Category: Yoga to treat diseases

14 Jun

Kaivalyadhamas Yoga Therapy for Back Pain

During our stay at Kaivalyadhama Yoga Hospital, the facility’s resident physican, Dr. Bhalekar, gave an hour lecture on Yoga and the treatment of back pain due to spondylosis.  He did a great job of explaining things and provided a basic program of therapy.  Here’s a recap.

Essentially, spondylosis is a general term for the degenerative changes of the spine that tend to come with aging.  The disks between the vertebrae, which usually act like spongy jelly-filled donuts to cushion the bones, get dehydrated, squished, and narrowed.  Sometimes they pop out in places along their circumference.  When they do, the disks can compress nerves and even the spinal column itself.  Bone spurs form.  The spurs can also narrow the spinal canal and compress nerve roots.  The facet joints, the spaces between the posterior connecting points of the vertebrae, narrow.  The bones may then rub against each other causing arthritic pain.

Dr. ­­­­Bhalekar recommends that anyone suffering from an acute episode of back pain lie down in makarasana for twenty minutes.  In this asana, you simply lie on your stomach with your feet a little more than shoulder width apart and rest your head on your forearms for a pillow.

To do any more than that, he suggests waiting at least four weeks before starting a program of Yoga after any sudden injury or severe pain.

His program includes:

  1. Niralambasana – on your stomach on the floor with your chin cradled in your hands similar to sphinx pose
  2. Ardha Shalabhasana – the locust pose on your stomach with hands at your sides and then extend each leg upward for five seconds at a time
  3. Bhujangasana –  the cobra pose on your stomach with the torso raised upwards and resting on your hands with elbows slightly bent for 30 seconds repeated three times.
  4. Marjarasana – the cat pose – on your hands and knees intermittently arching and rounding your back, then a variation with the extension of each leg straight out behind for a few seconds each
  5. Supta tadasana – flat on your back, reaching and stretching above your head with your hands and pointing your toes for a full length stretch of the body
  6. Pavanamuktasana – the wind releasing pose – on your back on the floor with your knees bent and brought up together to the chest holding them with the hands or even grasping opposite elbows if possible
  7. Pavanamuktasana variation in which you keep the back flat on the floor but roll the hips and bent knees to each side for a few seconds
  8. Konasana – standing with one hand on the hip and the opposite one stretched over the head, bending laterally as far to the hand held hip side as possible.

The avoidance of the back bend, chakrasana, and rajakapotanasana is recommended for anyone with a history of back pain due to spondylosis or disk injury.  Sun salutations, more vigorous exercises done quickly, are also best avoided when there’s been a history of injury or trauma.

As with many different styles of Yoga, the asanas at Kaivalyadhama have their own names, and they cant always be matched to poses in other styles.  For Yoga therapy patients with a history of spondylosis, Dr. Bhalekar provides a summary paper of these asanas with photographs of their demonstration.  The papers may then be used as a reference for continued home practice.

For others, the publishing department may be contacted here to order asana charts and books with photographs.  They also have a specific title related to back pain, Notes on Back Care

30 May

Yoga and Back Pain

Just about everybody experiences back pain at one time or another. It’s one of the most frequent reasons for visiting a primary care doctor’s office.

The most common diagnosis for low back pain is lumbar strain and spasm. Damage to back muscles and ligaments most frequently occurs by lifting and twisting at the same time, but the slightest sudden movement can result in crippling back pain.

Sometimes a disc between the back bones ‘slips’ and causes sciatica, a radiating pain into the leg. Arthritis can develop in the facet joints, tiny joints linking one back bone to the next. Postural problems, injuries and conditions like scoliosis can all contribute to poor alignment of the back bones with resulting pain.

Even though back pain is so common, modern medicine does a pretty poor job of healing it. Too many people end up having surgeries that don’t help and worsening chronic pain that won’t resolve even with strong narcotic pain medication. With back pain, self healing and prevention of future episodes are keys to a happy back.

The trick is to keep back muscles strengthened, stretched and relaxed through a program of Yoga therapy that also nourishes the discs between the vertebrae, or back bones, and strengthens abdominal and other core muscles.

 

 

Yoga and Back Pain

Yoga and back pain are a good fit. Research studies show that Yoga therapy reduces pain, improves ability to function in daily tasks, and improves the ability to control pain levels which decreases feelings of helplessness and depression. In one study 88 percent of a Yoga therapy group either reduced the amount of medication they were taking or eliminated it completely compared to only 35 percent of controls.(1,2)

How Yoga Can Help Your Back

  • Improves posture
  • Relaxes and stretches tense muscles
  • Addresses the manomaya kosha, the emotional and mental body, that contributes to and sometimes creates perceived pain
  • Strengthens core muscle groups
  • Nourishes discs by helping them to imbibe, or soak up, needed nutrients
  • Lowers stress levels
  • Brings awareness of alignment

What to Do If You Have Back Pain

  • You may need to see a physician to rule out infection, neurological problems, fractures and cancer. While they are rare causes of back pain, they shouldn’t be missed. Please realize though that a good work-up by a primary care physician does NOT mean that Xrays, MRIs and CTs are necessary and their inappropriate use can even be harmful. A good history and physical done by an appropriately trained physician is usually all that is needed.
  • Science suggests that the fastest recoveries are made by those who begin physical therapy the day of an injury or the day after. It follows that the same is true for Yoga therapy. Bed rest is no longer recommended. Be gentle at first, move slowly, and don’t push for extreme postures.
  • Find a Yoga therapist or qualified Yoga teacher nearby for individualized guidance, at least initially.
  • Maintain a daily (or at least thrice weekly) home program to prevent further injury and pain. Here is Kaivalyadhama’s Yoga therapy program for back pain. The institution of Kaivalyadhama is one of India’s oldest and most respected Yoga therapy hospitals. Or here is free podcast by my yogi friend, Satyam, at Renaissance Yoga.

References:

  1. Williams K et al. Therapeutic applications of Iyengar yoga for healing chronic low back pain. International Journal of Yoga Therapy. 2003; 13:55-67.
  2. Sherman KJ et al. Comparing Yoga, exercise, and a self care book for chronic low back pain: a randomized, controlled trial. Ann Intern Med. 2005 Dec 20; 143:849-56.
19 May

Inversions During Menstruation?

Whipstitch Chronicles just published a nice blog reviewing information currently on the internet about the hazards of doing inverted postures while menstruating.

Overall, the blog was great, but I have an objection to one line.

The medical perspective has basically verified that there is no reason to fear that inverted poses during menses will increase a woman’s risk factor for developing endometriosis, a painful pelvic condition that can lead to infertility.

This is so not true.

I understand where she gets it. In the Yoga journals a medical doctor once quoted some (at the time – a decade or so ago) cutting edge research about the cause of endometriosis that pointed to factors other than retrograde flow as causative. The studies referred to determined that migrated stem cells within the pelvic cavity developed into endometrial tissue. Now we know those stem cells likely come from the endometrial layer of the uterus   from retrograde flow. Others docs have said that most women have some backwards flow but that not all women develop endometriosis. Thats true. There are other factors working in concert, but retrograde flow is a risk factor and the more backward flow, the more likely one is to develop disease.

Although we still don’t really know for sure what makes some women have the disease and not others, Samspons 1927 theory of retrograde menstruation remains the prevailing scientific hypothesis for what causes endometriosis. Its complicated, and other factors play a part- things like genetics, epigenetics, immune function, environmental toxins like dioxins, etc.

For sure, women who have more frequent periods, those who bleed heavier, and those with a blockage to normal flow through the vagina are the most likely to develop endometriosis. That indicates the amount of backward flow is important in development. Quantity matters. Baboon studies back this up the more endometrial tissue in the pelvic cavity, the more likely you are to develop disease.

“While there are no studies looking specifically at whether or not women who practice inversions during their periods are more likely to develop endometriosis (arguably a very difficult study to really do well), prudence is wise. Anyone with a personal or family history of endometriosis should never do inversions while on their period. Other women need to be careful too, especially during the days of heaviest flow. If they choose to invert during menses, then time in the posture should be limited to one minute.”

The longer time spent inverted and the heavier the flow, the more likely there is to be retrograde drainage of endometrium into the pelvic cavity. The presence of endometrial cells in the pelvic cavity in sufficient quantity increases the risk for endometriosis.

These consequences, of course, arent observable right away. You may feel fine right after spending 20 minutes in sirsasana during the time of heaviest menstrual flow, but youve possibly just begun a cascade of changes that ultimately lead to a debilitating and painful disease, one that often leads to infertility.