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January 18, 2017

Improving Back Pain with Yoga

Life can be a real pain in the…uh…back. The truth is that as many as 80% of people will be affected by low back pain at some point in their life. Estimates put it at somewhere between the 2nd and 5th complaint in the primary care setting which means, as doctors and providers, we see this all the time. Not only does this cause physical pain, but it is also a tremendous financial drain, costing upwards of $50 billion dollars annually in direct care costs, not to mention the indirect costs that result from missed days at work.

So what causes back pain? The causes can be many and the risk factors are not well defined. Some of the associated factors include smoking, alcohol, job dissatisfaction, depression, and increased body mass index (BMI). The majority of back pain, about 85%, is considered “non-specific” and is usually attributed to a muscle strain or sprain, a herniated disc, or spinal stenosis, which is a narrowing of the openings in the spinal column through which our nervous system travels. It is also important to rule out any rare (<1% of all cases of back pain), but emergent, causes for back pain which includes cancer, cauda equina, and vertebral infection. Be sure to tell your provider if you have experienced symptoms including unintended weight loss, fever, fatigue, changes in your bladder or bowels, or numbness in the genital area.

So now that we know how big of a pain this is (pun intended), let’s discuss some treatments. The current guidelines on treatment for low back pain, provided by The American College of Physicians (ACP) and the American Pain Society (APS) and the NICE guidelines in the United Kingdom focus on the “usual treatment,” which generally consists of expectant management, maintaining a normal activity level, and the use of NSAIDS (ibuprofen, Aleve, Motrin) or acetaminophen. Unfortunately, there is not a big focus on the use of complementary and alternative therapies, which can be profound. I specifically want to focus on the benefits of yoga.

In the past 5-10 years, we have seen a two-fold increase in the amount of people who say they are actively practicing yoga in the United States. The National Institute of Health touts the benefits of yoga, stating that it provides a decrease in pain, depression, and disability and an increase in function as compared to “usual medical care.” Numerous recent studies also support these conclusions, finding yoga to be more effective than traditional care, patient education, or physical therapy alone. Yoga strengthens core muscles that support the spine and improves flexibility and balance. It is also thought to help patients break the cycle of hyper-vigilance and avoidance of activity that can prevent healing. Yoga is also a safe activity and can be recommended for anyone who has been cleared for a regular exercise regimen by their provider.

Are you ready to throw on some Lululemon and do some headstands? No? The wonderful news is that yoga is a “practice,” meaning that it is a very personal and individual. There are numerous different types of yoga including vinyasa, iyenar, hatha, and restorative, just to name a few- but I promise there is a practice perfect for everyone. Yoga is about becoming in tune with your body and finding out what you need at that particular time and place. So if it is simply lying on the floor in Shavasana or resting in child’s pose, then that is wonderful. The point is that you are focusing on you and your body’s needs. If you are interested in yoga, please join our flow yoga class on 2/2 at

If you are interested in yoga, please join our flow yoga class on 2/2 at 7:00 pm. All attendees receive a free recipe book created by Avance Care Dietitians, snacks and beverages.

For more information and tickets please visit: Flow Yoga!

Below are also some links on where to find more information as well as some sites for local studios I know and love.

Namaste. Meghan L Presnell, FNP-C

Links: International Association of Yoga Therapists:

National Center for Complementary and Integrative Health:

Local Studios: Blue Lotus: Evolve Yoga:

Open Door Yoga:

References Brosseau, L., Wells, G. A., Poitras, S., Tugwell, P., & Casimiro, L. (2012). Ottawa panel evidence-based clinical practice guidelines on therapeutic massage for low back pain. Journal of Bodywork and Movement Therapies, 16(4), 424. Retrieved from ect=true&db=amed&AN=0161398&site=ehost-live&scope=site

Chou, R., Friedly, J., Skelly, A., Hashimoto, R., Weimer, M., Fu, R., Dana, T., Kraegel, P., Griffin, J., Grusing, S., Brodt, T. (2016). Noninvasive treatments for low back pain. Agency for Healthcare Research and Quality. Retrieved from

Chou, R., Qaseem, A., Snow, V., Casey, D., Cross, J. T.,Jr, Shekelle, P., . . . American Pain Society Low Back Pain Guidelines Panel. (2007). Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American college of physicians and the American pain society. Annals of Internal Medicine, 147(7), 478-491. doi:147/7/478 [pii]

Clarke, T. C., Black, L. I., Stussman, B. J., Barnes, P. M., & Nahin, R. L. (2015). Trends in the use of complementary health approaches among adults: United states, 2002-2012. National Health Statistics Reports, (79)(79), 1-16.

Heuch, I., Hagen, K., & Zwart, J. A. (2013). Body mass index as a risk factor for developing chronic low back pain: A follow-up in the nord-trøndelag health study. Spine (03622436), 38(2), 133-139 7p. doi:10.1097/BRS.0b013e3182647af2

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