Introduction

Yoga is a physical and mental discipline that originated many centuries ago in ancient India. It is derived from a Sanskrit word meaning to “take control” or “to unite.” Yoga incorporates the body, mind, and spirit to achieve harmony and balance with a universal consciousness. It is now associated with a form of exercise in which techniques are learned to control the body and mind through a series of asanas (postures).

There are five principles of yoga that form the basis of teachings and disciplined methods for attaining these goals: proper exercise (asanas), proper breathing (pranayama), proper relaxation (savasana), proper diet, and meditation (dhyana). Proper exercise is achieved through asanas or postures that stretch and tone the muscles and ligaments, increase spine and joint flexibility, and ease physical tensions though movement. Proper relaxation relieves muscle tension, conserves energy, and regulates body and mind function. Proper breathing provides for good health, by using all parts of the lung to increase vital oxygen uptake. Yoga breathing exercises control of prana, the life force, which in turn increases energy levels and focuses the mind. Proper diet, consumed in moderation, nourishes the body and mind. Positive thinking and meditation facilitate a peaceful mind, while relaxing the body¹.

Clinical and Basic Science

Yoga is classified by the National Institutes of Health as a form of Complementary and Alternative Medicine. There are many well-documented benefits to yoga, including improved flexibility and range of motion, improved posture, increased strength, decreased pain, improved balance, and improved coordination.² Individuals with an aging spine benefit from yoga because it “promotes a full range of motion, helps to restore flexibility, and improve circulation in muscles and around joints.”² Yoga therapy also creates a sense of well-being through the release of beta-endorphins, breaks up chronic muscle tension and stress, and prevents osteoporosis through weight-bearing exercises.

Yoga places “an emphasis on standing poses to develop strength, stability, stamina, concentration, and body alignment.” ³ Abnormalities of the deep spinal intrinsic muscles lead to postural and functional imbalances.Yoga therapy goals for the treatment of the aging spine include educating patients on proper body mechanics, correcting underlying internal malfunctions, and preventing recurrence of pain through healthy postural movement patterns. According to yoga philosophy, a person’s age is determined by the flexibility of the spine and not by the number of years lived.⁴ Yoga benefits the aging spine by imparting flexibility to the spine, firming up the skin, eliminating tension from the body, and strengthening abdominal muscles.

There are many different types of yoga that are practiced throughout the world. Hatha Yoga is what most people in the West associate with the word “yoga,” and is practiced for mental and physical health throughout the West. In the aging spine, individuals should focus their attention on the following types of Hatha Yoga: Iyengar, Ashtanga, Bikram, and Vini. Iyengar Yoga places great attention to detail and precise focus on body alignment with the use of props, such as cushions, benches, blocks or straps. It focuses on the structural alignment of the physical body through the development of postures with use of props to assist individuals that lack flexibility or compensate for injuries. Ashtanga Yoga allows for individual specialization of yoga moves that link breath and movement in flowing exercises. This form of yoga focuses on powerful flowing movements that increase flexibility, balance, and concentration to rehabilitated spines. Bikram Yoga is conducted in a very warm environment, which maintains body heat, making the spine more flexible by allowing the tissues to stretch. Room temperatures average 105°F (40°C), which is not always suitable for individuals with significant heart disease. Vini Yoga involves synchronizing the breath with progressive series of postures, which in turn produce intense internal heat and a profuse, purifying sweat that detoxifies muscles and organs. The flowing movements create heat in the body, which removes toxins and improves tendon, tissue, and muscle flexibility.⁵

Limited scientific research exists examining the benefits of yoga therapy for individuals with low back pain and aging spines. One study by Vidyasagar et al. looked at the effect of Hatha Yoga therapy in individuals with nonspecific low back pain. Their findings reveal that after completing 9 weeks of yoga therapy, the majority of the selected participants noted pain relief, although the study lacked long-term follow-up and a description on assessment of pain status.⁶ Another study by Williams et al. looked at chronic low back pain patients who participated in a 16-week Iyengar Yoga therapy. Their results show less pain, less functional disability, and a decrease in pain medication usage after 3 months.⁷