Given the spine’s intricate construction, it’s no wonder so many of us experience back pain. Whether chronic or occasional, an aching back can affect your mood, interfere with work and play, interrupt exercise, and disrupt sleep. And indeed, so many of our daily activities have the potential for triggering pain, improper bending or lifting, repetitive motions, long periods of sitting, or strenuous workouts can all cause discomfort, making back pain seem inevitable.
But back pain can be prevented, and chronic back pain significantly lessened without the use of painkillers or muscle relaxants. Disciplines (such as yoga and Pilates), bodywork (like Thai massage and Rolfing), and hands-on treatments (like chiropractic, the Alexander Method, and Feldenkrais), help to keep the spine, and all the muscles and soft tissues around it, supple and strong. With a bit of education and self-discipline, these seven practices can help alleviate the pain you have and help prevent future episodes, all without popping a pill.
This ancient practice is becoming a household term, as yoga’s balance of flexibility and strength as well as stillness and movement are giving it credibility everywhere, from elementary schools to hospitals. Yoga involves much more than the asanas, or poses, but also includes breathwork or pranayama and the withdrawal of the senses or pratyahara. A good yoga session includes elements of all three, and indeed the poses themselves combine stretching and strengthening in a way few other modes of exercise can match.
In her book The Healing Path of Yoga (Three Rivers Press, 2000), Nischala Joy Devi writes, “What makes yoga stretching different from most exercise is the additional benefit to the internal organs, glands, and nervous and cardiovascular systems . . . There is special emphasis placed on the spine and the freedom of energy to flow up and down it.” Many of yoga’s fundamental poses work to stretch and strengthen the muscles throughout the core. Downward-facing dog pose lengthens the body and engages the core, stretching all along the spine. Standing and balancing poses tone the abdominals and strengthen the legs, backward bends followed by forward bends nourish and lengthen the muscles of the trunk by first contracting muscles (in backbends) then stretching them (with forward bends). Yoga’s many twists also work the muscles of the back and the obliques, providing a gentle squeeze to the vertebrae, encouraging blood flow, and promoting flexible and supple connective tissues.
Named after its founder, Joseph Pilates, Pilates emphasizes moving the body with the breath, developing core strength and flexibility, and promoting balance andconcentration. Unlike yoga, Pilates was developed as a system of exercise, complete with specially formulated equipment designed to target the deep muscles of the abdomen, back, and pelvis, increasing strength and improving posture. Until recently, professional dancers, who recognize that a strong core is the secret of superb balance and posture, had been the primarily practitioners of Pilates.
Pilates is an obvious choice for back pain management and prevention because so many back problems are the result of poor posture and underdeveloped musculature. Because it demands slow smooth movements, Pilates increases body awareness, specifically spine and postural awareness, throughout the exercises. Such exercise inevitably helps practitioners remain more conscious of their spinal alignment throughout the day.
Pilates classes are available in two formats, private lessons, using specialized machines, and group mat classes, which are increasingly available at gyms, spas, and community centers. The exercises look deceptively simple, but the focused and controlled movements, in coordination with the breath, are challenging. You may not break a sweat, but you will leave feeling stronger, taller, and more aware of your alignment.
Combining the stretching and manipulation of partner yoga, the energetic focus of acupressure, and the benefits of massage, Thai bodywork is a 1,000-year-old healing art. With roots in Tui Na (acupressure) and Ayurvedic massage, Thai massage is a component of Traditional Thai medicine, which also uses meditation and herbal medicine to promote health and healing. Like many Asian modalities, Thai massage is based on the theory of intrinsic energy flow throughout the body, where there is imbalance, illness or discomfort often results.
A typical Thai massage addresses the sen (energy) lines of the body and uses compression and physical manipulation to stretch and tone soft tissues, free stagnant energy, and relieve the body of physical and emotional tension. For those with back troubles, Thai massage can be a particularly effective form of bodywork, given its attention to both the physical and energetic bodies, and the way the manipulations impact the deep muscles of the spine and trunk. A typical session involves lying on one’s back, on either side, then face down, and finally sitting. This allows the bodyworker to address the body’s energy meridians, and different muscle groups from different angles. Like yoga, Thai massage uses a combination of flexing, stretching, and twisting the muscles to increase circulation and enhance length and strength.
Developed by Dr. Ida Rolf as a method of soft tissue manipulation to “enhance the whole person by organizing the body in gravity”, Rolfing is a form of bodywork known as structural integration. Thus, Rolfing recognizes the interconnectedness of the body’s tissues and structures and addresses it as a whole. Traditional Rolfing is done in a ten-session format, according to the protocol that Dr. Rolf herself taught.
Rolfing is centered on whole body posture. The therapist begins by looking at the person’s body, recognizing for example, that a problem with the upper back may be linked to the pelvis, and a problem with the hips may be found in the jaw. For those with back pain, Rolfing can be beneficial to determining the cause and providing manual techniques to release motion restrictions. But Rolfers also assess the client’s habitual restrictive movement patterns and provide them with the tools for change. In short, Rolfing goes beyond a typical massage because in addition to bodywork, clients are given an education in how to better experience and use their bodies.
Individuals who have completed the series are amazed at the transformation in their body’s posture and movement. In fact, the change is often so pronounced that therapists photograph their clients before and after so they can see the effects as well as feel them.
This practice generally has the most skeptics, and yet as a healing art, chiropractic isn’t all that different from any other form of holistic bodywork. Its goal is to remove obstacles to wellness through non-invasive procedures. In his book The Chiropractic Way (Bantam, 2003), Michael Lenarz, D.C., writes “In chiropractic philosophy, pain relief is really just the side effect of a properly functioning spinal system.”
Recognizing the vital importance of the spine as a neural pathway, chiropractors use manual manipulation to realign the spine to its natural state. These adjustments relieve misalignments of the spine that occur due to poor posture, repetitive motions, and improper bending or lifting, as well as major traumas like car accidents. Adjustments help restore full body integration, allow the nervous system to function properly, and can affect a number of conditions not normally associated with the nerves or spine.
During the first appointment, the doctor will perform an intake, x-ray your spinal column, and provide manual adjustments to help realign any vertebrae that may be Ëœout.’ Soreness is common after the first few sessions, since the muscles have adapted to the misaligned spine and must adjust to the natural setting, but generally, the manipulations themselves are not painful. Like massage, chiropractic can be done as a preventative measure or as a method of recovery for those experiencing back pain.
The Feldenkrais Method
Feldenkrais is a system of somatic education using movement and awareness to help the body perform more comfortably and effectively. Developed by Dr. Moshe Feldenkrais, the method combines principles of physics, biomechanics, and human development with a martial arts philosophy of readiness of movement.
Unlike many other modalities, Feldenkrais emphasizes neuromuscular functioning, using movement to ‘rewire’ the nervous system and help individuals bring greater awareness to habitual patterns that may be causing pain or strain, and to parts of the body that are underutilized. Feldenkrais works within whatever structural limitations may be present, teaching students how to reorganize, regulate, and control movements, moving more consciously and intelligently.
Feldenkrais practitioner Frank Wildman writes, “[Feldenkrais] teaches you how to become your own measure for efficient movement, how to make distinctions that can lead to a pain-free back. You will learn to perceive consciously how you move, where there is tension in your body, where you exert unnecessary effort, and when you are not making use of your full potential.”
Like Pilates, Feldenkrais is taught in group movement classes and private one-on-one sessions focused on functional integration. The former involves a teacher taking a group through one of many movement lessons; the latter allows the individual to receive a lesson tailored to their individual needs and concerns.
The Alexander technique
Considered the grandfather of other somatic/kinesthetic practices like Feldenkrais, Rolfing, and Hellerwork, the Alexander Technique is a method of understanding coordination using both the body and the mind. Taught in lessons, this practice helps clients observe their physical habits, discover movementpatterns that use unnecessary effort, and employ methods to ‘unlearn’ these inefficient mannerisms, enabling freer movement with less tension. Devised by F. Matthias Alexander in the late nineteenth century, the technique requires patience, practice, and ‘a willingness to welcome the unfamiliar’ in order to allow new habits and patterns to emerge.
Lessons are taught in groups or privately, with a student’s motion often guided by the teacher. Instructors guide students in ‘inhibiting’ learned responses by stalling, tricking, sidestepping, or boring the old response to make way for a new pattern. One principle unique to the technique is the importance of head position in leading full body motion. Emphasis is placed on observing head position as it balances at the neck to the entire body’s ability to respond. Results include greater ease of movement, improved posture, and a feeling of effortlessness. Habitual movements become more economical, requiring less energy and creating less strain.
Everyday back exercisesAs adapted from Everyday Wellness for Women, by Dr. Deborah Kern.
Half Spinal Twist
Sit at the edge of a chair. With your ankles directly beneath your knees, bring both knees together. Take one hand and place it on the outside of your opposite knee. With your other hand reach back to grasp the back of the seat. Inhale, lengthening your spine. Exhale and gently pull with both hands to instigate a twist. Make sure your knees stay facing forward. Hold for 4-6 breaths, then slowly release your hands to a neutral position. Repeat on the other side.
Low Back Stretch
Lie on your back and draw both knees into your chest. Hug your knees with both arms. Then, bring your forehead as close to your knees as possible and take a deep breath. Notice how the breath expands the low back. Take in a little more air. Now let it all out with a sigh. Repeat before bedtime and every morning upon waking to help relieve and prevent back pain.
Tight hamstrings are a major cause of low back pain. Daily stretches keep them loose and limber. Place your hands on a rail or countertop. Walk your feet away from your hands until your torso is parallel to the ground and your hips are over your ankles. Inhale, stretching your arms long next to your ears, exhale and sink your body a bit lower into the stretch. Remember to bend from the hips. Hold for 4-6 breaths.