Yoga Tips For Back Pain to Move Well & Feel Better.

I am passionate about helping people move well to feel better. I think part of this passion arises from my own experiences with injury and chronic pain, and not knowing what to do about it.

For most of us, pain is confusing. Movement is also confusing. We know that movement impacts our pain and vice versa, but we may not understand the direct correlation between moving well and feeling better. We may not even understand what it means to move well.

That’s what I’d like to open a discussion about in this article. First, I’d like to address pain and our mindsets around it, because we can’t move forward from chronic back pain until we have our heads screwed on straight. Then I’d like to suggest some ways to move better, and my hope is that you’ll also begin to feel better as a result of that movement.

I am not offering medical advice, nor am I prescribing exercise for rehabilitation. I am only qualified to share my interest in movement that helps our bodies work and feel better as we age.

Tune-Up Your Mindset

Thinking initiates behavior, so before we start changing our behavior, let’s start with changing our thinking. 

When I was growing up, my mom was in near-constant chronic pain from an auto-immune illness. There wasn’t a lot of discussion regarding mindsets, it was always assumed that the pain was fixed no matter how we thought about it. She’s not with us any longer, so I can’t open the discussion with her. That’s probably why I’m picking the conversation up in blog posts like this. 

Understanding pain

Our first mindset tune-up begins with our understanding of pain. 

I grew up assuming that pain was something that was happening in our tissues. Maybe you did, too. Luckily, we know more about pain now, which means we can update our ways of thinking about it. 

Here’s a little bit about how pain actually works:

• Pain is an output from our brain, not an input from our tissues

• Pain and tissue damage are poorly correlated

• Pain is influenced by a myriad of lifestyle factors, called the bio-psycho-social model of pain

Here’s what those bullet points tell us about our experience with back pain:

1. Just because we are experiencing pain, does not mean we have corresponding tissue damage

2. Conversely, we may have tissue damage in areas where we don’t experience pain (Which begs the question: What are we really interested in addressing--pain or tissue damage? [Examples of things I ponder when thinking about things like this])

3. Our back pain may be created by a myriad of other factors beyond tissue damage, including how stressed we are at work, the quality of our personal relationships, what we’ve had to eat recently, how often we move our bodies (and what parts of our bodies we move when we move), whether we’re catastrophizing the pain we’re experiencing, etc.

The main takeaway is this: Yes, pain is real, it just probably isn’t real the way you’re used to thinking about it. Thinking about it differently is the first step towards changing behavior to address your back pain in a long-lasting and meaningful way.

The next part of the mindset tune-up involves understanding the nature of tissue adaptation and what to do with the pain that you have.

Resiliency & Adaptability 

The good news is that our body is resilient and adaptable: Our tissues are continuously remodeling in response to how we use them.

There’s an interesting paradox here because while being in pain doesn’t necessarily mean our tissues are injured, improving the quality of our tissues tends to help our pain. I’ll dive into how to improve the quality of our tissues in the next section--for now, the main takeaway is that our tissues are highly adaptable. They are often more resilient and adaptable than our mindset, which is why we started our discussion here. 

This is especially helpful if you are someone who catastrophizes your pain, which is something I’m known to do if I wake up with an ache I wasn’t having yesterday. Understanding the nature of tissue adaptation provides a useful counter argument when you notice yourself going down the rabbit hole of doom. Again: Mindset for the win.

Jules Mitchell’s book, Yoga Biomechanics: Stretching Redefined is a great tool for understanding tissue adaptation. Reader beware: It is dense, but it’s the most scientifically up to date resource for understanding the mechanics of yoga movement.

Get Smart About Movement 

Correcting our mindset is a lifelong practice of educating ourselves about the things we think we already know. Getting smart about movement entails putting that education to good use.

Now we know that pain is a multifactorial biopsychosocial experience produced in our brains. We know that our tissues are adaptable and resilient, and that they are always responding to how we use them. So let’s talk about how to use them. 

There are certain movement nutrients our bodies need in order to work and feel better as we age. There are a variety of activities we can choose to meet those needs and in the next section I’ll get into the specifics of using yoga to address back pain specifically. For now, consider this section as a high-level view into what our body needs as a whole, and how we might meet those needs, even if it’s beyond the scope of our yoga practice. 

Strength

Strength is our ability to generate contractile force against resistance. In other words, it’s our ability to use our muscles to do hard things. 

In an ideal world, we would all be educated about our bodies and their movement nutrient needs throughout our lifetimes, and generating full-body strength would be an intuitive process that occurs naturally with our daily movement. We would be strong enough to lift, carry, haul, crawl, squat, climb, run, jump, swim, push, and pull in a variety of shapes and with a variety of load.

This is not the world we’re living in. Our reality is mostly sedentary lives, broken up by small chunks of time that we call “exercise”. For most of us, our strength is not universally developed across our entire body. 

I call that first scenario an ideal world because that’s really what it is: Our brains are programmed to crave strength because strength makes our nervous system feel safe. When we give our nervous system the experiences she needs to feel safe, she outputs less pain, tightness and inflammation. Historically, we provided these experiences to our nervous system naturally throughout the course of the day, as we spent most of our time foraging or keeping camp. 

Mobility

Each joint is capable of certain movements. Mobility refers to the range of motion we’re able to control with our strength in each joint position.

Note: Mobility does not refer to the range of motion that we can passively endure, which is likely much more than the range we’re able to control with our strength. (That’s the difference between active and passive ranges of motion.) 

If strength is our ability to generate contractile force against resistance, mobility is our ability to maintain that contractile force throughout a full range of motion. This is another aspect of making our nervous system feel safe. The more mobility we have, the more movement options we have at any given time, which is when our brain feels safest.

Stability

Stability is what you get when you put strength and mobility together. It refers to something that can withstand perturbation, that can bounce back to a starting position quickly, that doesn’t collapse under pressure. 

It’s the element of control in our movement.

Variability

Here’s something that might not be very obvious: Our brain loves variety and diversity. The newer a movement is in our bodies, the more benefits we see. I love the example my teacher Jules Mitchell sometimes uses: If you were playing tennis against Venus Williams, who do you think would leave that game with more strength adaptations happening in their tissues? Probably not Venus, because her tissues are already adapted. It would be yours! 

Sometimes movement makes us feel better not because it’s the perfect panacea to your ailment, but simply because it’s a novel stimulus to your tissues and nervous system. 

This might look like rotating activities or spicing up the activities you already do to include more variety and diversity. 

Moving With Pain: Yoga Edition

First thing’s first, you might be having pain for all kinds of reasons. Talking about the nature of pain is within the scope of my practice, telling you what to do with your pain is not. This section is meant to dive into some more specifics regarding yoga and back pain, not to give you a movement prescription, but to open up the doorway to critical thinking. 

As I mentioned before, our movement nutrients can be met with or without yoga. I’m choosing to look at this through the lens of yoga simply because that’s the movement I love to do most. At the same time, I’ve needed to adapt my physical yoga practice over the years to feature more targeted movement nutrients to address various aches and pains in my body. This is to say: I’ve been in the trenches.

In order to address yoga and back pain, I’ve divided the conversation based on the location of the pain. 

Things to consider:

• Do you have back pain before, during or after yoga? 

• Does yoga make your back pain better or worse?

• Have you identified any movements that trigger your pain -or- make it feel better?

Answering these questions will help orient you as you move through this next bit :) 

Yoga For Upper Back Pain

*No matter where your pain is, treat it as a whole body experience. Focus on moving well in your whole body, and pay attention to see what influences your pain one way or another. This allows you to address your pain without needing to understand the complexity of it. 

When we’re talking about the upper back, we’re talking about structures like the shoulders, ribs, head, neck and thoracic spine (the vertebrae with the ribs on them). I imagine that these structures might all need some attention and TLC. The spine and ribs likely need to be able to access their neutral position more readily and easily. The shoulders could probably stand to be strengthened and mobilized through all ranges of motion. 

While addressing all these things, you’ll invariably end up addressing things farther down the line, like the wrists or the pelvis or the hips or the knees or the ankles or the feet. Be open to the possibility that where you’re feeling your pain is not where the problem originates. 

Yoga For Lower Back Pain

*Read section above, because it also applies here :) 

Low back pain is one of the biggest complaints our culture has. In the same way that when looking at the upper back, we’re really looking at the structures around it; when we’re addressing low back pain, we need to address structures around the low back. The hips probably need to be strengthened and mobilized. The pelvis likely needs to be able to access its neutral position more readily and easily. The legs and feet may need further development, along with the core (360 degrees of tissue around the trunk). 

Getting Started:

If you like, your next steps involve saddling yourself with the resources you need to be successful. Ask yourself whether you need medical attention. Consider your current movement habits and what changes you can make to move more of yourself more of the time. Be honest about your current consumption of movement nutrients and what you need more of in your movement diet. 

And then: Find your teachers. A teacher can be someone at your local gym or yoga studio. It can be the friend you wake up early to go running with. It can be someone online who puts out stellar content. It can be your dog. 

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