“The yogi will tell you that you feel and look as young as your spine is elastic,” classic American yoga teacher Richard Hittleman once said, and countless people have echoed this thought throughout history. Certainly, nothing makes you feel quite as old as that day you have trouble getting out of bed or standing up straight after sitting on the floor or in a car. 

Almost all of us have experienced some version of this problem; experts estimate that some four out of five Americans will have a back problem at some point in their lives.

It is no wonder that so many of us experience back problems. According to Stacy Lynn, founder of Enlightened Fitness in Centerville and internationally trained yoga therapist, exercise physiologist and sports medicine specialist, back pain can have many causes. These include factors which may be somewhat or entirely out of our control, like age, genetics, unexpected injuries and the demands of our job (and, as we all know, sitting a desk for eight hours can be one of the hardest things for your back). 

Additionally, back pain may be caused by factors that are within our control, like fitness level, weight, smoking habits and stress levels. Finally, it may be caused by physiological conditions like osteoarthritis, ankylosing spondylitis and other conditions.

Going to the mat

However, before someone with chronic back pain assumes that their pain can only be alleviated by surgery Lynn suggests that sufferers try a complementary practice like yoga. “Yoga can be a good complement to Western medicine,” she says. “If practiced correctly it strengthens the musculature, increases flexibility, improves posture and helps people perform activities in a safer way.” 

It makes sense that this centuries-old practice would help with back pain. “Pain is typically caused by an imbalance,” Lynn explains. Problems like tightness in the hip flexors or weak core muscles can cause the body to compensate by over-using other muscles to maintain function, leading to muscle spasm and pain. The pain can then start a downward spiral of emotion in which one expects to feel pain and be limited by it, which depresses the mood and heightens the perception of pain. 

Yoga can help this aspect of back pain as well, working with the mind-body connection to enhance positive emotions and decrease stress. “It helps your body (tap into) your parasympathetic nervous system,” Lynn says, explaining that practices like yoga can help the practitioner turn from the “fight or flight” response to the “rest and digest” functions that it needs to heal injury.

The most important fact to understand about yoga is that it is accessible to almost everyone regardless of degree of flexibility, amount of mobility or physical fitness level. Poses, called “asanas,” can always be modified or adapted to the needs of the student and a qualified instructor will be trained in helping the student make adjustments in order to practice safely and comfortably. In addition, there are a variety of styles of yoga available, ranging from very athletic vinyasa (flow) classes to chair yoga and practices that can be completed at home on the bed. “Shop around for a teacher and a class that you like,” Lynn says.

The most important factor, Lynn says, is to do a little homework and be sure that your yoga instructor is properly trained. Yoga teachers are certified through the Yoga Alliance and have completed many hours of instruction to help them lead successful classes and help students adapt poses to their needs. 

Yoga therapists are certified through the International Association of Yoga Therapists, and with more training in specific areas are equipped to work with students with specific needs that want to use yoga to address particular problems.

When it’s time for surgery

Most people with back pain will never have to face the surgeon’s knife. “Only about 1 percent of back pain is surgical,” says Dr. Jeffrey Hoskins, orthopedic spine surgeon with Premier Health. When surgery is indicated it is usually for “a clear problem like instability, infection, or tumors, (but) most surgeries are performed for nerve-related pain,” he says. That is, surgeries typically address pressure that is put on a nerve or a bundle of nerves by degeneration or misalignment within the spine.

For example, in some people, the spinal facets, which Hoskins calls the “knuckles of the spine,” can become overgrown, putting pressure on the nerves. A disc herniation can cause similar nerve pressure and pain. Degenerative disc disease, a kind of arthritis in which the disc itself dehydrates over time, can lead to other conditions like spinal stenosis. 

Although surgery is not a foregone conclusion with any of these conditions those patients who would benefit from surgery may be offered a procedure like a laminectomy, in which a small piece of bone is removed to allow the surgeon to remove part of a herniated disc or to remove pressure on a nerve bundle. Other conditions may require a spinal fusion, a technique for restoring stability.

Hoskins notes that “indications for (spinal) surgery have not changed for years,” but techniques certainly have. Today’s spinal surgeries use smaller incisions and are less invasive than surgeries in the past. Hoskins also explains that patients are now managed better post-operatively, leading to shorter hospital stays.

Of course, a single magazine article is not nearly enough space to help back pain sufferers know exactly what is ailing their back. “Not everybody’s problem is the same (and) that doesn’t mean the treatment will be or should be the same,” says Hoskins. In fact, he reiterates that “most people won’t need surgery.” But along the way, there are many options to keep your spine feeling young and flexible.

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