Allopathic View/Western Medicine
Causes of Lower Back Pain
www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain
Most commonly, mechanical issues and soft-tissue injuries are the cause of low back pain. These injuries can include damage to the intervertebral discs, compression of nerve roots, and improper movement of the spinal joints. The single most common cause of lower back pain is a torn or pulled muscle and/or ligament.
A low back sprain or strain can happen suddenly, or can develop slowly over time from repetitive movements. Strains occur when a muscle is stretched too far and tears, damaging the muscle itself. Sprains happen when over-stretching and tearing affects ligaments, which connect the bones together. For practical purposes, it does not matter whether the muscle or ligament is damaged, as the symptoms and treatment are the same.
Common causes of sprain and strain include:
a) Lifting a heavy object, or twisting the spine while lifting
b) Sudden movements that place too much stress on the low back, such as a fall
c) Poor posture over time
d) Sports injuries, especially in sports that involve twisting or large forces of impact
While sprains and strains do not sound serious and do not typically cause long-lasting pain, the acute pain can be quite severe. Pain is considered chronic once it lasts for more than three months and exceeds the body’s natural healing process. Chronic pain in the low back often involves a disc problem, a joint problem, and/or an irritated nerve root.
Common causes include:
a) Lumbar herniated disc. The jelly-like center of a lumbar disc can break through the tough outer
layer and irritate a nearby nerve root. The herniated portion of the disc is full of proteins that
cause inflammation when they reach a nerve root, and inflammation as well as nerve compression
cause nerve root pain. The disc wall is also richly supplied by nerve fibers, and a tear through the
wall can cause severe pain.
b) Degenerative disc disease. At birth, intervertebral discs are full of water and at their healthiest.
As people age over time, discs lose hydration and wear down. As the disc loses hydration, it cannot resist forces as well, and transfers force to the disc wall that may develop tears and cause pain or weakening that can lead to a herniation. The disc can also collapse and contribute to stenosis.
c) Facet joint dysfunction. There are two facet joints behind each disc at each motion segment in
the lumbar spine. These joints have cartilage between the bones and are surrounded by a capsular
ligament, which is richly innervated by nerves. These joints can be painful by themselves, or in
conjunction with disc pain.
d) Sacroiliac joint dysfunction. The sacroiliac joint connects the sacrum at the bottom of the spine
to each side of the pelvis. It is a strong, low-motion joint that primarily absorbs shock and tension
between the upper body and the lower body. The sacroiliac joint can become painful if it becomes
inflamed (sacroiliitis) or if there is too much or too little motion of the joint.
e) Spinal stenosis. This condition causes pain through narrowing of the spinal canal where the nerve
roots are located. The narrowing can be central, forminal, or both, and can be at a single level or
multiple levels in the lower back.
f) Spondylolisthesis. This condition occurs when one vertebra slips over the adjacent one. There are
5 types of spondylolisthesis but the most common are secondary to a defect or fracture of the pars
(between the facet joints) or mechanical instability of the facet joints (degenerative). The pain can
be caused by instability (back) or compression of the nerves (leg).
g) Osteoarthritis. This condition results from wear and tear of the disc and facet joints. It causes
pain, inflammation, instability, and stenosis to a variable degree, and can occur at a single level or
multiple levels of the lower spine. Spinal osteoarthritis is associated with aging and is slowly
progressive. It is also referred to as spondylosis or degenerative joint disease.
h) Curvature of the spine can include scoliosis or kyphosis. The deformity may be
associated with lower back pain if it leads to the breakdown of the discs, facet joints, sacroiliac
joints or stenosis.
i) Trauma. Acute fractures or dislocations of the spine can lead to pain. Lower back pain that
develops after a trauma, such as a motor vehicle accident or a fall, should be medically evaluated.
Compression fracture. A fracture that occurs in the cylindrical vertebra, in which the bone
essentially caves in on itself, can cause sudden pain. This type of fracture is most common due to
weak bones, such as from osteoporosis, and is more common in older people.
It is important to note that the presence of one or more of these conditions does not necessarily mean that is the cause of pain. For example, osteoarthritis or degenerative disc disease could appear on an imaging study but the person may not report pain.
Less Common Causes of Low Back Pain
While considerably less common, low back pain may also be caused by:
a) Infection. Also called osteomyelitis, a spinal infection is rare but can cause severe pain and is life
threatening if untreated. It can be caused by surgical procedures, injections, or spread through the
blood stream. Patients with a compromised immune system are more susceptible to developing an
infection in the spine.
b) Tumor. Most spinal tumors start in another part of the body and metastasize to the spine. The
most common tumors that spread to the spine start from cancer in the breast, prostate, kidney,
thyroid, or lung. Any new symptoms of back pain in a patient with a known diagnosis of cancer
should be evaluated for possible spinal metastasis.
c) Autoimmune disease. Back pain is a possible symptom associated with autoimmune conditions,
such as ankylosing spondylitis, rheumatoid arthritis, lupus, crohn’s disease, fibromyalgia, and
others.
YOGA AND BACK PAIN
- Yoga means union. Pain is a sign of separation.
- Everything we need to heal is inside of us. Our goal is to remember our unity and wholeness.
Back pain is an epidemic in our country. Here are some ways yoga can contribute to back health:
a) Yoga asanas correct posture, release areas of chronically contracted muscles, strengthen areas of weakness, increase supply of nutrients such as oxygen, remove metabolic waste, lengthen the vertebral column, and create space between the vertebrae.
b) Pranayama relaxes the musculature of the back, brings awareness and energy into the back, massages the back and spine, and increases the supply of nutrients.
c) Body awareness is perhaps the greatest ally in back care. Most people are not aware of the postural habits and areas of chronic tension that contribute to back pain.
d) Guided imagery can be used to relieve and heal back problems.
e) Meditation can release the unconscious beliefs and holding patterns that may be at the root of back tension.
f) Relaxation allows the healing process to function optimally.
g) The following postures focus on overall wellness for the back and spine. Use only postures that are comfortable for you. Remember that your own body is the best guide to what is most beneficial.
YOGA, BACK PAIN AND THE PANCHAKOSHA SYSTEM
“Abdominal tension and stress are frequently at the root of lower back pain, for as the muscles in the belly tighten and contract, the begin to tug on the muscles that surround the spine, forcing them too become contracted and rigid. The armoring and dis-ease can accumulate until chronic pain and recurring back injuries take control of the health potentials for this region.
Most people with lower back trouble report that they first experienced difficulty with their backs as a result of some injury or back-straining activity, such as lifting heavy weights, sitting in uncomfortable furniture, or sleeping on too soft a bed. Yet it seems to me that the back disturbance does not begin at the time of the acute injury occurred because the muscles and emotions of the back had been chronically held and contracted for some time, thereby predisposing the area to injury.
Why do so many people have tension and stress in this portion of the body mind? I believe the answer lies in the fact that this region, in addition to being directly connected to the feeling and power center, the belly, also acts as a mediator between the psychosomatic aspects of the top and bottom halves of the bodymind.” – Ken Dychtwald, The BodyMind
KOSHIC VIEW
1) Annamayakosha: Imbalance of muscular and or skeletal system (front/back split, top/bottom split). Top/Bottom split is characterized by a small top and large bottom physically or large top and small bottom. Front/Back split. Injury, strain, or trauma. Postural Problem. Structural Issue (leg length, high hip)
2) Pranamayakosha: Imbalance of energetic body (root, sacral and/or solar plexus chakra imbalances. front/back split, top/bottom split). The bottom half of the bodymind is concerned with stabilizing, moving, balancing, supporting, rooting and grounding. The top half of the bodymind has to do with seeing, hearing, speaking, thinking, expressing, stroking, hitting, holding, communicating and breathing. Inability to breathe diaphragmatically. Paradoxical Breathing.
3) Manomayakosha: Top/Bottom Split where bottom half is oriented toward privacy, support, introspection, emotional stability, dependency and motion/stasis. The top half of the body is concerned with outward expression, socializing, interpersonal communication/manipulation, self-assertion, action and aspirations. Front/Back split. The front side represents the social self and the conscious self. It is what we knowingly present to the world. The back side is the private and unconscious elements of the self. It sometimes becomes the storehouse of all the things in life we don’t want to deal with. Back of the body is where a lot of “negative” emotion is stored.
4) Vijnanamayakosha: Acceptance of Self, Presence, Understanding the situation as a witness
5) Anandamayakosha: Connecting to the things that bring you joy
1. INTAKE / CHECK-IN
a) What the nature of you back pain or injury.
b) When did you first began to experience this pain /discomfort.
c) What medical care or treatment have you received for it.
d) Is the pain constant or intermittent?
e) On a scale from 1 to 10, what is the intensity of the pain?
f) What kinds of activities / situations seem to aggravate it?
If the injury is recent or if there is any swelling, inflammation, redness, numbness or tingling, difficulty with bowel or bladder functioning, or radiating pain, yoga therapy will begin with minimal movements as a way of directing awareness to the area and focus on pranayama, mudra, meditation and yoga nidra. Contact Nya 310/420-1682 or nyapatrinos@yahoo.com if you want to work on your back in a Yoga Therapy Setting.
2. BODY AWARENESS EXERCISE WITH BODY MAP
3. INITIAL SHARING
4. BREATH AWARENESS FOR THE BACK
Breath is one of the keys to optimal health and wellbeing, and the foundation of all the breathing techniques is abdominal or diaphragmatic breathing.
5. MUDRA MEDITATION
Anudandi Mudra
CORE QUALITY
Back Pain Relief
ESPECIALLY HELPFUL FOR
• Releasing tension from the back.
• Supporting optimal posture.
• Providing a massaging effect for the area of the kidneys and adrenal glands.
• Reducing stress.
INSTRUCTIONS
1. Make the hands into fists, with the thumbs inside and the palms facing the body.
2. Extend the little fingers and touch them firmly together at their tips.
3. Hold the gesture below the navel or rest the hands on the lap.
4. If there is discomfort in the seated position, use the restorative position, lying on your back.
5. Relax the shoulders back and down, with the elbows held slightly away from the body and the spine naturally
Kanishtha Sharira Mudra
CORE QUALITY
Lower Body Breathing
ESPECIALLY HELPFUL FOR
• Connecting to the lower body.
• Activating the diaphragm, the main muscle of respiration, supporting fuller abdominal breathing. • Optimizing digestion.
• Releasing tension from the low back. • Instilling equanimity
centering.
• Building a sense of confidence.
INSTRUCTIONS
1. Place the web between your thumbs and index fingers on either side of your waist, just below the ribs, with the thumbs facing backward and the fingers pointing forward.
2. Keep the fingers together with the palms and forearms parallel to the earth.
3. Hold the elbows out and away from the body, with the shoulders relaxed back and down and the spine naturally
Vittam Mudra
CORE QUALITY
Free Flow of Vital Energy
ESPECIALLY HELPFUL FOR
• Reestablishing the free flow of subtle energy.
• Nourishing the reproductive and urinary systems.
• Relaxing the lower back.
• Awakening vitality.
INSTRUCTIONS
1. Hold the hands slightly cupped in front of the lower abdomen with the palms facing each other about twelve inches apart.
2. Allow the hands to naturally expand away from each other on the inhalation and to rest gently back toward each other on the exhalation.
3. Relax the shoulders back and down, with the spine naturally aligned.
6. WARM-UPS AND ASANA
We’ll now begin to stretch, relax, and bring awareness to every part of the body.
[The shoulder and neck movements can be done standing, seated in a chair, or seated on the floor. Allow all the initial movements to be exercises in awareness rather than physical exercise.
What to bring Awareness to
a) Notice all the sensations in the back and spine
b) Feel the spine lengthening and feel the space being created between the vertebrae.
c) Feel the spinal discs alive with fluid and filled with energy.
d) Sense the spinal cord being bathed in healing nurturing fluid.
e) Feel the blood filling the spine and back, bringing nutrients to every cell.
f) Notice the ability of each muscle to fully contract and then to completely let go.
(Work with specific tight muscle groups in this way).
Series 1: Gentle Postures for Back Care – Integrative Yoga Therapy
1. Tadasana (standing or supine): Lengthening the spine
2. Shoulder Girdle Movements: shoulder and spine flexibility
3. Neck Movements: Neck Flexibility
4. Cat Movements: Spinal flexibility and strength
5. Hip Circles: hip and low back flexibility
6. Child’s Pose: Back flexibility and Length
7. Cobra for Back strength
8. Sphinx for Spinal flexibility
9. Half Locust for Low back strength
10. Abdominal Strengthening
11. Constructive Rest
12. Pelvic Lifts: Spinal flexibility and strength
13. Knee to Chest: Hip, quadriceps, and psoas
14. Hamstring Stretch:
15. Supine Spinal Twist or Standing w/ Chair: Flexibility in rotation
16. Half Shoulder Stand
17. Savasana
Series 2: Postures for Back Care – Integrative Yoga Therapy
1. Cat or Other Warm Ups: Spinal flexibility and strength
2. Tadasana: Spinal alignment
3. Ardha Chandrasana Series:
a) Lateral Bend:
b) Supported Back Arch (Sphinx):
c) Forward Bend (Uttanasana): Spinal flexibility
4. Triangle (modified): Lateral bending, hip flexibility
5. Lateral Angle (modified): Hip, spine, and shoulder flexibility
6. Tree: Balance, alignment
7. Chair: Leg strength, hip flexibility
8. Child’s Pose: Flexibility of knees, hips, back
9. Cobra: Spinal strength
10. Half Locust: Lower spinal strength
11. Abdominal Strengthening: Abdominal strength
12. Leg Stretch: Hamstring flexibility
13. Bridge: Gluteal strength, hip and back flexibility
14. Knee to Chest: Hip, knee, and iliopsoas flexibility
15. Knee Down Twist: Hip and low back flexibility
16. Half Forward Bend: Flexibility on one side
17. Forward Bend: Flexibility of back and backs of legs
18. Half Shoulder Stand: Inner balance
19. Fish: Flexibility of thoracic and cervical spine
20. Savasana: Inner calm
7. YOGA NIDRA / GUIDED IMAGERY
8. SILENT RELAXATION
9. MEDITATION
[Sit 1 to 5 minutes.]
10. FINAL SHARING AND AFFIRMATION
GUIDE TO ASANAS FOR SPECIFIC CONDITIONS – GHOSH LINEAGE
Ankylosing spondylitis: an inflammatory disease involving the spine and sacroiliac joints, and is therefore also a form of spondylarthritis. A combination of spondylitis and inflammation of the intervertebral disc space is termed a spondylodiscitis. Spondylitis is one of the most common causes of back and neck pain, and results from inflammation of the vertebral joints.
- No sukasana (easy pose), No ardha chandrasana (1/2 moon), No boat, No camel, No bhadrasana (butterfly), No sarvangasana (bridge)
Spondolithisis
- No warrior 1 or 2, no janusirshasana (seated head to knee), No pawanmuktasana (wind removing pose)
Lumbar spondylosis
- No halasana (plough), ardha kurmasana (half tortoise),
- Yes Makrasana
Lumbar Spondylosis
- Yes Warrior 1, Yes Locust, Yes Leg pulling lying down
- No sarvangasana (bridge), No Janusirshasana (seated head to knee), No supta vajrasana (saddle), No sasangasana, No vipariti Karani
Back Ache
- Yes Sarvagasana (Bridge), Yes Prone postures
Back Injuries
- No utkatasana (awkard/chair pose)
Back Pain
- Yes lifting of shoulder joints with pulling of shoulder blades, Yes Sarvagasana/Bridge (especially upper back pain), Yes Prone leg press (not supine), Yes Lifting of knee joints pillow under the knee, Yes Knee rolling lying down (upper back pain),Yes Ardha Chandrasana/Ghosh Lineage ½ Moon (upper back pain), Yes Pelvic lateral tilt lying down, Yes Cobra with cross legs, Yes Locust (lower back pain)
- No toulangasana (balancing stick, warrior 3), No SURYA namaskar
Herniated Discs
- no sasangasana (rabbit), No boat
Low back pain/Lumbago
- Yes crocodile
- No paschimottanasana (seated forward fold), no camel
Slipped Discs
- Yes Ardha Matsyendrasana/ ½ Lord of the Fishes but contra-indicated with postural arthritis, pedeledema and spine fractures.
- no sarvangasana, No paschimottanasana, No sasangasana
- Yes Makrasana (crocodile), Yes locust, Yes Knee rolling - lying down
Spine Flexibility
- Yes halasana/plough (if flexibility is there), Yes Marjasana/cat (gently)
Spine Fratures
- No Matsyendrasana (fish), No camel, No trikonasana
Spin detoxification
- Trikonasana (triangle)
Spinal Deformity
- Jastiasana
Spinal Injuiries
- No utkatasana, no halasana , No pashimottanasana, No suptapadagustasana, No toulangasana, No ardha Chandrasana, No locust
Spinal Nourishment
- Yes Brishasana (Ram), Yes Crocodile, Yes Prone postures, Yes halasana, yes Sukasana, Yes Supta padagustasaana, Yes Camel, Yes Cobra
Spine rejuvenation
- Yes bow, Yes paschimottanasana, Yes UTTANAPADASANA (leg raises)
Kyphosis
- Yes sukasana
Nephritis.
Nephritis is inflammation of the kidneys and may involve the glomeruli, tubules, or interstitial tissue surrounding the glomeruli and tubules.
- no DHANURASANA (bow)
Osteomyelitis
- no vajrasana (hero) , No padmasana (lotus)
Osteoporosis
Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses such as bending over or coughing can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine. Back pain can be a symptom caused by a fractured or collapsed vertebra
- No utkatasana, No brishasana, No supta bhadrasana, No supta vajrasana No vajrasana No padmasana
No singhasana (lion), No bhadrasana
Sciatica
Yes Parsa Savasana, Yes Brishasana, Yes Back kicking, Saralbhujangasana (seal pose with curls turned under), Yes Lifting of knee joints pillow under the knee, Yes Makrasana, Yes janu sirshana,
Yes Supta vajrasana, Yes Vajrasana, Yes pelvic lateral tilt, Yes Cobra resting on hands (sphinx) with leg twisting
Sciolosis
- Ardha matsyendrasana (contra-indicated with postural arthritis, pedaledema and spine fractures.
- Yes Sukasana, Yes Bhadrasana (butterfly)
Simple Yoga Poses for Back Pain
Here are some simple things for lower and middle back back. Spend 1 to 5 minutes in each position.
CONSTRUCTIVE REST - ARDHA SAVASANA
with slow deep breaths concentrating on breath in belly and then 360 degree breathing all in and out of your nose.
PELVIC TITLS
SUPPORTED BRIDGE POSE - YOU CAN USE A PILLOW OR TOWEL UNDER YOUR SACRUM
SUPPORTED SHOULDER STAND - SHOULDER STAND - OR LEGS UP THE WALL
LOW CROCODILE POSE
SPHINX - EVEN BETTER IF YOU CROSS YOUR ANKLES AND TURN SIDE TO SIDE
LOOKING AT YOUR TAIL BONE
SAVASANA - SUPPORTED SAVASANA
Notes on Protecting the Sactoiliac Joints in Forward Bends, Twists and Wide Legged Poses
Movement of the sacroiliac joints can be a source of back pain.
Don’t confuse what we are calling SI pain with other types of back pain, because, in most cases, the explanations and suggestions for back pain caused by the SI can't are not the same for people with
other types of pain.
The cardinal symptom of SI pain is an ache on or around the posterior superior iliac spine (PSIS), on one side of the body only.
The PSIS is the rear-most point of bone on the pelvis. In most students you can palpate it by pressing your fingers into the back of the pelvis above the main mass of the buttock, about two or three inches to the side of the center line of the upper sacrum.
Most students with SI problems will tell you that long periods of sitting and most types of forward bends aggravate their pain, but this is also true for students with sciatica and other back problems.
Those with SI pain are often particularly aggravated by wide-legged (abducted) poses, such as Baddha Konasana (Bound Angle Pose), Upavistha Konasana (Wide-Angle Seated Forward Bend), Prasarita Padottanasana (Wide-Legged Forward Bend), Utthita Trikonasana (Extended Triangle Pose), Virabhadrasana II (Warrior II Pose), and Utthita Parsvakonasana (Extended Side Angle Pose). They also have trouble with twists, such as Marichyasana III (Pose Dedicated to the Sage Marichi III), and side-bends, such as Parivrtta Janu Sirsasana (Revolved Head-to-Knee Pose). For many, the worst pose is a combination of twisting, abduction, and forward bending, namely Janu Sirsasana (Head-to-Knee Pose).
A joint is where two bones come together. The sacroiliac joint is where the sacrum bone and the ilium bone join one another.
The sacrum and the two ilium bones often merge into a single bone but this is not always the case.
Many health professionals who have worked with yogis believe that the cause of their sacroiliac pain is excessive movement of the joint, leading to misalignment, ligament strain, and, possibly, eventual deterioration of cartilage and bone on the auricular surfaces. Another hypothesis is that the source of SI pain is sprained or torn ligaments, rather than injury to the joint surfaces themselves.
Backbends can be good or bad for the SI joints, while forward bends usually spell trouble. Postures that spread the thighs wide apart (into abduction), like Baddha Konasana, Upavistha Konasana, and Virabhadrasana II are also big time troublemakers.
