be with Mr. Iyengar when his oldest daughter was pregnant, and she had back pain. She stood on her head until a few days before delivery. What is dangerous are twists because they pull the ligaments that hold the uterus in place quite asymmetrically. There are other limitations too. See the book.

ARDMAN: The book has warnings on every pose as to whether it is safe when pregnant.

MODERATOR: We are almost out of time. Before we wrap things up for today, do you have any final words for us?

FISHMAN: Yoga has given off many sprouts in the last 3,000 years and many physical therapy and exercise programs contain a good deal of yoga in them. One of the singular advantages of yoga is that you can do it on your own, so it fosters independence rather than dependence. Yoga is not a science, it's a practice. You do it or you don't.

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