Dr. Stefano Sinicropi, M.D.

The most common physical complaint heard by employers these days is back pain. It leads to loss of productivity, increased need for time off, and higher healthcare costs. People in pain want relief. Too often, those with back pain are given general exercises and told if those don’t work, they may need to consider surgery.

As someone who works therapeutically using yoga for pain relief, I am often surprised at the one-size-fits-all exercises given to back pain patients. And in our “no pain, no gain” culture, folks continue to do them in the hopes that even though it isn’t working right now, it will work over time.

Wrong.  If it hurts now, it won’t hurt less upon repetition.

When assessing a new client who presents with back pain, my first question isn’t, “What is the diagnosis you’ve been given?” Not that I don’t ask about diagnoses, but more important to me is how the individual experiences their pain. Where in the body does it occur? Is it worse in movement or when stationary? Do certain positions or activities aggravate it more than others?

The next step is to look at the curves of the spine as they are right now. Is the lumbar curve flat or excessively deep? What does the thoracic spine look like? Does the spine curve or twist due to scoliosis? Mild scoliosis is very common and often unknown to the individual. Does the head sit atop the spine or forward of it? I also observe the pelvis and check to see if it tilts anteriorly or posteriorly, or if one side is higher than the other.

But wait! There’s more!

I also look at how the legs and feet stack up below the spine. When the legs do their job of holding up the body, it is amazing how much the back muscles can let go and release.

Given all these possible places in the body where imbalance can occur, it becomes clear how specific the work must be to the individual.

I can’t possibly give all the variations of back-related yoga work I prescribe, but I can give you a sample of two ways I might work:

Dandasana for general low-back pain (not sciatica)

For this, I usually work with the legs. Waking up the shins is not a phrase most of us know, but it is a vital activity. This is done with a partner. Dandasana:

• Sit or lie down on the floor with legs extended.
• If sitting, lean back onto hands for support. If lying down, support head with blanket or pillow, just enough to keep forehead and chin equidistant from the ground.
• Place soles of feet on a wall, backs of heels on the floor. Keep feet parallel
• Keep knees slightly bent, calf muscles hovering off floor.
• Have a partner place palms of hands low on the shins (near the ankles).
• Partner should start pressing down toward floor while individual in pose resists the weight on their legs. Keep pressing heels into wall while resisting the weight on the shins.
• Hold for 10 seconds.
• Stand up.

If this is the correct work, the person with back pain will feel some relief even after the very first attempt. The ease won’t last long, but over time, repeated waking up the shins will have a cumulative effect. Again, that is “IF THIS IS THE CORRECT WORK.”

Uttanasana

This exercise is for pain that heads into pelvis and hips (including sciatica):

• Stand with feet parallel.
• Roll up a towel so it is in a roll 3 – 4” in diameter.
• Place towel high up between thighs, near the groin.
• Squeeze the towel without letting knees move in toward each other, without rolling onto inside edges of feet..
• Keep knees slightly bent and spine long
• Start to fold forward hinging at the hip. Only fold forward about a foot.Keep spine long and chest open and knees slightly bent.
• Come back upright.
• Exhale as you fold forward again; inhale on the way up. Squeeze the towel the entire time, on the way over and on the way up.
• Repeat 10 times total.

If this is the correct work, there will be relief felt immediately. As above, it may not last, but over time the body will learn to stand differently and the new alignment will endure.

In my private sessions, I have utilized these and many other yoga poses, using resistance to wake up under-stimulated muscles and to allow overworked muscles to release. We might work lying face down or face up; on all fours; seated; standing. We might use props or partners. The focus might be on bringing the legs into better alignment (as above). It might be on how to create a curve where the spine has flattened. We might be trying to support a deep curve so it can return to a more optimal length. But it will not be general. Ever.

Exercises and yoga classes are general. You and your pain are specific.

About the Author

Lynn Shuck is a certified Eischens Yoga Instructor.  She has been practicing yoga for 24 years and has been teaching yoga since 1996.  Her training with Roger Eischens led her to work specifically with alignment as well as injury recovery/prevention. Lynn is known for her deep understanding of anatomy, as well as her ability to bring yoga to all kinds of people. She relocated from Michigan to Minnesota in 2011. For more about Lynn, visit www.lynnshuck.com

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