Is YOGA an Effective Cure for Backache?
By Chong Chiew Kieok
Backache is one of the most common problems faced by many today, yet there is no simple effective cure offered by the modern medical science (Karmananda 2003). It is reported that at least 50%-60% of the population will suffer from the incident of acute or more long-term back pain at some stage during their life. Karmananda (2003) also mentioned that : ?...yoga offers a simple, effective and permanent cure for this troublesome (backache) condition. ??
This study aims to look at the effectiveness of yoga therapy on backache since it is widely claimed by yoga practitioners that yoga is effective for treatment of backache, which western medicinal practitioners are still in search for more effective methods for such solutions, especially for permanent cure.
The research methodologies adopted in this study include a case study of the Therapeutic Hospital and a small survey of teacher trainees at the Yoga Vidya Gurukul at Nashik, India. The information collected in these two sites form the main findings of this research.
The organization of the article is as follows: Section 1 briefly introduces the topic of the research. Section 2 outlines the structure of the vertebra and the spinal column. This is followed by the case study report of the Therapeutic Hospital at Nashik, India and Section 4 provides the results of a census of the October 2005 teacher trainees at the Yoga Vidya Gurukul, Nashik, India. Section 5 concludes.
The Vertebra and Backache
The main support to human beings that keep them erect in standing position is the backbone, formed by 33 vertebrae. These vertebrae are further divided into five sections, namely the cervical region which contains 7 vertebrae (C1 to C7), the thoracic region which contains 12 vertebrae (T1 to T12), the lumber region consists of 5 vertebrae (L1 to L5), the sacrum region consists of 5 vertebrae (S1 to S5), and the coccyx region consists of 4 vertebrae.
Backache comes in when the muscles are under fatigue, for example: when we attempt to turn in certain direction yet the muscle refuses to do so. Backache commonly happens at the neck or the lumber region as these are the regions that most twisting, turning or bending occurs. One of the main reasons of the backache is that our backs are commonly used in one-direction only (that is the forward bending), therefore, when we attempt to bend in other directions, especially the reverse direction of forward bending, we may just hurt our backs. Therefore, the most common place backache happens is either at the neck or the lumber region.
Case Study Report
The Experience of the Therapeutic Hospital at Nashik India
In order to further understand the effectiveness of yoga therapy on the cure of backaches, the researcher interviewed the key person in charge of the Therapeutic Hospital at Nashik (hereinafter called the Therapeutic Hospital or the Hospital), India, Dr. Pravin Despande, on the clinical records of their patients.
In general, the Therapeutic Hospital treats about 60 patients in a month, 15 patients each in the morning and evening for 30-day sessions, and another 30 in patients. Approximately 70%-80% of the Hospital?s patients are there because of backache, 5%-6% are due to diabetes, 5% because of asthma, another 5% because of heart disease or hypertension, the balance are due to problems caused by digestive system, arthritis or knee problems.
Despite the fact that most of the patients go to the Hospital due to backache problems, the Hospital does not categorize the patients due to different natures of backache, although the backache could be due to different factors and occasionally some variations in treatments are being given.
In general, almost all backache patients to the Hospital are over 40 years of age, with majority of them aged around 50-60 years old. Approximately three-quarters (70%-75%) of the backache patients are females, and most of these patients are working in the office, traveling job or travelers on 2-wheelers. Approximately 60% of the patients with backache are due to obesity.
The Yoga treatment given by the Hospital is a monthly course of an hour daily yoga session. As most of the patients are above 40 years in age, the yoga session conducted in the Hospital is Yoga Sanjivan. The other components in the 30-day package include: master cleansing, pranayama, chanting, natural homeopathy and/or oil enigma.
The deep breathing practice in the package is brahmari (with inhale through both nostrils and exhale with noise). The patients practiced the brahmari 21 times (approximately 5 minutes) daily for the 30-day course.
The natural homeopathy consists of massage and steam bath. Massage is given twice a day, once each in the morning and evening, consecutively for 3 days. However, only in patients are massaged twice a day, out patients are only massaged once a day. In the massage, sanjivan oil is used as a painkiller, and also to reduce the friction on the skin of the patients while the massage is being conducted.
On the other hand, for patients suffer from backache at the lumber, an additional treatment is given, that is the oil enigma. Oil enigma is an injection of 50 cm3 of sesame oil between 5:30 pm to 6:30 pm everyday. Clinical results in the Hospital showed that the oil enigma treatment has been very effective for backache at the lumber region.
Dr. Pravin also said that the clinical report shows that all the backache patients are recovered within 15 days. Between 80%-90% of backache patients are cured within 5-10 days. However, the Hospital rejects patients who have no feeling on their limbs. The Hospital only accepts these patients after their operations. A 20-day programme will be given to these patients: approximately 10 days of natural homeopathy programme followed by another 10 days of yogic programme.
Dr. Pravin also said that although sanjivan yoga has been very effective in curing the backache of the patients in the Hospital, the patients need to continue with the yoga practice after they have completed the therapy programme at the Hospital. The clinical record indicates that those who did not continue practice yoga at home after completing the programme at the Hospital would return to the hospital after 3-4 months for the similar programme to cure the recurring backache. The clinical results of the Hospital seem to indicate that yoga is a very effective alternative to cure backaches. However, backache patients need to make yoga a routine in their lives to ensure they are free from backaches permanently. The yogasanas to be practiced by backache are in no means difficult since the Hospital?s patients can perform that although most of them are above 50 years old.
Major Findings of the Census of Yoga Teacher Trainees at Nashik, India
The information requested from the trainees include: (i) personal background information: gender, age, years of full time education since elementary 1, occupation; (ii) health status: weight, height, pulse rate, blood pressure; (iii) backache information: experienced backache during the training period, experienced backache before coming to the training; causes of backaches, cure for backaches; and (iv) number of hours doing yoga in a week.
The data collected is analysed using Statistical Package for Social Sciences (SPSS) and most of the information are tabulated by job type which is categorized based on the occupation reported by the respondents.
The occupation of the respondents is categorized into passive and active, based on the nature of the occupation described to the researcher. ?Passive? refers to occupations that are mostly office-based, involved long hours of sitting and limited amount of movement while ?Active? refers to occupations that involve lots of movements, limited continuous period of sitting, and/or with longer hours of outdoor activities than sitting in the office. 4.1 Personal Background Information Slightly less than half (46%) of the respondents reported that their job is better described as passive rather than active. Table 1 presents the information on the personal background of the survey respondents by gender. The findings indicate that in general, respondents who hold a passive job is older in age (average age is 34.6 years old) compared to those who have an active job (average age is 29.7 years old). However, these two groups of respondents are very similar in terms of time spent in full time education since elementary school.
Table 1 : Personal Background Information of October 2005 Teacher Trainees
It is indeed interesting to find out that regardless of the nature of job, whether it is active or passive, the difference in terms of physical health indicators collected from the survey such as height, weight, pulse rate, systolic, diastolic or the body mass index (BMI) remain to be quite small. Although the BMI for trainees with passive occupation appears to be slightly higher than that of the active group, but the mean BMI for both categories of respondents are well within the normal range. (Please refer to Table 2 for more details.)
Table 2 : The Mean of Physical Health Indicators by Job Type
Information on Backaches and Amount of Time Spent on Yoga
Table 3 shows the proportion of the trainees in the Gurukul who complained about backache in October since they started the course at India. The findings showed that only 5% of the females complained about frequent backache while 25% of the male trainees indicated so. However, the proportion of male and female trainees that mentioned they never experienced any backaches in October are rather similar, approximately half from each group.
It is interesting to see that 71% of the trainees with jobs categorized as ?Active? indicated in the census that they did not suffer from any form of backaches in the first three weeks of the training and only 29% indicated they sometimes felt some aching at the back due to overstretching themselves in yoga classes. Conversely, only one-third of the trainees with ?Passive? job indicated no backache at all in the first three weeks, and a quarter of them indicated always suffered from backache in the first three weeks of their training in the Gurukul.
Further analysis showed that regardless of the nature of their work, those trainees who reported they never suffer from any form of backache in the first three weeks actually spent at least five hours weekly doing Yoga (before they come for the course).
As reflected in Table 4, two-thirds of those who mentioned that they always suffer from backaches in the first three weeks of the course at the Gurukul but they never suffer any backache before coming to the course. Sixty percent (60%) of these trainees mentioned that the reasons of the frequent backaches were due to overstrained or over stretched of their muscles as they tried to achieve the ideal positions in the asanas taught and one trainee indicated that the backache was due to her weak lower back. Others mentioned improper sitting positions, mental stress, leaving of heavy loads (earlier injury), and lumber scoliosis as the main causes of their backaches during the course.
Interestingly, only 20% of those who suffered from backaches occasionally during the course indicated that they never suffer from any backache before the course and approximately the same proportion (21%) of the trainees who suffered from backaches occasionally before the course reported that they never suffered from any backaches during the course. The yoga asanas practiced during the course appeared to have cured their backaches they have been suffering before coming to the course. However, yogasanas seem to be less effective on old injuries caused in their younger days due to sport activities. However, no trainee indicates that they are using any medication on backaches whether it is before or during the course.
Table 3 : Proportions of Backache Before Coming to the Course (in %) Male Female Passive Active
Table 4 : Proportions of Backaches Incidence Before and During the Course at the Gurukul Backache Before Coming to the Course Backache in October Total
Eight trainees also said that they do treat their backaches, of which 75% said that they do yoga to get rid of the backaches and a-quarter mentioned that they go for massage to release them from the problem.
Table 5 presents some interesting findings on the relationship with incidence of backaches and the physical health indicators collected in the census.
A very clear trend is seen on the relationship between the incidence of backache and the mean number of hours spent on yoga before coming to the course. The findings seem to indicate that for those who spent more than 4 hours weekly in doing yoga do not suffer from backache. Further investigation into the raw data appears to indicate that the mean hours to spend on yoga weekly could be even as low as 2 hours as those who spent 8 or 10 hours weekly on yoga still suffers from backaches occasionally due to scoliosis or earlier injuries. The other clear trend revealed in Table 5 is the incidence of backache with body mass index where the higher is the BMI the more often they suffer from backaches.
However, no clear trend is observed in the relationship between the pulse rate, and systolic of the trainees and the incidence of backaches reported. On the other hand, the findings also showed that the trainees with higher mean of diastolic reported to have higher incidence of backaches.
Table 5 : The Mean Time Spent on Yoga Before the Course and Other Physical Health Indicators by the Level of Backaches During the Course
Backache during the course Statistics No. of hours spent on Yoga before the course Body Mass Index* Pulse Rate Systolic Diastolic
* An outlier is excluded in the case of ?sometimes? suffering of backache during the course
The results of the census of the teacher trainees in the Gurukul in October 2005 reveal the followings :
The nature of work, whether it is active or passive, appears to be related to the frequency of backaches
From the clear trend between the number of yoga practicing hours weekly and the incidence of backache complaints, there appear to be some minimum number of yoga practice hours to get rid of the backaches caused by factors which could be work-related, sitting posture, over-stretched of muscles, scoliosis, etc. However, for earlier injuries due to sports, yoga practice may help to reduce the incidence of backache but may not get rid of it completely.
Body mass index appears to have a strong influence on the incidence of backaches, that is, the higher is the BMI, the more often one may suffer from backaches.
The higher is the diastolic, the higher is the incidence of backaches reported by the trainees.
The research aims to look at the effectiveness of yogasanas on backaches. Based on the clinical report of a therapeutic hospital and the census of the October teacher trainees at Yoga Gurukul at Nashik, India, the study concluded that yogasanas can be effective for backaches that are caused by factors such as obesity, improper sitting posture, strains of muscles, and lumber scoliosis. However, for backaches caused by old sport injuries, the effectiveness of yogasanas need further research, both in terms of the types of asanas to be practiced as well as the type of injuries to be considered. Both the findings from the case study and the census indicate that a backache-free life can be expected for those who treat yoga as a routine in their daily lives. Hence, future research should focus on the number of hours of yoga practice daily or weekly for a backache-free life.
- Karmananda, S. (2003).Yogic Management of Common Diseases. Yaga Publications Trust, Murger, Bihar, India.
- Mandlik, V. (2005). Backache and Yoga. Lecture conducted at the Yoga Vidya Gurukul. Nashik, India.
- Pearce, E. (1997). Anatomy & Physiology for Nurses. Jaypee Brothers Medical Publishers (P) Ltd., India.