In the clinic this month is a 35 year old male I’ll call Craig for the purpose of this study. Craig has had episodic low back pain for multiple years that is occasionally severe enough to require him to miss work and also affects his ability to play with his kids. Craig’s job requires him to lift heavy objects frequently and spend large amounts of time hunched over a workstation. Craig loves yoga as it usually makes him and his back feel better, but he has been unable to attend class anymore due to the severity of his pain.
At his initial examination, I put Craig through a variety of movement tests designed to methodically stress and strain tissues of the spine in order to gain an understanding of what might be producing his symptoms
One of the main things we look for in back patients like Craig is what we call a directional preference. This is exactly what it sounds like – we simply look for movements which ease the pain consistently. The directional preference might be in any direction, but it is often in either flexion of the spine (forward bending) or in extension (arching).
So, it was a little surprising in Craig’s exam that he felt worse in both the slouched and erect sitting position. In fact, sitting erect made his symptoms travel down into his leg. Similarly, in another test which places the patient in a position like happy baby pose the pain also spread down his leg.
The exam reveals the solution: Finally, Craig attempted a position called a press-up that is very similar to cobra. Initially, this position was not comfortable, but it did not recreate his leg pain and it did not make his symptoms worse. This was reason enough to continue, so I had him repeat this position multiple times and his discomfort nearly abolished. Even performing happy baby pose or erect sitting was now
comfortable. Craig took this exercise home along with some tips regarding proper posture, and reported significant improvement over the next 2 weeks.
Despite feeling much better at work, and being able to ease his pain consistently as needed, Craig still had some pain with Uttanasana. His goal was to be able to return to his yoga practice, so we knew we still had work to do. His condition was stable, so I had him go through a series of repeated flexed positions which immediately had the desired effect. Over the course of the next couple sessions he noticed that his spine was moving “freely” again.
It was time to try some yoga! For the last 2 sessions, I’ve led him through fairly vigorous asana and he’s feeling “great”, and ready to return to class.
In addition to being able to return to his yoga practice, Craig now has multiple tools which will help to keep him from experiencing back pain in the future.