Why Doctors Are Recommending Yoga Instead of Opioids for Chronic Back Pain
The vast majority of American adults will experience lower back pain at some point in their lives, and now a major organization is recommending that doctors treat it in a new way. On Monday, the American College of Physicians released updated guidelines that urge doctors to avoid medication as the first-line therapy for lower back pain—a departure from its previous guidelines.
Instead, the organization says doctors should urge patients to use alternative therapies, like yoga, heat, exercise, acupuncture, massage therapy, low-level laser therapy, cognitive behavioral therapy, or spinal manipulation under the guidance of a medical professional before they try medication. Physicians should also tell their patients that lower back pain typically improves over time, regardless of the treatment they use.
If a patient wants medication, the organization says over-the-counter pain relievers like naproxen (Aleve) and ibuprofen (Advil) could help, as can muscle relaxers, but it notes that steroid injections and acetaminophen (Tylenol) have not been found to be helpful.
Since opioids have such a high risk for addiction and accidental overdose, the ACP says they should be considered a last option for treatment. Even then, they should only be considered for patients who haven’t had success with other therapies.
Lower back pain is one of the most common reasons why people visit a doctor in the United States, the ACP says, and about 25 percent of all American adults report these aches lasting at least one day in the previous three months.
These new guidelines just “make sense,” David N. Maine, M.D., director of The Center for Interventional Pain Medicine at Mercy Medical Hospital in Baltimore, tells SELF. “Most people do get better from acute low back pain, so most treatments do not need to be pharmacologic or invasive,” he says.
Morton Tavel, M.D., a clinical professor of medicine at the Indiana University School of Medicine and author of Snake Oil Is Alive and Well: The Clash Between Myths and Reality—Reflections of a Physician, agrees. “Since most episodes of back pain resolve spontaneously, any measures employed will be credited with its ‘cure,’” he tells SELF. That’s why he says it’s so important to avoid opioids—they can be addictive and won’t speed recovery anyway.
While the ACP listed several options that people with lower back pain can try, Dr. Maine says that no particular type of therapy has found to be better than another. Acupuncture may be just as helpful for your back pain as yoga—it just depends on what you prefer. These methods may even be helpful due to a placebo effect, i.e., if you think it helps ease your pain, it can, Dr. Tavel says.
However, Santhosh Thomas, D.O., medical director of the Center for Spine Health at the Cleveland Clinic, tells SELF that yoga in particular can help with conditioning, which can improve flexibility and core strength. “These things are often lacking in people with chronic pain,” he says, adding that moving more and building strength can also help prevent future back pain.
Of course, if you’re suffering from lower back pain, you shouldn’t simply write off your symptoms and hope they’ll go away. While you could go straight to a yoga class or masseuse for therapy, Dr. Maine says your doctor may be able to provide some additional guidance.
It’s important to note that the new guidelines should be used for chronic back pain, not a sudden injury that you get from, say lifting something heavy, Dr. Thomas says, or lower back pain that radiates into other areas of your body. That’s why Dr. Maine says it’s important to see a doctor if you have any weakness, the pain is radiating into your extremities, you still have pain after two to three weeks, or the pain is quickly getting worse.
Therapeutic Viniyoga is designed for each individual. It should be used instead of the physical exercise geared yoga.
Meet Gary Kraftsow. The first American yoga teacher to be certified by T.K.V. Desikachar and is now one of the leading proponents of Viniyoga Yoga Therapy.
The National Center for Complementary and Integrative Health has recently published scientific studies indicating that yoga, among other therapies, may be helpful for treating patients suffering from fibromyalgia.
In general, research on complementary health approaches for fibromyalgia must be regarded as preliminary. However, recent systematic reviews and randomized clinical trials provide encouraging evidence that practices such as tai chi, qi gong, yoga, massage therapy, acupuncture, and balneotherapy may help relieve some fibromyalgia symptoms.
To read the full article, click NCCIH
Initial study results revealed that participation in trauma-informed gentle yoga leads to a significant reduction in symptoms of post-traumatic stress.
Elaine breathes slowly, in and out, for a few rounds of simple pranayama before she has to stop. Images too scary for her to describe race in and overwhelm her. After a few moments, with Jocelyn Jenkins, her therapist, sitting next to her, Elaine tries again. Several sessions later they move on to very basic, very slow sun salutations; she becomes aware of her muscles, noticing any resistance in her body, stopping when she gets too agitated.
Although these postures and breathing exercises sound easy and soothing for most of us, they represent enormous progress for Elaine (not her real name), who cut herself off from any connection with her body or her emotions years ago. Jenkins remembers the first time she met her. Elaine was very agitated, in a constant state of hyper-arousal, “alert to every movement in the room, every sound, even the rise of my eyebrow,” Jenkins says. But when it came to talking about her emotions, Elaine shut down.
Here’s why. As a young girl, Elaine was brutally raped. Unbelievably, no one in her family noticed—not even when she came to the dinner table covered from head to toe in bruises.
Without anyone to guide her or help her make sense of what had happened, Elaine tried to rid herself of any residual sensations she felt—she binged and purged, used laxatives, and finally severely restricted her calories in an attempt to numb the pain, be invisible, and “yet at the same time,” Jenkins told me, “get someone to notice.” But no one did. Elaine felt alone and abandoned by the people she thought would protect her. By the time she checked into the Eating Recovery Center outside of Denver, Colorado, where Jenkins met (and noticed) her, she had a history of unsavory relationships with men, self-destructive behaviors, and no idea how to move forward.
Elaine is a survivor of childhood trauma, and her inability to control her emotions, trust her body, or form meaningful and loving relationships is a common cluster of side effects associated with complex post-traumatic stress disorder (complex PTSD), according to Judith Herman, professor of clinical psychiatry at Harvard and author of Trauma and Recovery, who coined the term. This particularly insidious form of PTSD affects those who suffer from chronic childhood abuse.
While we often think of PTSD as the intense and unexplained symptoms military men and women experience coming home from battle, this anxiety disorder can take many forms and touch a much wider population. Being raped, getting hit by a car, witnessing a violent crime, being in a war zone, losing your best friend to cancer, or even being scared of the possibility of something bad happening can all contribute to PTSD. How you deal with how you feel in the aftermath of such events determines the level of trauma that gets lodged in your cells.
Yoga can make a big difference for trauma survivors like Elaine, and we are beginning to see more research that backs up her experience. A three-year NIH-funded yoga and trauma study conducted at the Trauma Center at Justice Resource Institute in Brookline, Massachusetts, with women who have treatment-resistant complex PTSD, has shown promising results. Bessel van der Kolk, MD, the study’s principal investigator, and his colleagues presented preliminary findings at the 2010 International Society for Traumatic Stress Studies conference in Montreal last November. Initial study results revealed that participation in trauma-informed gentle yoga leads to a significant reduction (over 30 percent) in symptoms of post-traumatic stress, including fewer intrusive thoughts and less dissociation from the body. By the end of the study (after only 10 weeks of yoga) several women in the yoga group no longer met diagnostic criteria for PTSD.
Other smaller studies show yoga increases heart rate variability (HRV), a measure of how robust the brain’s arousal systems are. It appears that traumatized people have unusually low HRV, says van der Kolk—who is also founder and medical director of the Trauma Center—which could explain why they are “so reactive to minor stresses and so prone to develop a variety of physical illnesses.” Yoga’s ability to touch us on every level of our being—physical, mental, emotional, and spiritual—makes it a powerful and effective means for trauma victims to reinhabit their bodies safely, calm their minds, experience emotions directly, and begin to feel a sense of strength and control.
To read the entire article go to Yoga International
The Impact of Bending your Body in Yoga Poses on the Brain
There are two functional parts of the brain that play a key role in stress. These serve the functions of emotion and cognitive function. So I am calling them the ’emotional’ brain (amygdala and its connections and medial forebrain structures including the medial prefrontal cortex) and the ‘logical’ brain (the dorsolateral prefrontal cortex, other parts of the prefrontal cortex, parts of the cingulate cortex and parts of the hippocampus).
The emotional brain is able to initiate a ‘stress response’ via the sympathetic nervous system which culminates in adrenaline and cortisol racing through our circulation.The logical brain is always trying to ‘turn-off’ this stress response and it is also trying to restrain the emotional brain. The stronger our logical brain, the better it becomes at doing these two things. When the stress response is ‘turned off’, our parasympathetic nervous system signal is ‘turned on’. This signal ‘relaxes’ the body. So a strong logical brain goes hand in hand with relaxation.
The stress response and ‘relaxing’ signals travel through the body along a particular route and parts of this route have little ‘switches’ which we can physically manipulate to turn the signals on or off. The neck is an example of where such switches are located (by the carotid arteries). Continue reading
The health benefits of yoga are quite real, but few people understand the how it can affect the mind.
After my last weekend of yoga teacher training, a friend asked me at dinner, “Why do you do yoga? So you can learn to do what, headstands?”
Why do people do yoga?
More than 90% of people who come to yoga do so for physical exercise, improved health, or stress management, but for most people, their primary reason for doing yoga will change. One study found that two-thirds of yoga students and 85% of yoga teachers have a change of heart regarding why they practice yoga—most often changing to spirituality or self-actualization, a sense of fulfilling their potential. The practice of yoga offers far more than physical postures and headstands—there is self-reflection, the practice of kindness and compassion, and continued growth and awareness of yourself and others.
To read the full article go to: Psychology Today
As more and more doctors are recommending yoga for a variety of health conditions, the physically therapeutic benefits have become indisputable. However, Yoga Therapy can also be approached from a spiritual rather than physical standpoint, addressing holistic needs in mind and soul as well as body.
Through the spiritual approach, the entire science of yoga as written about in the Yoga Sutras is employed, not just the physically restorative postures. All practices undertaken, from postures to pranayama to meditation, are for the purpose of liberating consciousness from the limited identification of self as strictly human, to a more expansive one of the Divine Self having a human experience. It is natural to connect first through the physical body, as it is the vehicle we operate on a daily basis. And certainly if we have an injury or suffer from chronic pain, the body must be addressed. Similar to physical therapy, yoga movements can significantly decrease pain and suffering, and help one regain vital energy and at the same time that we are doing so, we can begin to change our perception from being the body to being in the body.
Once the body’s demands have been reached, yoga’s mental practices help us deal with internal struggles such as emotional change, loss, indecision and anxiety. Correlating to a branch of psychology called psycho-neuroimmunology, that studies the interaction between the nervous, endocrine and immune systems, we see how the body reflects our internal state of thought and feeling. The application of yogic techniques to affect specific changes in vital functions of the body’s organs and systems allows us to shift from unconscious response to a chosen response in tense circumstances. For example, if we experience anxiety or panic attacks, we can utilize balancing breath exercises (Pranayama) to reset the parasympathetic nervous system’s fight or flight response and gain a more mental equilibrium.
My name is Ryan. I started receiving treatment for PTSD (anxiety) resulting from a serious car accident. I was previously interested in yoga prior to my counseling. This is what brought me to Patricia Simpson as a therapist. While versed in yoga, I was self-taught. This left me with a more physical understanding of the practice. My intent was to have Mrs. Simpson teach me the proper emotional and spiritual side of yoga/meditation.
When I received my evaluation and was diagnosed with PTSD. Mrs. Simpson instantly recognized how I learn, through books. She recommended several crucial texts on the practice of Viniyoga and the audio meditative practice of Yoga Nidra (iRest). These were to be my “first steps” in my journey to peace.
We started our sessions talking about what activities or thoughts affect me the most. Mrs. Simpson carefully listened and evaluated. She generously shared some of her own personal bouts with anxiety. To know you are not alone with this was very comforting as well and reassuring. We continued discussing the history of the yogic practices. This gave me a background and centuries of proof that this practice can work. Her knowledge of the subject was impressive. While open to holistic thinking, one can not rationally abide by that alone. Sensing my hesitation she immediately began to discuss the physiological aspect to my practice. Her explanations of the various types and functions of the nervous system was enough to convince the skeptic in me. She explained the need for the body and the mind to work together being essential to a calm, healthy existence. She continued introducing various breathing techniques based on the yoga sutras. Like all new activities you wish to master, these required dedicated practice. Mrs. Simpson helped to guide me, assessing what made me frustrated or gave me difficulty and adjusted to suit.
After about a month of sessions she felt I was ready to start my physical training. She was kind enough to invite me to her personal practice studio to teach me. After a thorough sight evaluation of my posture and other physical structures we started with a general Viniyoga practice. She took great care to study the way I was performing the poses to insure I would be free of injury. I was corrected when I was improperly positioned. This gave me confidence in her teachings. The next session, a week later I was given a personal yoga practice. I am to perform these poses for 6 weeks to see if I have any results.
With the help of Patricia Simpson and yogic/meditative practices I feel more in control of my anxiety and PTSD. This is not to say I found a simple cure because we all know this disorder is anything but simple. I have good days and bad days. The good days are more and more. Thanks to Patricia Simpson’s efforts and guidance I feel I am taking a step in the right direction.
Do you want to feel less stress and sleep better?
This week, the Vermont House of Representatives passed a resolution recognizing the economic and health benefits of the yoga industry.
Julie Kelley sat down with yoga student Dave Sterret and Anna Van Fleet, who is training to be a yoga therapist, to learn more about this movement.
Yoga is also used for veterans who are struggling with post traumatic stress disorder. You can find classes through the the Veterans Administration in White River Junction.
How Old, How Often and for How Long Should Children Practice Yoga ?
Yoga for you and your child.
You are, or can be your child’s first yoga teacher. Regardless of your fitness level, you and your child can practice and learn about yoga together. Sharing yoga encourages community, connection, compassion, and communication in families. The non-competitive spirit of yoga is a welcome reprieve from peer and performance pressures.
How old should the child be?
Children can begin as early as three or four. Little ones respond best when yoga is presented as play. Postures that require balance, strength and coordination may be challenging. The support you give your child instills trust, confidence and self esteem.
How often can the child practice?
Family yoga time is a special time for you and your child. Find a day and time and be consistent. Ritual, routine and discipline an are important part of practice. It is through regular practice that you will find the greatest physical, physiological and emotional benefits.
How long should the practice be?
Practice for as long as your child is engaged. Wrap up your session when your child tires or loses interest. If you or your child have any physical limitations, consult a yoga therapist before beginning the following practice. Adaptations and modifications may be made. A good yoga therapist or yoga instructor can help you learn how to adapt.
Go to YogiTimes to see the specific suggested practice.