Yoga for Chronic Back Pain

Do you or someone you know suffer from Chronic Low Back Pain?  According to PainMed.org, nearly 100 million Americans suffer from chronic pain.1  Over $600 BILLION is spent annually on medications, interventional procedures, and lost wages as a result of chronic pain.  Of the 100 million American’s suffering from chronic pain, nearly 31 million suffer from chronic low-back pain.

To understand chronic pain, we first need to understand the various types of pain.  There are two major categories of pain that the body feels:  acute pain and chronic pain.  Acute pain is a type of pain that may arise quickly and lasts temporary.  Acute pain typically lasts less than 6 weeks with proper medical treatment.  Examples of acute pain include, bites, scratches, burns, cuts, scrapes. etc.

Chronic pain on the other hand is a type of pain that lasts for an extended or indefinite period of time.  There are several categories and subcategories of chronic pain; however, for the purpose of this article I will be focusing on neuropathic chronic pain as it relates to individuals suffering from low back pain. “Neuropathic Pain is a complex, chronic pain state that usually is accompanied by tissue injury. With neuropathic pain, the nerve fibers themselves might be damaged, dysfunctional, or injured. These damaged nerve fibers send incorrect signals to other pain centers. The impact of a nerve fiber injury includes a change in nerve function both at the site of injury and areas around the injury.”2  Chronic pain is often times treated with medication, interventional procedures, physical therapy, and even surgery.  While spine surgery has an 85% success rate in lowering overall pain scores; second and third back surgeries show a significant decrease in success rates with only 30% (2nd surgery) and 15% (3rd surgery) of patients having successful outcomes.3

One of the major problems that arises from chronic pain is the pain cycle that begins to develop and persist.  Below is an example of  one of the feedback cycles for chronic pain.pastedGraphic.pdf

Image taken from http://www.arthritis.ca/pain4

So how can we break this cycle?  Just because someone is suffering from chronic pain, doesn’t mean they can’t reduce or potentially remove their pain.  Having worked with chronic pain patients for the past six years, I have had first hand experience of how chronic pain effects not only the patients overall quality of life, but the lives of loved ones and care givers around them.

As an instructor and yoga practitioner I have turned to yoga as a method to help not only cure my own struggles with chronic pain, but I also have the opportunity to see the effects that a daily practice has on my students.  Numerous studies have shown conclusive evidence that yoga is a superior alternative to help manage chronic low back pain compared to standard physical therapy practices and medication prescriptions.  A study completed in November 2011 concluded that “Offering a 12-week yoga program to adults with chronic or recurrent low back pain led to greater improvements in back function than did usual care.”5

Another study looking at the “Efficacy of Yoga as an Intervention for Chronic Low Back Pain” concluded that “healthcare practitioners should consider yoga as an efficacious intervention in addition to standard education or no care. With the complexities involved in formulating an effective treatment for low back pain, yoga is a viable option. Research demonstrated that yoga reduces functional disability, has a positive effect on QOL (quality of life), and a negative effect on stress, depression and pain intensity.”6  The study looked at different styles of yoga to include Iyengar and Hatha Yoga.  All styles showed evidence in helping to reduce lower back pain, increase functionality, and decrease stress/anxiety/depression.

In the western world, yoga is often times glazed over in the continuum of medical treatment – with medication and surgery being the first line of defense to treat patients.  We need to shift this paradigm in medical thinking.  Yoga is a non-invasive therapy, in fact – it can be a very passive tool especially when we focus on pranayama/breathing exercises.  Yoga teaches us to go inside and focus on the self.  Yoga not only addresses the symptoms, but when practiced steadily, yoga helps us to find the source and cause of many of our own ailments.  The actions, mindfulness, concentration, and awareness that we maintain through a personal yoga practice allows us to help relieve the physical tension and release emotional and mental stress we may be harboring.

The practice of yoga has been thriving for thousands of years.  There has been a steep increase in regular practitioners over the past 4 years.  According to the Huffington Post, In 2008 there were roughly 15.8 million yoga practitioners.  From 2008 to 2012, that number grew by nearly 4 million.7  With that said – I don’t believe yoga is merely a trend – I believe that it deserves significant attention from the medical community.  I think that if physicians can begin referring more patients to practice yoga (mind/body/spirit) we might actually see a reduction in overall healthcare costs.

“Yoga does not remove us from the reality or responsibilities of everyday life but rather places our feet firmly and resolutely in the practical ground of experience. We don’t transcend our lives; we return to the life we left behind in the hopes of something better.” ~ Donna Farhi

References:

  1. http://www.PainMed.org
  2. http://www.theacpa.org/condition/neuropathic-pain
  3. Back Surgery That Does Not Relieve Pain.  By Robert J. Gatchel, PhD, ABPP, Emily Brede, RN and Whitney Worzer, MS, PhD Candidate
  4. http://www.arthritis.ca/pain
  5. Yoga for chronic low back pain: a randomized trial.  Tilbrook HE1, Cox H, Hewitt CE, Kang’ombe AR, Chuang LH, Jayakody S, Aplin JD, Semlyen A, Trewhela A, Watt I, Torgerson DJ.  University of York, Heslington, United Kingdom. helen.tilbrook@york.ac.uk  http://www.ncbi.nlm.nih.gov/pubmed/22041945
  6. The Efficacy of Yoga as an Intervention for Chronic Low Back Pain:  A Systematic Review of Randomized Controlled Trials Alison M. Diaz, BS, Morey J. Kolber, PT, PhD, Chetan K. Patel, MD, Patrick S. Pabian, PT, DPT, Carey E. Rothschild, PT, DPT, William J. Hanney, PT, DPT, PhDDisclosures. Am J Lifestyle Med. 2013;7(6):418-430.
  7. http://www.thehuffingtonpost.com.

 

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