Yoga could kill you! But it also might help with your low back pain
Todays guest post comes from Jenna Rubin, if you’re interested in submitting a guest post send me an email with your idea at firstname.lastname@example.org
In a review titled “the adverse events associated with yoga”, there were several unorthodox practices which resulted in further injury from doing yoga. Death was reported in a yoga practice where individuals were advised to do “mouth to mouth” breathing in which one yoga participant blew down the others throat so hard the receiver ended up with pneumomediastinum (air in the chest cavity). Additionally, a practice called “ kunjal kriya”, was demonstrated in several yoga sessions in which individuals voluntarily vomited as a form of spiritual cleansing. It seems that yoga might kill you! (probably not though) but it may also help with chronic low back pain.
In the past couple months I have become infatuated with the mechanisms behind non-specific chronic low back pain. The reason back pain is referred to as “non-specific”, is because no tissue damage or injury can be found to explain the pain. Eighty percent of the population in the United States suffers from low back pain at some point. Twenty five percent of the population has chronic low back pain, which means that the pain has lasted longer than three months. The question is, why do some people continue to experience unpleasant sensations in the absence of injury?
Could it be that certain individuals are so tired of taking care of their responsibilities that they put themselves into a state of disability to catch a break? Could it be that the chairs people sit in all day are much like torture devices and are creating “poor posture”, and compression of the spine. Based on the research I have been reading, it seems likely that chronic pain is a mechanism which stems from psychological dysfunction.
It is my philosophy that society as a whole has become overly dependent on outside help to overcome any hardship, small or large. If something hurts, you can take some medication, if you can’t do something, then somebody else will do it for you etc. Whatever happened to trying to figure things out before asking questions, or being self-efficient, and gaining the strength to deal with your problems? In relation to chronic low back pain, it seems as if after an individual experiences pain acutely, they begin looking for something to relieve the problem, obsess about it and therefore create more pain.
Similarly to chronic low back pain, about 25% percent of the people in the United States suffer from anxiety and depressive disorders. These disorders are accompanied by feelings of hopelessness/ helplessness, in which a person feels they are unable to help themselves and need outside assistance. If you are lost in the jungle and a Black Panther jumps out in front of you and you reach in your back pocket to pull out your gun and realize all that you have is a banana, an anxiety attack might be useful. The anxiety will speed of your heart rate, pump blood into your limbs and perhaps give you the energy to get away FAST. The response that occurs during a panic attack is called “the fight and flight response”, which can help us in times of danger. However, 25% of the population will have the flight and fight response in a scenario where no threat exists.
Much like anxiety and depression chronic pain is beginning to be investigated from a psychological perspective. According to the “Neuromatrix Pain Theory” proposed by Ronald Melzack, pain can be triggered by the memory of a physically damaging experience, even when a threatening stimulus is not currently present. When an injury or tissue damage actually happens our bodies try to maintain homeostasis using our perceptions of pain, the action programs we take to resolve the problem, and stress regulation responses which often increase cortisol levels.
If a person does not have self-efficient coping strategies, and inadequate stress responses, the pain response may continue based on the memory of the event, rather than the event itself. Additionally, if cortisol levels are increased in the absence of injury, the hormone can cause actual damage to our physiology. Therefore, while many of these processes are subconscious, it is possible that we put ourselves into a state of disability by holding on to painful memories. In several studies a correlation has been determined between high anxiety/depression, and chronic pain. Perchance, the same inconsistency in the nervous system which triggers the flight and fight at the wrong time, also triggers chronic pain.
Because chronic low back pain appears to be as much physical as it is psychological, I began looking into therapeutic methods which combine both attributes.
Yoga has been a passion of mine for the past few years, and it is very much so a psychological and physical practice. I generally feel happier when I leave yoga. Maybe it is just because I burst out laughing every time we are supposed to do “corpse” pose (a pose that requires complete stillness and silence), I guess I’m not much of a corpse.
There is always a lot of talk about yoga healing the digestive system, creating a space for positivity, curing disease etc. This one time a yoga teacher I had said “let all of your air flow out”, and a man in the front row let out a huge fart. I think the experience was probably more embarrassing than healing in his case. Anyhow, there does seem to be a connection between practicing yoga and relief of low back pain from the literature I have read.
The first study I looked at described how female veterans who suffered from chronic low back pain completed a ten week yoga program and experienced decreases in self-reported low back pain. Interestingly enough, the female veterans also self-reported decreases in depression. In another study, individuals completed a 48 week yoga program. Following the program participants had decreases in functional disability, depression, pain intensity, and medication use. Something I find even more interesting was the research I found comparing physical therapy to yoga in the treatment of low back pain.
Yoga and physical therapy both are movement based, but yoga differs in adding a psychological healing component by using deep breathing techniques and meditation. The fight and flight response triggers sympathetic nervous system activity which revs us up. Deep breathing initiates parasympathetic nervous system activity which calms us down. In a study conducted by Karen J Sherman, individuals with chronic low back pain were either assigned to a self-care education group, physical exercise group, or yoga therapy group for 12 weeks. Following completion of the programs, yoga was shown to be the superior method for decreasing pain. The researchers of the study suggest that the mental focus emphasis of the yoga practice may have an influence on decreasing pain.
Additionally, in a study done by Tekur and colleagues yoga was shown to be better than physical therapy in alleviating pain, anxiety and depression, as well as being more cost effective than physical therapy. Moreover, a study which looked at yoga’s influence on cortisol, depression and anxiety in pregnant women, showed decreases in all three after a 12 week intervention of yoga.
At this point I am just speculating, but there seems to be a correlation between the psychological benefits of doing yoga, and decreases in pain levels from yoga. None of these studies provided information regarding the actual mechanism of pain decrease, but they did provide a correlation.
Yoga is a practice which incorporates both psychological healing, and physical health. Therefore, it may be an efficient method to aid in physical problems which are associated with malfunctioning psychology. Science is telling us that if we hang on to negative experiences, and painful memories they will manifest themselves and become physical.
There is a rehabilitation method for anxiety called “exposure therapy” in which a person just does all the things that they are scared of in order to prove to themselves that the fear isn’t actually threatening. I think individuals should do the things they are scared of, believe they are capable of doing things without help, and try to find the answers to questions themselves before always being dependent on somebody else. Do not wait around to be saved, if you can save yourself. Independency is an incredible quality, which gives a person the strength to take care of themselves, and be a motivational role model for others. I was at the strength and conditioning symposium this past weekend at SUNY Cortland, strength coach, John Gaglione suggested that instead of thinking about the worst thing that could happen, think about the best thing that could happen. For some reason we think we can protect ourselves by thinking about bad events, when really we are amplifying negativity and pain. Thinking about something, does not make it come true. I have decided that every day I am going to tell myself,“I will win a billion dollars in the lottery today”. While this is probably not going to happen, I am not going to encounter a panther on my way to class either.
Anxiety and Depression Association of America. (1999). Retrieved from Facts and Statistics: http://www.adaa.org/about-adaa/press-room/facts-statistics
Field, T. (2013). Yoga and social support reduce prenatal depression anxiety and cortisol. Journal of Body Work and Movement Therapies, 17, 397-403.
Groessl, E. J. (2012). The benefits of yoga for women veterans with chronic low back pain. Journal of alternative and complementary medicine, 18(9), 832-838.
Holger Cramer, C. K. (2013). Adverse Events Associated with Yoga: A Systematic Review of Published Case Reports and Case Series. PLOS, 8(10), 1-8.
Jansen, A. S. (1995). Central command neurons of the sympathetic nervous system: basis of the fight-or-flight response. Science, 644-646.
Melzack, R. (2001). Pain and the Neuromatrix in the Brain. Journal of Dental Education, 65(12), 1378-1382.
Sherman, K. (2005). Comparing Yoga, exercise and a self care book for chronic low back pain. Annals of Internal Medicine, 849-856.
Tekur, P. (2012). A comprehensive yoga programs improve pain, anxiet and depression in chronic low back pain patients more than exercise: An RCT. Complementary Therapies in Medicine, 20, 107-118.
Williams, K. (2005). Effect of Iyengar yoga therapy for chronic low back pain. PAIN, 107-117.