Healing Lower Back Pain with Iyengar Yoga

Lower back pain is a common occurrence as we age and become less physically active. Over the years at North Shore Yoga we have worked with hundreds of students with various levels of pain and with regular yoga practice combined with specific guidance on postures and yoga poses we seen some amazing outcomes.

Below is a very informative article that was published in the International Journal of Yoga Therapy.;

Low back pain is a significant public health problem that has reached epidemic proportions. It places a substantial burden on the workforce and the health care system. It has proven very difficult to treat, and it is one of the most commonly reported reasons for the use of complementary and alternative medicine.2 Many different methods of Yoga exist and each has its own technique for preventing and treating disease. This article describes the rationale and method for the therapeutic application of Iyengar Yoga for chronic low back pain. Preliminary results are also presented from a pilot study evaluating the efficacy of a 16-week program of Iyengar Yoga therapy in persons with non-specific chronic low back pain.


Yoga is a 5,000-year-old tradition whose classical aim is liberation from suffering in this life. Ancient texts make it clear that mental and physical illness or lack of health are impediments to this goal. Yoga was used in antiquity to overcome these impediments in preparation for attaining the goal of self-realization and liberation from suffering. Although the ancient seers recognized the health and healing effects of Yoga, they were not the primary goal of practice as is the case in America today. Yoga is now regarded in the West as a holistic approach to health and recently has been classified by the National Institutes of Health as a form of Complementary and Alternative Medicine (CAM).

In India, however, Yoga is not an alternative healing system but a part of main- stream medicine. In either case, this therapeutic applica- tion of Yoga requires the classical postures to be adapted to address the specific problems associated with each medical condition.
Many different methods of Yoga exist and each has its own technique for preventing and treating disease. The most common methods of Yoga therapy in the US are the Iyengar method, Viniyoga, Integrative Yoga Therapy, and Phoenix Rising Yoga Therapy. The Iyengar method is based on the teachings of the Yoga master B. K. S. Iyengar, author of the classics Light on Yoga4 and Light on Pranayama. Iyengar’s teachings are deeply grounded in the ancient Yoga tradition, and his intense personal practice and more than 60 years of teaching have produced significant innovations. Among the most noteworthy are: 1) an emphasis on standing poses to develop strength, stability, stamina, concentration, and body alignment, 2) the use of props to facilitate learning and to adjust poses for those who are inflexible, and 3) instruction on how to use Yoga to ease various ailments and stress.
His system is based on the eight constituents of Patanjali’s Astanga-Yoga that lead to self-realization and liberation. They include yama, niyama, âsana, prânâ- yâma, pratyâhâra, dhârâna, dhyâna, and samâdhi. Most schools of Yoga practice each limb separately using âsana as preparation for meditation. Iyengar’s unique contribution has been the realization that all limbs may be practiced and integrated into âsana and prânâyâma.
The therapeutic application of Iyengar Yoga has been used in medical settings and in Yoga centers by teachers having Junior Intermediate III or higher certification.
This paper will describe the therapeutic application of Iyengar Yoga for treatment of chronic low back pain, the rationale behind the method, and preliminary findings from a pilot study evaluating the efficacy of a 16-week program with ambulatory adults with chronic low back pain.

The Goal of Yoga Therapy for Low Back Pain

The primary goal of Yoga therapy for low back pain (LBP) is the relief of pain and functional limitation caused by a chronic lower back disorder. This is achieved by minimizing, healing, and ultimately correcting underlying physical mal- functions through a series of anatomically correct postures. Unlike most conventional medical treatments that focus on treating LBP symptoms through medications and surgical procedures, Yoga therapy works to correct underlying internal malfunctions that contribute to mechanical causes of non-specific LBP. It is through the process of helping people with LBP to rest the area of pain and then educating them in proper alignment of bones, muscles, and connective tissue and movements that the healing occurs and changes the underlying root cause of the dis- comfort. The practice of Yoga is designed to educate students in the use of a daily regimen of self-care that acts to manage and ultimately prevent the recurrence of chronic LBP through healthy postural and movement patterns.

Reasons for Implementing Therapeutic Yoga for Low Back Pain

Although the regular practice of Iyengar Yoga is viewed to be healing and health retaining,8,9 there are several reasons for implementing a therapeutic version of Yoga for someone with LBP. Classical postures require effort and skill to be health enhancing and therapeutic, whereas an individual in pain requires the injured area to rest prior to introducing corrective action. It also takes time to develop the awareness and neuro-muscular coordination to perform the poses in a way that corrects imbalances contributing to LBP. In addition, Yoga therapy relies much more on external support through the use of props. This external support enables the student to rest the injured area and achieve correct postural alignment and movement in the postures.
Specific body positioning for each Yoga posture opens and creates space longitudinally, horizontally, and circumferentially without aggravating injured areas. Iyengar Yoga is noteworthy because this particular method incorporates props such as ropes, benches, bolsters, blankets, weights, straps, blocks, and other devices to provide support during performance of the postures. Props are useful for facilitating rest and relaxation, avoiding unnecessary strain, revealing latent muscle strains, inflammation, or restrictions due to stiffness or injury, and for helping the student achieve correct
body position and movement in the postures. These props also help immobilize joints so that specific areas are targeted. They also provide controlled traction, which assists active or passive forms of movement depending on the pose and the capacity of the student. It is the ulti- mate goal of Yoga therapy to enable a student to attain a healthy back free from LBP. The teacher assists the student to transition from supported poses to the execution of classical poses without support. Practice of the classical postures furthers the student’s awareness of latent imbalances and requires mastery of corrective movements.

The Evaluation Procedure

Iyengar Yoga therapy begins with an evaluation of an individual’s known medical history for possible causes of pain followed by a diagnostic examination of the student. The instructor performs this initial examination as the student performs tâdâsana (mountain pose), a basic standing pose that permits the instructor to look for signs of dysfunction and imbalance in specific regions of the body such as the feet, legs, knees, hips, torso, chest, shoulders, neck, head, and carriage, and how these dysfunctions affect posture, levelness of the pelvic girdle, alignment of the spinal vertebrae, and gait. Attention is paid to the alignment of bones and pelvis, muscle tone, and the tightness, hardness, or color of the skin for signs of muscle imbalance and poor circulation.
The Yoga instructor continues to gain insight into the biomechanical causes of LBP from observing performance of the postures. Areas of tightness and hyperflexibility that create imbalances in the musculoskeletal system are exposed.

Read the full article : Therapeutic-Application-Yoga-Lumbar-pain-2003