Why am I – an Edinburgh osteopath – such a fan of yoga for lower back pain? I’m a fan of what works – and yoga works for lower back pain. There’s been a lot of media coverage of this lately, following the publication of updated guidelines from the American College of Physicians. To save you reading the whole guideline, in essence, they say that there’s good evidence that physical activity – including yoga – is good for long-standing lower back pain. The November 2016 NICE guideline for Lower Back Pain and Sciatica also recommends “mind-body” exercise such as yoga.
The media seem to have focused on yoga, despite the fact that there are a number of physical activities recommended in the American guideline. I am still not aware of any compelling research evidence that shows that yoga is better than other physical activities – but it’s at least as good as the others. This is true for all exercise interventions for “non-specific lower back pain” – no one approach has been shown to be consistently better than the others. There is some evidence that if you’re a bit more targeted, rather than just lumping all people into the “non-specific” category, some exercises are better for some types of lower back pain problems (this is an area I focus on in my new book and website).
So, why am I so keen on yoga? For a couple of reasons…
I’ve had an inconsistent home practice of yoga for 20 years. My observation is that even once per week is enough to prevent my mid back from tightening up and giving me an ache (which can then spread up to the right side of my neck). I do a lot of different forms of physical activity, but it seems to be yoga that stops this particular symptom from flaring up.
Yoga means union. This means that the vast majority of yoga teachers focus on body and mind. The gold-standard approach to pain is called the Biopsychosocial approach, proposed by George Engel in 1977. It’s important to consider that what we think about pain (psycho), and how those around us respond to and support us (social), are at least as important as the underlying physical (bio) component. I think a yoga class because it’s social (not just the teacher, but the fellow participants) helps to foster positive attitudes and provides support. The mind element of yoga helps us to feel calmer and safer which is important when facing pain. The physical element is obviously good for us; so long as the movements you do don’t aggravate any underlying physical weakness.
I think yoga teachers (and those teaching other disciplines such as pilates) are in a great position to help people with persistent lower back pain, which is why running a course to educate teachers on how lower backs work and how pain works. I’ve already had quite a few approaches to teaching this topic – I guess when you write a book on lower back pain, and it’s very exercise orientated, this was likely to happen. Which is great – I love teaching 😉
If you’d like to add your name to the list, just drop me an email; or if you know an exercise professional (I don’t think some yogis like being called that, so sorry), who may be interested, please forward this to him/her. Thank you.