Yoga for Back Pain, Part 3

In this post, Baxter Bell, MD continues his discussion on low back pain, offering ways to create traction with a friend or on your own.
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In this post, Baxter Bell, MD continues his discussion on low back pain, offering ways to create traction with a friend or on your own.

On a recent flight home from a weekend workshop in Wyoming, as I sat in the oh- so-comfortable seating of one of our major airlines, I decided to peruse the SkyMall magazine that can be found in every seat back pouch of every plane in the country. I am always wondering if there will actually be something in there that I cannot live without. Of course, the last time that happened was about 15 years ago, and I still use the nifty wallet I got to this day. But what jumped out at me, as I squirmed to stay comfortable on hour two of my flight, was the number of devices for all sorts of health issues—most notably, for low-back pain. There were at least a half dozen different gizmos to help you cure your back pain, and you could easily drop $500-600 if you got them all. A recurrent theme for many of the devices was a way to create traction on your spine as a way to reduce low-back pain.

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The pages of SkyMall are not the only place where you can find traction prescribed for improving LBP. In fact many medical offices dealing with low-back pain, like your neighborhood chiropractor, may have a very fancy table and set up to do just that. Despite the lack of scientific evidence that traction as a single form of treatment for low-back pain is effective, many students find the yoga suggestions below helpful in a multi-pronged approach to the problem. I had a friend with such pain, who after trying a lot of other things, swears that the weekly table traction he got at his chiropractor’s office finally did the trick. His only complaint was the cost: a lot!

As I've discussed in my past few posts about studies on back pain and easing it with yoga, your practice can provide you with safe, gradual traction to relieve tight muscles and connective tissue in the low back and possibly improve the space between the lumbar vertebrae. And at much less the out-of-pocket cost! Some of the poses you already do, if done mindfully with an eye to not triggering any low-back pain while in them, could be helping to create some traction already. Poses like Downward-Facing Dog and Standing Forward Fold, with a slight bend to the knees for both to allow the pelvis to create most of the forward folding action over the leg bones, can allow for some traction on the lumbar spine. If you have a history of a bulging or herniated disc, you should check in with your doctor before doing these poses regularly.

What works really nicely and gives more traction for the entire spine, is to do a version of Down Dog that involves a partner standing behind you, holding a strap that is placed across the top of your thighs. As you go up into Down Dog on your own, the partner will pull the strap firmly against your thighs while leaning back. This allows your arms to become almost unnecessary in keeping you in the pose. Your main job becomes cultivating the feeling that you are lengthening your spine away from your legs in the direction of your hands. Your partner anchors you up and back at the thighs and gravity pulling your forward and down does the rest to create traction for the spine. Stay for up to two minutes. Always take a minute or so when you come out to see how the back responds to this. If you feel good afterwards, it is usually safe to proceed further.

If you don’t have a friend that can do this with you (although I highly recommend you train one to do so) you can use a sturdy doorknob and a long yoga strap to accomplish the same thing. Make the strap into a non-slip large loop, thread it around the inside and outside doorknob of an indoor door, with the door open into a room you can practice Dog into. Step your body inside the loop, holding it up against the top of your front thigh as you face away from the door. Bend your knees, lean your weight forward into the strap, and drop your hands to the floor. At this point you will likely walk your feet back a bit, so they will be on either side of the door, while walking your hands forward until you are in Down Dog, with the strap creating a good pull back on your thighs. In the partner and door versions of Down Dog, you can stay for up to two minutes if things are pain free. With the door method, bend the knees and walk forward away from door, and the body will swing up from the back pressure of the strap. If you have a "yoga wall," you have likely played with this similar pose with your sling on the higher set of bolts.

With a yoga wall, you can also do a hanging version of Cobbler Pose, which really maximizes gravity’s effect on the spine. The only problem is that you need a very strong core to get in and out of that pose safely, so I will not describe it here, but next post I will address core strengthening and low back pain specifically.

One last idea: Position yourself close to a wall and lay down on your back about one shins-length from the wall. With your knees bent to 90 degrees, put your feet up on the wall so that your shins are parallel with the floor. You will have a nice 90-degree bend also at the hips and thigh bones. Here you can place your hands on the thighs down by the root of the legs. Push your hands into the thighs directly toward the wall. This will create a kind of secondary traction on the spine as your hands move your thighbones away from the pelvis and the pelvis gets pulled along for the ride. Again, maintain the push for up to two minutes, or as tolerated. and assess how it feels after you come out of pose.

As with all practices, as long as your back is not feeling worse after your yoga traction experiments, you will want to do these variations regularly over the course of a few weeks or longer to establish ongoing benefits.