Hatha Yoga for Chronic Lower Back Pain is Evidence-Based

People have practiced yoga for thousands of years for self-awareness, as a form of meditation and to increase flexibility and strength. Yoga involves physical poses and controlled breathing. Among the physical benefits, certain yoga poses can help improve moderate to severe chronic lower back pain.1 Hatha yoga is the most basic style of yoga. Hatha yoga and other yoga styles are provided through lifestyle and integrative medical centers, gyms, community centers, parks, yoga studios, DVDs, and through downloadable apps.

Research Evidence for Hatha Yoga

University researchers published their study outcomes in the Annals of Internal Medicine. The study involved 320 adults with chronic low back pain from low-income households of varied racial backgrounds. The outcomes revealed the participants in the yoga and physical therapy groups showed similar improvement in low back pain and activity. These 2 groups were shown to be less likely to use pain medications after 3 months of study participation.1

Clinical guidelines released by the American College of Physicians recommend yoga and other non-drug options as a first step to treat chronic low back pain. Other suggestions include tai chi, multidisciplinary rehabilitation and various relaxation and stress-reduction techniques.2

A recent study published in the Journal of Alternative and Complementary Medicine found that Hatha yoga helped relieve back pain as well as conventional therapeutic exercises in patients with chronic nonspecific low back pain. Seventy people were randomly selected to participate in the study; 35 were assigned to the yoga treatment intervention and 35 to the exercise treatment plan. Key study outcome measures included back pain intensity, usage of pain medication, and how participants viewed their low back pain improvement and functional ability. Both groups reported less pain and improved function 6 and 12 weeks after the study completed.3

4 Yoga Poses That May Help Manage Back Pain

You don’t have to bend yourself into a pretzel to benefit from Hatha yoga. Even simple poses provide a gentle stretch that can help ease chronic back pain. Yoga poses focus on proper posture and spinal alignment that maintains normal spinal curvature.

The following poses are back-friendly and found in most Hatha yoga classes.

  • Please Note: Be mindful of yoga poses that involve simultaneous bending and twisting movements, as these are not recommended for everyone with a back and/or neck condition. Always talk with your doctor before beginning any exercise program, including yoga.

Mountain Pose (Tadasana; tada means mountain)
Woman performing yoga, mountain poseThe mountain pose increases your awareness of your posture, which may help you make improvements, leading to less back pain. Photo Source: iStock.com.

When performed correctly, the Mountain Pose involves all of your muscles and is the foundation for other poses. It can make you more aware of your posture thereby improving posture and reducing back pain.

  • Stand tall on the floor or your yoga mat with your feet together or hip-distance apart.
  • Place your arms at your sides.
  • Distribute your body weight evenly on the bottom of your feet.
  • Keeping your legs straight, knees not locked, squeeze your thigh muscles and tuck your tailbone inward.
  • Inhale while lifting from your waist and push the top of your head toward the ceiling. You should feel your spine straighten and elongate.
  • Exhale while dropping your shoulders downward as you reach your hands toward the floor.
  • Inhale as you move your arms upward forming the letter H with your arms and legs.
  • Hold for several breaths.
  • Exhale as you move your arms down by your sides.

Cat/Cow Stretch (Marjaryasana; mariari means cat)
Woman performing yoga, cat/cow poseThe cat/cow yoga movement can help stretch muscles. Photo Source: iStock.com.

The cat/cow pose can help increase flexibility in your neck, upper back, shoulders, and back. The movement can help stretch muscles in your hips and back.

Awareness tip: If you have a neck problem and/or neck pain, it is best to keep your head aligned with your torso (eg, avoid looking upward).

  • Start on all fours—on your hands and knees. Your hands and arms should be shoulder-distance apart and your knees should be hip-distance apart.
  • Inhale, and then as you exhale, slowly start to draw your navel toward your spine and gently tuck your tailbone.
  • As you inhale again, repeat the pose. Be sure to link your breath to your movement.
  • As you exhale, gently move your head toward the floor.

Child’s Pose (Balasana; bala means child)
Woman performing yoga, child's poseThe child’s pose provides your back’s muscles a gentle stretch. Photo Source: iStock.com.

The child’s pose is known to help reduce stress and fatigue in addition to gently stretching and relaxing your back’s muscles.

  • Kneel on the mat, sit on your heels and spread your knees apart approximately hip distance.
  • Rest your arms by your sides.
  • Inhale while you sit up straight and lengthen your spine from the top of your head through your sacrum (lower back).
  • Exhale as you bend forward and extend both arms forward as you rest your torso on both thighs.
  • Extend your arms rest the palms of both hands on the floor.

Bridge Pose (Setu Bandha Sarvangasana; setu means bridge, bandha means lock)
Woman performing yoga, bridge poseThe bridge pose movement helps to stretch and lengthen your spine. Photo Source: iStock.com.

The bridge pose is another stress relieving movement that lengthens (stretches) the spine, thighs and hip joints.

  • Lie on your back, bend both knees with both feet flat on the floor about hip-distance apart.
  • Place your arms straight by the sides of your body, palms on the floor.
  • Slowly begin to lift your hips off the floor. Hold for 3 seconds.
  • Slowly roll back down to the floor, vertebra by vertebra.

Hatha and Other Yoga Poses to Avoid

Skip poses that combine bending and twisting, such as Triangle pose and spinal twists, and poses that incorporate backward bends, including Camel and Cobra pose. When performing Corpse pose, which usually occurs at the end of a yoga session, keep your knees bent and feet on the floor to avoid causing low back pain or exacerbating chronic back pain—see the picture below.
Woman performing yoga, corpse poseKeeping your knees bent during the corpse pose, evenly slightly and supported by a cushion or rolled up towel, takes pressure off your lower back. Photo Source: iStock.com.

How to Locate a Certified Registered Yoga Instructor

Your doctor or healthcare provider may be an excellent resource to help you locate a Registered Yoga Teacher (RYT). Yoga Alliance and The International Association of Yoga Therapists (IAYT) are two organizations known to oversee yoga instruction and teacher certification.

When you see credentials such as E-RYT 500 and/or C-IAYT following a provider’s name, you know they are qualified to lead yoga instruction. For example:

  • E-RYT 500 is an Experienced Registered Yoga Teacher with a 500-hour certification meaning he/she has completed 500 hours of classroom learning, taught at least 4 years and 2,000 hours.
  • C-IAYT means the teacher is Certified by the International Association of Yoga Teachers. Training is comprehensive and includes anatomy breath work, meditation, and back care. Some yoga teachers specialize in therapies directed at treating cancer or spinal disorders, such as the Cleveland Clinic.

Both Yoga Alliance and IAYT have website directories to help patients and people locate yoga teachers in their localities.

Yoga teachers have practiced the poses that comprise Hatha yoga for centuries to improve physical, mental and spiritual health. If you’re looking for a holistic way to help ease chronic lower back pain, use the resources provided to find a qualified yoga teacher. But before you do—always talk with your treating doctor or healthcare provider before starting any style of yoga or exercise, especially if you have back or neck pain.

Updated on: 11/27/19
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Yoga Breathing and Meditation Techniques for Back Pain

Yoga is so much more than just stretching. It also incorporates breathing exercises and meditation. Discover how certain breathing exercises and meditation techniques can help reduce and prevent back pain.
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