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Back Builders

A yoga-based regimen can help dramatically decrease recovery time for lower back injuries.

By Nell Lake

Approximately 80 percent of Americans experience lower back pain at some point in their lives. For many this pain is caused by an injury to one of their spinal disks—the soft, jellylike pads located between the vertebrae. A "herniated" or "prolapsed" disk is one that has bulged and can put pressure on nearby nerves. The condition, as sufferers know, can be debilitating, painful, and difficult to treat.

Until recently conventional medicine's standard approach has been to prescribe both medications for the pain and rest to help the disk heal. A patient may even face the prospect of surgery. However, these are not always successful, nor do they prevent the injury from recurring. Now there may be a safer and more effective alternative to relieve lower back pain: yoga, which may prevent disk injuries and dramatically speed recovery.

Last year Vijay Vad, M.D., who is a specialist in sports medicine at the Hospital for Special Surgery in New York, launched "Back Builders," a new program combining yoga, breathwork, and Pilates to help patients heal from disk injuries. A native of India who has practiced yoga since he was 3, Vad had been inspired to develop a more formal program of "medical yoga" following September 11, 2001. "After that stressful event we saw a huge rise in lower back injuries," he says. "Lower back pain is really a mind-body problem, closely related to stress. We thought, "Why not put together a program that joins the mind and body components?' "

Twenty-five program participants practiced a series of poses and exercises, mostly supine, three times a week at home while they were still largely immobilized by their injuries. Later they participated in a more challenging Back Builders class three times a week at Practice Yoga studio in Manhattan. Vad also followed a second group of 25 disk-injury patients who did not participate in the yoga program. Both groups took the pain medications Celebrex and Vicodin.

After six months Vad found remarkable results: 80 percent of those in the Back Builders program experienced markedly decreased pain, compared with 44 percent of those on medications only. The yoga also seemed to help in preventing recurrences: Only 12 percent of the yoga practitioners experienced another acute episode of their injury, compared with 56 percent of those on medications alone. Also, the pain medication use of those doing yoga declined by 40 percent. "Some of these people needed epidurals to cope with their pain," explains Jennifer Walker, who owns Practice Yoga studio and developed Back Builders with Vad. "Now after six months they're doing poses like Warrior I and lunges."

The basic idea behind Back Builders is this: Build core strength and flexibility and lengthen the spine to create space between the vertebrae, thus minimizing pressure on the disks and allowing them to heal. The program eliminates potentially harmful poses—such as sitting postures and forward bends, which can compress the vertebrae of the lower spine—and instead emphasizes asanas that build support for the spine by strengthening the abdominal and back muscles. The class's hip-opening poses encourage spinal length, as do postures that stretch the hamstrings and calves. Participants also do gentle back extensions. Vad is currently working to make the program public, with a video and book scheduled to be released next January.

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Reader Comments

Mark Goldfarb

Most of the articles about a specific topic such as this one on "backs' are not specific. I would love to see a specific routine, in the preferred order of completion. Please, include specific asanas instead of the generalized non specific ideas. This seems to be a general trend at yoga journal.

Linda Smith

Peggy Cappy has a wonderful DVD called Back Care Basics which addresses many of the issues mentioned in this article. It is a gentle series of postures that strengthen the core and work on relieving low back issues. Her teaching method is accessible to everyone. I have recommended this to my students with back issues with much success.


I recently took a class & flowing from ardha candrasana to standing split, I felt a sharp pain in my lower back that sent me to my knees. The pain was so intense that it was extremely difficult to even get into childs pose. That night, I was immobilized with chronic pain. I could not walk, let alone move. This happened 3 days ago & slowly I am improving. It feels as though there is compression on my lower spine causing jolts of pain. I normally practice yoga daily & would like to know if there are any suggestions on what to do??

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