- New research builds on existing evidence supporting the benefits of yoga for low back pain.
- A 4-week telehealth yoga program significantly reduced low back pain among participants with the condition.
- The researchers found certain yoga poses emphasizing hip flexion improved the flexion-relaxation ratio, a biomarker of chronic lower back pain.
- Larger studies are needed to determine the long-term effects of yoga on low back pain relief.
While yoga is not a cure-all, there is no shortage of science-backed benefits of the practice.
Yoga is frequently studied for its potential to relieve chronic low back pain, an often difficult-to-treat condition that in 2020 affected 619 million people globally.
Now, an Italian research team specializing in rehabilitative medicine has furthered our understanding of yoga’s positive impact on low back pain.
The researchers evaluated the effects of a 4-week yoga program on the flexion-relaxation phenomenon, a biomarker of chronic low back pain limiting paraspinal muscle activity or range of motion.
They recruited 10 females ages 18–40 with nonspecific chronic low back pain (NCLBP) and 11 females without. Both groups participated in a structured 8-session yoga program; the first session was conducted in a clinic, and the remaining sessions were offered via telehealth. The 30-minute sessions included a sequence of nearly 30 yoga postures (asanas), breathwork, and other mindfulness practices.
The findings, published February 21 in the Journal of Orthopaedic Research, show a significant reduction in pain intensity in the back pain group. Yoga also benefitted neuromuscular response during spinal flexion in both groups, thus improving participants’ flexion-relaxation ratio.
Due to the small number of participants and short study duration, the researchers note that further studies are needed to determine any long‐term effects of yoga on low back pain.
“Relieving back pain still remains a challenge, [and] asanas can become an addition to the range of possibilities in managing this disorder,” Dr. Alessandro de Sire, associate professor of physical and rehabilitative medicine at the University of Catanzaro Magna Graecia and physician at University Hospital Renato Dulbecco in Italy, told Healthline.
Yoga reduces back pain, improves mobility
The study builds on existing evidence supporting the benefits of yoga for low back pain relief.
Researchers observed a reduction in pain intensity after 4 weeks using a 10-point visual analog scale (6.8 average pain at the start of the study, 3.3 after the yoga sessions).
Yoga also improved participants’ flexion–relaxation phenomenon (5.12 at the start of the study, 9.49 after the sessions), which was measured with electromyography during maximum voluntary flexion (rounding) of the spine.
Given the short-term nature of the study, researchers used a Prophet evaluation to predict positive flexion-relaxation trends for an additional month after the intervention. The evaluation forecasts that tele-yoga asana could continue to positively affect pain intensity and spinal mobility.
The yoga postures included in the study varied, but many involved some type of hip flexion (forward bend) with a neutral spine.
“I appreciate that this study explored the ways that asana can relax muscles, and it echoes what yoga traditionally tells us, which is that forward bending poses are generally calming and relaxing,” Jivana Heyman, a yoga therapist in Santa Barbara, CA, founder of Accessible Yoga and author of Yoga Revolution, told Healthline.
“Hip flexion can be very beneficial for people with low back pain because it can increase range of motion without overly engaging the lower back. My sense is that people with chronic low back pain hold additional tension in that area as a protective mechanism, and asana can help to release some of that tension,” Heyman said.
Yoga poses for chronic low back pain
There are countless studies about yoga, but they don’t always disclose which poses were used to achieve the desired outcome.
Rather than study a particular style of yoga (i.e., Hatha or Vinyasa), the researchers included a regimen of nearly 30 postures to demonstrate how yoga works to relieve low back pain more clearly.
De Sire said each pose in the sequence was held for five breaths (around 1 minute each) for a total of 30 minutes per session.
“Asanas can commonly be difficult and misleading to assimilate; providing the reader with specific postures might guarantee scientific reproducibility, but above all greater dissemination of the practice with scientific evidence,” de Sire explained.
Heyman said he appreciated the inclusion of the poses in the study.
“Often doctors refer patients with low back pain to yoga, and the patients are left to figure out what practices or classes are appropriate for them,” he said. “They could easily end up in a yoga class that is too physically intense, which could cause more injury or simply leave them feeling that yoga is not for them.”
The following yoga poses for low back pain were included in the study:
- Easy Seat (Sukhasana)
- Cat Stretch (Marjariasana)
- Mountain Pose (Tadasana)
- Crescent Lunge (Ashta Chandrasana)
- Cow Pose (Bitilasana)
- Downward-Facing Dog (Adho Mukha Svanasana)
- Pyramid Pose (Parsvottanasana)
- Pigeon Pose (Eka pada rajakapotasana)
- Half Lift (Ardha Uttanasana)
- Chair Pose (Utkatasana)
- Cobra Pose (Bhujangasana)
- Crocodile Pose (Makarasana)
- Child’s Pose (Balasana)
- Standing Foward Bend (Uttanasana)
- Half Lord of the Fishes Pose (Ardha Matsyendrasana)
- Staff Pose (Dandasana)
- Gate Pose (Parighasana)
- Head-to-Knee Forward Bend (Janu Sirsasana)
- Cobbler’s Pose (Baddha Konasana)
- Caterpillar Pose (Ardha Paschimottanasana)
- Eye of the Needle Pose (Sucirandhrasana)
- Belly Twist Pose (Supta Jathara Parivartanasana)
- Happy Baby (Apanasana)
- Legs Up the Wall Pose (Viparita Karani)
- Plow Pose (Halasana)
- Bridge Pose (Setu Bandha Sarvangasana)
- Corpse Pose (Savasana)
A promising intervention for low back pain relief
The study’s model predicts the positive results of yoga for back pain could be maintained long-term, de Sire explained, but larger, more rigorous studies are needed to determine this effect.
Still, Heyman said that yoga can be a helpful intervention for finding relief from low back pain.
“This study adds to the growing literature that supports yoga as a viable treatment for low back pain, which is a major cause of disability and lost work in the U.S. and around the world,” he said.
“I have found that my students with low back pain gain even more benefit from the yoga practices that help regulate their nervous systems and reduce tension and stress. So building a well-rounded yoga practice that focuses not just on asana but on stress reduction and nervous system regulation could offer even greater benefit to people with low back pain,” he added.
Tips to get started with yoga if you have low back pain
If you live with low back pain and are interested in trying yoga, it’s a good idea to do some research to find appropriate classes and qualified instructors.
“If you’re looking to start yoga and you have low back pain, I’d recommend that you look for yoga therapists (C-IAYT) or classes with titles such as ‘Accessible Yoga,’ ‘Adaptive Yoga,’ and ‘Gentle Yoga,” Heyman shared, adding that chair yoga can also be a great place for beginners.
“Be careful about jumping into classes with titles like ‘All Levels’ or flow classes where there are quick movements,” he noted.
Heyman said the most important component of any yoga class is clarity of instruction and the teacher’s ability to individualize the practice to meet the practitioner’s needs.
“Talk to the teacher before class starts to let them know about your condition so they can adapt the practices for you,” he said, emphasizing yoga props as a helpful tool for finding comfortable variations within poses.
“People with low back pain tend to be very aware of what movements feel safe, and it’s important to support them in exploring these poses in a safe and accessible way,” Heyman said.
Takeaway
A new study helps further our understanding of the benefits of yoga for low back pain relief.
The 4-week, 8-session telehealth yoga program significantly reduced low back pain among subjects with the condition. Yoga postures involving hip flexion appear to improve the flexion-relaxation phenomenon, a biomarker of low back pain.
Larger studies are needed to determine the long-term effects of yoga on low back pain relief.
