Yoga Asanas for Backache

Back pain is a common complain faced by most of the people during life time. It feels like an ache, tension or stiffness/ soreness in back which can be triggered by bad posture while sitting or standing, bending awkwardly, or lifting weight incorrectly. In many patients, it is not due to a serious disease and the exact cause is not identified then it is termed as nonspecific lower back pain. The patients are advised to keep themselves active and mobile; some patients may get relief by pain killers. Many patients may get relief within 6 weeks, but it may recur from time to time. Some cases may develop chronic (persistent) pain and may need further treatment for that.


Introduction
Back pain is a common complain faced by most of the people during life time.It feels like an ache, tension or stiffness/ soreness in back which can be triggered by bad posture while sitting or standing, bending awkwardly, or lifting weight incorrectly.In many patients, it is not due to a serious disease and the exact cause is not identified then it is termed as nonspecific lower back pain.The patients are advised to keep themselves active and mobile; some patients may get relief by pain killers.Many patients may get relief within 6 weeks, but it may recur from time to time.Some cases may develop chronic (persistent) pain and may need further treatment for that.

Anatomy of the low back
The spinal column is made up of circular bones called 'vertebrae' and between each vertebra is a disc made up of a strong fibrous outer layer and a softer, gel-like centre.The discs act as shock absorbers and allow the flexibility of spinal column.The structures in lumbar area which may be responsible for low back pain are lumbar vertebra, vertebral discs, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.The nerves that provide sensation and stimulate the muscles of the low back, the thighs, legs, feet, and toes all come out of the lumbar spinal column through bony openings known as "foramen."The group of muscles that are responsible for flexion, extension and rotation of the back and movement of the lower limbs are attached to the lumbar spine through tendons.

Causes of Back pain
Some of the common causes of back pain are as follows: Strain -this is the common cause of back pain: Strained muscles, strained ligaments, lifting weight improperly, and Lifting too heavy weight, an abrupt and awkward movement.

Structural problems
The following structural problems may also result in back pain:

Journal of Yoga and Physiotherapy
Bulging disks: Like the ruptured disks, a bulging disk can result in more pressure on a nerve.

Sciatica:
A sharp and shooting pain that travels from hips, down the back of the leg up to the foot caused by a bulging or herniated disc by pressing the nerve.
Arthritis: Patients suffering from osteoarthritis experience pain with the joints of the hips, lower back, knees and hands.In some cases, spinal stenosis can develop the space around the spinal cord narrows, which causes back pain.
Abnormal curvature of the spine: The spinal curves are unusual then the patient is more likely to experience back pain.E.g. scoliosis.
Osteoporosis: Condition in which bones, including the spinal vertebrae, become brittle and porous, and leading to compression fractures.
Bad mattress: If a mattress does not have good support to the body parts and does not keep the spine straight, there is a greater risk of developing back pain.

Everyday Activities or Poor Posture
Back pain can also be the result of some day today activities or from poor posture.Bending and sitting awkwardly, Pushing, Pulling, Carrying, lifting, standing for long periods, Bending down for long periods, Twisting, Coughing, Sneezing, Muscle tension, Over-stretching, Long driving sessions without a break.

Diagnosing Back Pain
Most of the physicians will be able to diagnose back pain after carrying out a thorough physical examination and interrogating the patient.If the doctor suspects some deep injury to the back, then various tests may be advised to be done.Also, there is suspicion about the back pain might be due to an underlying cause, or if the pain persists for too long, further investigations may be advised to rule out the pathology.Investigations like X-rays or CT (computerized tomography) or MRI (magnetic resonance imaging) scan may be used to get a better view of the state of the soft tissues of patient's back [1][2][3][4][5].

Treatment for Back Pain
Back pain needs treatment and prevention for further recurrence.Measures to get relief of back pain are:

f)
Pain killers may be advised by the doctor for pain control.
Yoga Asanas may be helpful in relieving back pain, but before starting consult a physician and a yoga expert for learning various asanas to avoid any complications.Yoga Asanas which help to relive back pain are as follows Tadasan Method (Figure 1) First stand straight with feet in contact with each other, inhale and lift heel up and raise both hands together straight up over the head as much as possible and interlock the hands and stretch the palms.Keep for few seconds and relax.

Conclusion
Back pain should not be neglected, avoid the work which causes back pain.It should be seriously diagnosed and treated appropriately.The asanas mentioned in this paper are helpful in relieving the back pain along with other benefits also.All these asanas should be done strictly under expert supervision to avoid any complications.If there is no improvement in pain, immediately consult a doctor.
a) A back brace to support back b) Local application of Cold packs and heat therapy or massage c) Stretching and strengthening exercises like yoga asanas may be helpful d) Traction (if necessary) e) Lifestyle change for prevention of back pain.

Figure 2 :
Figure 2: Parsvakonasana Other benefits of parshvakonasana a) The spinal muscles are toned up by this posture.b) It helps to revitalize the whole body.

Figure 4 :
Figure 4: Bhujangasan Shalabhasan Method (Figure 5) Lie on stomach with legs stretched and hands on either side.The chin should be touching the ground.Place hands,

Figure 5 :
Figure 5: Shalabhasan Other benefits of shalabhasana a) Relieves arthritis and rheumatism pain.b) It strengthens the muscles of back, legs, whole body, and abdominal organs.Purvottanasana Method (Figure 6) Place hands near the shoulder with fingertips pointing forwards towards the feet.Bend knees and place your feet on the floor hip-width distance apart.On an exhalation, push your hands and feet to lift your hips to the same height as shoulders and straighten arms toes touching the ground, let head hang back behind.Stay here for up to 30 seconds and slowly come down.

Figure 6 :
Figure 6: Purvottanasana Other benefits of purvottanasana a) Strengthens the muscles of hands, wrists, back, and legs.b) Stretches the shoulders, chest, and front of ankles.Gomukhasana Method (Figure 7) In sitting posture bend left leg, bring its heel under the right thigh near to right hip, then bend right leg over the left knee and let your right heel come close to left hip.Your

Figure 7 :Figure 8 :
Figure 7: Gomukhasana Benefits of gomukhasana a) Stretches the muscles and relieves pain of back, hips, thighs, ankles and chest, shoulders and arms.b) It helps to make the spine straight and improves body posture.c)It is beneficial in respiratory problems as it gives exercise to the lungs.Uttkatasana Method

Figure 9 :
Figure 9: Ushtrasana Other benefits of ushtrasana a) Helps to improve lung capacity, the muscles of chest, abdomen, and neck and back becomes flexible.b) Relieves Neck, Shoulders and back pain.c) Reduce the fats on the stomach, stimulates abdominal organs and improves digestion.Adhomukha swanasana Method (Figure 10) From hands and knees position, place hands shoulder distance apart, fingers spread wide, wrist creases parallel with top of mat.Place knees slightly further back than hips.Tuck toes under, and straighten legs, bring heels toward the ground.Press hips back and lift pelvis towards ceiling.Tuck chin slightly to lengthen back of neck.Get into position like shown in photo, keep for 4-5 breaths and relax.

Figure 11 :
Figure 11: Paschimottanasana Benefits of paschimottanasana a) Reduces fat from the abdomen.b) Stretches the spinal muscles and brings flexibility.c) Relieves constipation and digestive disorder.d) Tones the abdominal pelvic organs.

Figure 12 :
Figure 12: Ardhamatsyendrasana Other benefits of ardhamatsyendrasana a) This is best of the twisting postures as it rotates the spine around its own axis besides giving two side-twists to the spine throughout its length.b) Stretches and increases flexibility of the spine, shoulders, neck, and hips c) Stimulates function of abdominal organs and improves digestion and elimination of wastes d) Relieves symptoms of backache, fatigue, menstrual discomfort and sciatica pain.Katichakrasana Method (Figure 13) Stand straight and keep 1 to 1.5ft distance between both feet.Now spread both the hands in the line of the shoulders and after that keep left hand on the right shoulder

Figure 13 :
Figure 13: Katichakrasana Other benefits of katichakrasana a) Improves the flexibility of the neck, back and spinal muscles.b) Massages the abdominal visceral organs.c) Makes the waist thin and flexible by decreasing the fat on abdomen.