Back Pain – 10 key points

Courtesy Irish Independent

Back pain is unique to each person. While it may be a structural issue, stress, mood or poor sleep may all be at the root of the problem. Becoming aware of the various different factors provides a better understanding of the pain and how to address most appropriately.  All of these factors form part of the 121 Yoga process and the appropriate application of Yoga for the individual and their particular needs.

Key related extracts from an article published in the Irish Independent:

Back Pain is common
While back pain can be very painful and worrying, it is very common and rarely dangerous. A total of 84pc of people worldwide will experience back pain during their lifetime. It is equally common across all age groups; from young to old and doesn’t get worse with age. Therefore, it should not be seen as a result of ageing or “wear and tear”. Mostly people recover reasonably quickly, and many recover without the need for treatment. Some people experience repeated episodes of back pain which can be distressing, but again these are rarely dangerous.

Scans for back pain are rarely needed and can be harmful
Most people believe that a scan (for example an X-ray, MRI) will identify the cause of their back pain. However, the scientific research shows that scans are only needed when a serious condition is suspected (cancer, fracture/broken bone, infection). Luckily, these serious conditions are rare and account for approximately 1pc of all back pain worldwide.

The back is NOT that vulnerable to damage
Most people think the spine is something that needs to be protected. This is incorrect and has led to the provision of information and treatments that promote fear, protective guarding, avoidance and disability. Common examples include: “Your joint/pelvis/disc is slipped/out of place.”
People often move differently when in pain, giving the impression that something has gone out of place. However, scientific research has clearly shown that these structures do not go ‘out of place’ or ‘slip’.

The back is designed for bending and lifting
Like other body parts (for example the knee), the back is designed to move and adapt to many activities. It is important to be conditioned to lift; and shown how to lift heavy things correctly and safely. The back is designed to move and adapt to many activities. In the same way that a person can get a sore knee after doing an unaccustomed activity, people can get back pain when they lift something awkwardly or something that they aren’t used to.

You can have back pain without back damage or injury
The traditional view is that pain is a sign of injury or damage. While some back pain may be related to a sudden, repeated or heavy-loading event, we now know that the volume switch for back pain can be turned up by many other factors also. These include physical (minding/guarding the back, avoiding movements), psychological (fear of damage/pain or not getting better, low mood/depression, stress), health (being tired and run down, low energy), lifestyle (sleep problems, low levels of physical activity, being overweight), and social (poor relationships at work or home, work satisfaction, stressful life events like a death or illness) factors.

This means that you may feel more pain when you move or try to do something, even though you are not damaging your back. Ever have a headache when you are stressed, sad, tired or run down? Back pain is no different. For many people, back pain can occur from just a minor mechanical trigger, like picking something up from the ground or rolling over. In this situation it is due to the spinal structures being sensitised due to other factors such as sleeping position or stress.

Don’t take back pain lying down and don’t rush for surgery
Since people often think they have done damage when they get back pain, it is common for people to go to bed and rest until all pain is gone. However, there is very strong evidence that keeping active and returning to all usual activities gradually, including work and hobbies, is important in aiding recovery. While you may feel relief from rest initially, prolonged rest is unhelpful, and is associated with higher levels of pain, greater disability, and longer absence from work.
Surgery is rarely an option for back pain. There are some uncommon back conditions where there is pressure on the nerves that supply the leg and the patient gets leg symptoms such as pain, pins and needles or numbness. For these conditions surgery can help the leg symptoms but it is important to understand that surgery is not always required.

Exercise is good for back pain but people are often afraid
Contrary to popular belief, exercise is helpful for back pain….
It is emerging that the amount of exercise you do is more important than the type of exercise. More than 30 minutes per day has the greatest health benefits but any amount you can manage will result in benefit. The benefits of exercise even include reducing the risk of developing back pain.

Strong meds do not have strong benefits for back pain
Many people think strong pain needs a strong painkiller. This is not true. If you have a new episode of back pain, you should start with a simple over-the-counter painkiller and not rush for prescription medications. Scientific research has shown that strong painkillers such as those containing an opioid do not provide greater pain relief over simpler options, and actually have greater potential for harm.

Buyer beware: internet, fads, fashions and bandwagons
Be wary of commercial sites that are selling a product. We hear daily claims about miracle cures and best treatments for back pain in the media and on the internet.

Back pain can be cured
The thinking around the spine is distorted and infused with panic. Of course you can injure the back – but be confident that it will get better. It is common for people to be told that they cannot change their pain and they have to live with it. The evidence doesn’t bear this out. The back can also recover.

Think of it like an ankle sprain. It is incredibly painful at the start but it gets better with graduated activation. Avoiding movement would not help an ankle sprain, and the same goes for a back injury or back pain. The pain experience is unique to you and can involve an interplay of many different factors. It therefore makes sense that all of these factors must be considered in addressing your back pain. This could explain why many different treatments for pain fail in the long term as they only look at one piece of the puzzle.

Link to full article published in the Irish Independent.

Actually, let’s not be in the moment

Braulio Amado - Courtesy NY Times
Braulio Amado – Courtesy NY Times

“Mindfulness is supposed to be a defense against the pressures of modern life, but it’s starting to feel suspiciously like it’s actually adding to them. It’s a special circle of self-improvement hell, striving not just for a Pinterest-worthy home, but a Pinterest-worthy mind.”

“The idea that we should be constantly policing our thoughts away from the past, the future, the imagination or the abstract and back to whatever is happening right now has gained traction with spiritual leaders and investment bankers, armchair philosophers and government bureaucrats and human resources departments. Corporate America offers its employees mindfulness training to “streamline their productivity,” and the United States military offers it to the Marine Corps. Americans now spend an estimated $4 billion each year on “mindfulness products.””

“What differentiates humans from animals is exactly this ability to step mentally outside of whatever is happening to us right now, and to assign it context and significance. Our happiness does not come so much from our experiences themselves, but from the stories we tell ourselves that make them matter.”

New York Times for full article

The mind is part of a team…..

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Books in the bookcase leading me to read. Apt quote around my Yoga group this evening.
” The mind is part of a team, along with the body, the breath and the senses. Everything that we do is a product of that team, but the mind is generally the boss……..We know that the state of the mind affects the breath and, luckily for us, the opposite is also true”
What are we Seeking – TKV Desikachar

The Mind and Breath…..

 

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The mind and the breath are fundamentally linked. In Yoga practice we work with each to influence the other.

When we are anxious, fearful or disturbed in some way, the breath can become shorter, faster and irregular. Likewise, when we feel content, the breath has qualities of being longer, slower and even. Prāṇāyāma is a practice that supports change in this respect.

Āsana practice incorporating precise use of the breath with movement is an important preparation towards integration of the breath in prāṇāyāma.

Yoga Practice is about a re-turning towards our inner life……

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“Yoga Practice is about a re-turning towards our inner life. However, even without outer obstacles, we can encounter inner feelings that arise and manifest as obstacles to that re-turning.

Here it might be helpful to reflect on the four pillars of MaitrīKaruṇāMuditā and Upekṣā and the role they can have in helping to transform the unhelpful aspects of these inner feelings.

Bhāvana is a beneficial attitude that is consciously cultivated
despite tendencies to the contrary”
– T Krishnamacharya commentary on Yoga Sūtra Chapter One verse 33

With the spirit of Yoga Sūtra Chapter One verse 33 in mind, the cultivation of the four pillars is a practice that can support a stepping, rather than stalling, onto our mat or seat through:

  1. Maitrī –
    Cultivating a feeling of friendliness towards our own attempts,
    let alone other’s demands, to distract ourselves.
  2. Karuṇā –
    Cultivating a feeling of compassion towards our bodies and minds,
    whatever state we find them in.
  3. Muditā –
    Cultivating a feeling of looking for the positive spot in ourselves
    and what we can do well and now, rather than what we can’t do well or now.
  4. Upekṣā –
    Cultivating a feeling of keeping distance from the self-deprecation that can so often accompany our attempts to improve the quality of our inner life and old responses to inner tensions and memories.”

– Paul Harvey’s personal commentary on Yoga Sūtra Chapter One verse 33

…..it is the purpose of Yoga to unify their movement

TKV_Hindu_Oct_2000

“While it is theoretically possible for the body, the breath, and the mind to work independently, it is the purpose of Yoga to unify their movement. In our very first practice classes, we will experience this unification. What appears as Yoga to an outsider is mainly the physical aspects of our practice. They will not be aware of how we breathe, how we feel the breath, and how we coordinate breathing with physical movement.”

TKV Desikachar – Religiousness in Yoga, ch2, p13

Why have the breath envelop the movement…..

 

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Image: Paul Harvey’s Yogastudies.org

Q: Why have the breath envelop the movement?

A: “Mastery of the Āsana is about mastery of the breath in the form not just the form itself.
The best reference for observing that there is a quality of grace, as well as power within the achievement of the form, is a long smooth breath.
In t
erms of movement this notion means that you can be sure these qualities are embedded by keeping the breath longer than the movement.
This also offers an experience of stillness and an observation point for any stresses arising from the performance of the Āsana.
As mentioned in the original article around this topic there are also other levels beyond the four I discussed.”

The above is a question raised in response to the post ‘Keeping the Breath Longer than the Movement” together with Paul Harvey’s answer.

Man baffles doctors when thigh bone snaps after attempting Yoga pose

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Credit for images: © BMJ 2015

“A man in Ireland broke his leg and spent 10 days in the hospital after injuring himself in a surprising way — while practicing yoga.

The 38-year-old yoga enthusiast fractured the thighbone on his right leg while doing a difficult seated yoga pose known as Marichyasana posture B in his morning yoga class, according to a new report of the man’s case, which was published online Oct. 9 in the journal BMJ Case Reports. The pose involves sitting down, with the knee bent and drawn up to the chest, and then bending the torso toward the floor. “

“At the time of his injury, the man was practicing Ashtanga yoga, a physically demanding style, for an hour every morning.Research suggests that injuries from this style of yoga are more common in the hamstrings, knees and lower back, according to the report.”

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credit for image: © BMJ 2015

“Indeed, a bone scan taken at the hospital revealed that he the man had did in fact have osteopenia, a condition in which his bone density is lower than normal, which could increase his risk for low-energy fractures, Moriarity explained.

“Five months after his release from the hospital, the man could walk almost pain free and had resumed practicing yoga, but was doing only less-demanding postures.”

For article on Live Science
For Irish independent article 

‘Ideal body’ stress, social medial, reality TV and suicidal ideation

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“Over the last two years, Pieta House – the suicide and self-harm crisis centre – has witnessed a marked increase in the number of 13- to 17-year-old girls presenting with suicidal ideation.

The most consistent issue they are presenting with is their struggle to obtain “the perfect body”.

“…..young girls regularly name social media sites, reality TV and other popular television shows as the trigger of their weight obsession.

The problem also manifests due to pressure from peers, sexual identity issues, cyber-bullying, negative online comments and relationship troubles.”

“Last week, a new report from the Children’s Rights Alliance (CRA) revealed that Ireland had the highest rate of female youth suicides and the second-highest rate of male youth suicides in the EU between 2009 and 2011.”

“Over the past 12 months, the charity, which has supported more than 17,000 children, adolescents and adults since 2006, is seeing more teenage boys presenting with body image issues.”

“Boys are looking at six packs and think it’s the perfect body,” Ms Kiely said. “There is nothing wrong with wanting to be fit but if they are over-indulgent and are on steroids or taking protein supplements to build themselves and bulk up, that’s not healthy.”

“However, Pieta House believes this is also a good sign and that young people are reaching out.”

For full article Irish Independent