How yoga can decrease back and neck pain

You’re probably sitting now in your chair by your desk, reading this email on your computer or smartphone and I truly hope you will find this essay valuable. But first I want you to shift your attention to your body, specifically your neck, shoulders, and down your spine. Are your shoulders protracting and your chest collapses inwards? Is your head falling forward as you’re looking down at your device? As an experienced yogi and yoga teacher you’re probably not. But that’s how most of people nowadays spend majority of their time.  We work at least 8 hours a day in front of a computer. Even on our commute to and back from work, or even at home, we stare at our smartphones for way too long in wrong postures. Now add to that the amount of time we spend in sitting position which is not for your posture. Whether you’re a school student or an office worker, we spend most of our life sitting in a chair, car, movie theater or simply in front of a TV on a couch making our spine miserable. ​

This lifestyle has a huge affect on our spine. What I commonly refer to as tech neck is nothing else but leaning forward over a smartphone or other device which increases the load on the neck and upper back muscles. When we bring our head forward to check our phone, the head is out out of alignment making the rest of the spine misaligned as well. With sustained strain, muscles become inflamed and excessively tight, which leads to pain and in some cases to spinal structural deviations. I myself, have to honestly admit, while studying and working in office for countless hours, I have had put my spine through a lot. For me as a tall person I find it especially difficult to keep my posture aligned in a neutral position. I catch myselfI trying to “make myself shorter” to fit in with my shorter friends and colleagues. And while I sit down I hunch over my desk feeling pain in my neck. In addition  my pelvis falls forward causing my lower back to curve in hyperlordosis. I decided to do some exercises and my friend recommended me yoga.

What is yoga
Before we go further into the topic, it’s important to understand what yoga is. “The word yoga means ‘unity’ or ‘oneness’... union of the individual consciousness with the universal consciousness. On a more practical level, yoga is a means of balancing and harmonizing the body, mind and emotions. This is done by practice of asana, pranayama, mudra, bandha, shatkarma and meditation.”1)  What that means is when we do asanas/postures without incorporating the the spiritual aspect we simply exercise, it’s not yoga anymore. Yoga for many people is just a form of physical exercise helping them maintain or gain strength and flexibility. But there’s so much more to it. “According to medical scientists, yoga therapy is successful because of the balance created in the nervous and endocrine systems which directly influences all the other systems and organs of the 
body”.2)
When I took my first yoga class back in 2014 I didn’t know much about yoga. All I knew it has something to do with stretching and that you need a yoga mat to lay down on. After the class I knew it’s not going to be my last encounter with yoga. I remember very clearly the feeling of lightness and overall happiness as I was leaving that class. I gained a new perspective and I knew my life would look differently from that moment. And my perspective changed literally - I left that yoga hall one inch taller as my posture straightened and spine stretched.

General recommendations for asana practice
Literature suggests that yoga is safe and effective for relieving back pain. However, it is important to perform asanas carefully and, when needed, make adjustments to certain asanas or avoid some poses completely. It is recommended to consult experienced and competent yoga teacher or a doctor before commencing asanas. 
General guidelines for practicing asanas are as follows:

• Be careful, move slowly and focus on strengthening muscles around the affected areas; 
• Listen to your body, avoid anything that causes pain or increases existing pain. If there is excessive pain in any part of the body, the asana should be terminated immediately;
• Yoga is not about performing asanas perfectly, or to do any particular impressive looking asanas. Don’t compare yourself to others, take your time and enjoy the journey of yoga.

Ayurveda recommendations
In addition to recommendations on physical aspect of performing asanas, it is recommended to follow few guidelines regarding diet and water intake. Ayurveda teaches us philosophy of physical and mental health, how to find happiness. Its literal meaning is science/knowledge of life. Ayurveda recognizes three Doshas which are compound of basic elements ruling our lives: Vatta (air), Pitta (fire), and Kapha (water and earth). Practitioners of Ayurveda tech us that each and every one of us is ruled by these elements and any imbalances in those Doshas result in health complication affecting our mental and physical health. For example a person who is restless, usually calm, but also has high and low moments as well, just like the air in nature, is a Vatta person. Inbalances in Vatta can be recognized by decreased digestive system performance, increased wind in digestion system, or irregularities visible on finger nails. In such case Ayurveda recommends us to avoid food that increases air, as air dries out our digestive system. In general, food that has a short life, such as broccoli, spinach, cucumber. Instead, increase intake of water, herbs, grains and vegetables that last long after harvesting, i.e. pumpkin, carrots, beet roots.  As for the asanas, it is recommended to avoid forward falls as they increase air, and focus more on twisted asanas which increase digestion. Also asanas with backward bending and chest opening should help.
Although there’s no special dietary rules for yoga practitioners, it is best to eat natural food in moderate amounts, avoiding meat and processed foods. Food that causes acidity or gas in the digestive system, such as heavy, oily and spicy, should also be avoided. 
Experienced yoga practitioners recommend to perform asanas when stomach is empty, and for that reason morning time for yoga is the best. If practiced during the day its is recommended not to practice at least for 4-3 hours after a meal. As for water intake, Ayurveda practitioners recommend avoiding drinking water 30 minutes before practice, during, and for 30 minutes after the practice of asanas. 

Asanas
Now let’s take a look how actually yoga postures affect our bodies and help us manage back and neck pain. Let’s take a look at few basic asanas that any beginner should be able to perform with satisfying effect on well-being of their back.

• Shashankasana - pose of the moon or hare pose 

This beginners asana will stretch and strengthen the back muscles and separate the individual vertebrae from each other, releasing pressure off the spinal discs. This pose with forehead on the floor, similar to Balasana - child’s pose, can be your resting pose during sequences of asanas. Fell free to come to this pose whenever you feel like you need a break. Often nerve connections emanating from the spinal cord are squeezed by these discs, giving rise to a various forms of back ache. This posture encourages the discs to resume to their correct position.
To get in the position sit in Vajrasana (thunderbolt pose) with knees close together. Bring big toes together and separate the heels. Lower the buttocks onto the inside surface of your feet with the heels touching the sides of the hips. The back and head should be straight but not tense. Make sure to avoid excessive backward arching of the spine. Place your hands on the thighs just above knees and relax. After a few deep breaths, while inhaling rise your straight arms up shoulder width apart. Exhale and bend your trunk forward keeping your arms and head in one line. If possible your hands and forehead should touch the floor at the same time. Bend your arms slightly so they are fully relaxed  and let the elbows rest on the floor while buttocks remain touching the heels. Retain your breath for up to 5 seconds in this position and then simultaneously inhale and slowly raise the arms and trunk to vertical position. Breath out while placing hands on your thighs. This is one round, practice 3 to 5 rounds. Beginners should slowly increase the length of time in the final position until they are able to hold it comfortably for at least 3 minutes with normal breathing. 
Contraindications: Not to be performed by people with vey high blood pressure, slipped disc or those who suffer from vertigo. Another option for this pose is to separate your knees with toes together and bring your hands forward which allows more space for torso in between your thighs.

• Marjariasana - cat & Bitiliasana - cow pose

This gentle kneeling pose incorporates a backbend, and is practiced to warm up and improve flexibility of the spine, hips and shoulders. Come to kneeling position with knees aligned with hips and wrists right under your shoulders. Your spine should be neutral - this is your starting position. Inhale while raising the head and depressing the spine so that the back comes to a subtle, even curve. Expand the abdomen and fill the lungs with air and hold your breath for 3 seconds. Exhale while lowering the head and stretching the spine upward, contract your abdomen and tuck in the buttocks. Your head should come between the arms facing your thighs. Hold your exhale here for 3 seconds. Keep inhaling and exhaling while aligning your spine accordingly for 5 rounds of breaths. 

• Vyaghrasana- tiger pose

Tiger pose is similar to cat-cow, and just as the pose mentioned before, similarly improves flexibility of your spine and tone the spinal nerves. The starting point for Vyaghrasana is on your knees and hands on the mat and look forward. Gently arch your back downwards (towards the mat) and straighten your right leg back keeping your heel level on your thigh level. Make sure your hips are square (left and right hip bones pointing directly down to the mat). Now inhale and slowly bend that leg with toes pointing towards your head and try to stretch your leg closer to your head as if you’re trying to touch toes to your head. Try to hold that pose for 3-5 seconds holding your breath in. Now on your exhale  swing your leg towards your chest as you arch your back towards the ceiling and bend your head down, bringing the knee closer towards your forehead. As you hold this position for few seconds while retaining the breath outside try to keep the right foot off the floor by engaging your abdomen. Continue with the slow leg swinging and arching your spine movements for 5 breaths. Before changing your side to left leg, relax in neutral cat-cow position or sit down on your heels (child’s pose).

• Saral Bhujangasana - easy cobra pose

Easy cobra position is especially good for stiff backs and will help strengthen the arms and shoulders. For this position lie down on your stomach with whole body resting on the floor, forehead on the mat, arms resting next to your torso, legs straight, feet together with soles of the feet facing up (untucked). Bend your arms and place palms of the hands on the floor on each side of your head (more or less ear level), fingers pointing forward. Press your hands and forearms against the floor and raise the head, shoulders and chest up. Upper arms should be in vertical position creating a 90 degree angle with the forearms. Relax in this position for 5 breaths, rest down on the floor, and then repeat for few rounds. Once you feel comfortable in this position you can proceed to Bhujangasana - cobra pose.

• Bhujangasana - cobra pose

Begin lying down on your belly, legs straight on the floor and feet together just like in previous easy cobra pose, with the difference where you need to place your hands. Place the palms of your hands on the floor below and slightly to the side of the shoulders, with fingers together pointing forward. Make sure your elbows are pointed backwards and are close to the sides of your torso. It is important before you proceed into the pose, that you relax your lower back. Now slowly raise the head and tilt it backward, and slowly using the back muscles lift the shoulders and neck off the mat. Using your arm muscles, raise your chest and belly off the mat arching your back, but keeping your pubic bone and legs on the mat. It’s ok if your arms will not straighten completely, that will come with more back flexibility. After holding the position for few seconds, slowly bend your arms and lower the chest, shoulders and head down. You can relax lying down or go to child’s pose for a gentle counter bend of your back. 

• Shava Udarakarshanasana - universal spinal twist

Spinal twists are important for spinal health. Twists included in your yoga practice exercise your muscles, make your spine more flexible, and stimulate spinal nerves. I chose spinal twist on the floor because “supine twist can be safer than seated or standing twists changes the orientation of the impact of gravity on your intervertebral disks and spine”3). In simple terms, when we’re in standing position the gravity compresses disks in between vertebrae, and when laying down the load on disks is lighter which may allow for better spinal stretch.
Start this position by laying down with your legs together. Next stretch your arms out to the sides at shoulder level, palms facing the floor. Bend your right leg and place sole of the foot next to left kneecap. With your left hand on top of the right knee gently start bringing the right knee towards the floor on your left side of the body. Remember to keep both shoulders in touch with the floor. When one of the shoulders starts to lift off the floor stop pushing your right knee towards the floor. Keep the right leg bent and the foot in contact with left knee at all time and look to the right (opposite direction of twisting). Repeat on the left side of your body. 


Pranayama and meditation
Traditionally yoga is a way of preparation of body for meditation, and many scientists show that the benefits of meditative practices affect our lives in a positive way. Pranayama is defined as breath control in preparation for meditation. The word pranayama literally means expansion of life force vital energy. There are plenty of pranayama breathing techniques to choose from. It is important to begin with yogic breathing, which combines natural, abdominal, thoracic and clavicular breathing. Its purpose is to gain control of breath, correct poor breathing habits and increase oxygen intake. 
To perform yogic breathing sit in a comfortable meditation posture, inhale slowly allowing abdomen to expand, then feel the air reaching into the lungs and slowly expanding your rib cage. When the ribs are fully expanded inhale a little more and feel as the air reaches the upper chest lifting up your shoulders and collar bone slightly. This process should feel like one continuous movement, without any sudden movements or strain. When exhaling revers the process by lowering your shoulders, allow the chest and then abdomen to contract. Perform 5-10 rounds of breaths and notice how your breath is after that exercise. Now you’re ready to practice next pranayama - Nadi Shodhana.
This simple breathing exercise will bring you closer to meditation and is called Nadi Shodhana Pranayama, which means purification of energy channels. Sit in a comfortable meditation posture with your back straight, relax your body and close your eyes. Bring your right hand into Nasagra Mudra - place index and middle finger on the eyebrow center. The thumb should be above the right nostril, and the ring finger with small finger next to your left nostril. Your left hand should rest on your left thigh. Now with your thumb close the right nostril and exhale and inhale gently through the left nostril. After 5 breaths release the right nostril and close the left one with your ring finger allowing you to breath through the right nostril. Note that each inhale and exhale should be soundless and calm. After 5 rounds on each nostril bring your right hand down and start breathing with both nostrils. After this you’re ready for next stage of this exercise which means control of the duration of each breath. In your mind count to 5 the length of each inhale and exhale through the left, right and then both nostrils at the same time. Practice this for 5 rounds or 3-5 minutes.


My experience with meditation is at a very beginning state. There are many meditation techniques available for yoga practitioners. Some say that any information and materials available about meditation is not going to be true to you as it becomes from the outside of you, outside of your mind and soul. Meditation comes from within you. For me meditation can be any action we perform that we put our full awareness and intention into. Whether it’s an everyday chore or interaction with other people it will become a meditation once you put your awareness to it and it becomes a quality in itself. We often think meditation is something specific, like sitting down in front of incentives, at specific time or pose, light a candle, or pray to someone. Meditation is not a technique or a method but a process and understanding in itself. Meditation technique I use is based on recognizing all 5 senses: sight, hear, touch, smell and taste. I’ll try to walk you through this technique next time, as I’m still learning more about meditation.​

In conclusion
If you think because you have back problems you cant do yoga you’re wrong. Yoga can be a safe and effective way of relieving your pain. It may be necessary for you to take few adjustments in certain asanas or avoid some completely depending on your condition. 
“In age of mobile phones, internet and twenty four hour shopping, yogic practices make great personal and even business sense.”4). “Back pain is one of the most common disabling ailments and is a leading cause of lost productivity. Research show yoga not only reduces back pain by clinically significant levels, but also reduces the number of sick days taken. Yoga improves your awareness of how you align your body throughout the day, which can prevent many discomforts.”5).
 Don’t let yourself fall in the vicious circle - I cant exercise because of my back pain. The truth is you have a back pain because you don’t exercise at all or you’re doing it incorrect.