Executive Summary
Abstract
This study examines the effect of yoga practices for the back pain participants.
Methods
17 participants signed up for the workshop. Of them 3 were men and 14 were women. 10 participants completed the entire pre and post assessments.
As the participants’ level of pain conditions were varying at a wider range, practices related to relaxation and restoration were adopted for the first two weeks. Then restoration and stretching practices were followed for the next two weeks and for the last two weeks, we aimed at strengthening practices.
Results
There was an overall improvement in pain conditions where participants reported a significant improvement at the end of the workshop.
Conclusion
The intervention was done for only 6 weeks with 3 sessions/week basis. This study should be expanded to see the differences in severity of the pain levels when practiced on a daily basis for at least a period of 2-3 months to see a greater difference.
Workshop Objectives
Back Pain Management
The goal of the workshop was to help participants learn and explore themselves and to understand the underlying causes of their pain such as physical or emotional stress. The objective was also to give them an experience on how mindfulness practices with chantings can help in bringing in greater awareness of their body and mind and thereby helping in diffusing the intensity of the pain level.
About Pain
Pain is an uncomfortable feeling that tells you something may be wrong. It can be steady, throbbing, stabbing, aching, pinching, or described in many other ways. Sometimes it is less severe and at some times it is debilitating.
Back pain can be due to functional or structural issues. Functional back pain can be caused by stiffness, posture problems, muscle spasms while structural back pain is due to arthritis, disc problems, scoliosis, osteoporosis, sciatica etc where there is damage to the bones or nerves.
Based on the previous research data, it can be understood that yoga helps immensely for people with back pain. According to Chang et. al. (J Orthop Rheumatol. 2016 Jan), who did a systematic review of the effect of yoga on back pain, many studies showed that yoga reduces pain and disability.
These studies also showed that yoga can be practiced safely and is well received by participants. Some studies also indicate that yoga may improve psychological symptoms, but these effects are currently not as well established. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878447/>
Materials and Methods
Participants
17 participants participated in the workshop. Of them 3 were men and 14 were women. 1 participant dropped out due to an increase in the severity of their pain.
Design
The workshop took place over a 6 week period. Prior to the workshop, therapists conducted health assessments for all the participants. Sessions were conducted online. Each session was for a 75 minute duration. There were 3 sessions per week. After the six week session, the participants had their post health assessments guided by the therapists to see for the change in the parameters.
Methods
The participants had various other pain conditions along with back pain and their intensity were varying widely. Two of the participants who had structural pain - were given private sessions. Rest had functional pain - they were put in the same group.
The sessions were initially focussed on supine practices mostly emphasizing the relaxation of the back muscles and visualizing the diffusing of the pain. Practices which assist in lengthening the spine, creating space for the free flow of prana were taught to the participants. Gradually strengthening practices were introduced to highlight the importance of keeping the abdominal and back muscles fit which will help in bringing down the pain from occurring again.
Assessments
Pre and post health assessments had questions about their general lifestyle habits, sleep habits, stressors, pain areas and their pain levels.
Intervention - Yoga Techniques and Principles
Each week the therapist chose a theme for stress and pain management. Concepts such as
Ahimsa (non-violence),
Sthir sukham asanam (A good posture is practiced with stability and comfort) (PYS 2.46)
Tatah dvandva anabhighata ( Then (with yoga), all dualities cease to be )(PYS 2.48)
Heyam Dhukham Anagatam (Prevention is better than cure)(PYS 2.16)
Kartum-akartum-samarthaḥ (We have a choice at all times to be happy)
Due to different pain conditions and intensity of the pain level, the sessions were designed to have a lot of restoration practices for the first two weeks.
Restorative practices such as supine pelvic tilt (flattening of the back), bridge pose, Pawanmuktasana, lumbar twists, cat and cow, neck movements, Deep Relaxation Technique(DRT) were given.
These mindful practices which were weaved with A,U & M kara chantings helped participants to witness and accept the pain and to bring down the pain level.
In the next two weeks,
Some stretching practices like arms stretches, ardha uttanpadasana, seshasyanasana, hindolasana, shashankasana, baddha konasana etc., were added to the restoration practices.
A variation of surya namaskars were introduced to help with back pain. This helped participants gain flexibility in their back muscles, hamstrings etc.,
In the last two weeks, participants were getting better with their range of motion and their pain conditions.
Strengthening practices were introduced along with other practices especially to strengthen the core muscles. Some practices like yogic crunches, shalabasana, bhujangasana, virabhadrasana 2 etc were introduced.
Practices such as pranayama, DRT and chantings helped participants to stimulate their parasympathetic system to calm down and bring deeper awareness to the practices.
Data Analysis
Data was analyzed using google spreadsheet comparing pre and post data and generating simple charts.
Results
Pre and post Bhramari count - with the regular practice of Yoga for 6 weeks and 3 classes per week the bhramari count increased (an average of pre and post count in seconds is shown below in the graph)
Strength and Weakness of the Study
As this workshop was conducted online, people from different time zones were able to participate and get the benefits of back pain oriented yoga practices. Constant monitoring and interaction with the participants helped teachers to design the sessions. Participants with different pain conditions were able to experience and enjoy when variations were given.
The workshops being online, initially, the participants found it difficult to understand the instructions and follow it. The first week of practice was very challenging for both teachers and participants as everyone was in the learning curve of knowing/understanding the practices, setting the rhythm for the session etc. We could not do post assessment for some participants due to the participant's personal reasons.
Conclusion
Based on the above data, it clearly shows that the practice of yoga with sincerity and dedication has shown an overall improvement in the pain conditions, their sleep pattern, and an increase in lung capacity. The study can be expanded for a longer period of time to understand the longer benefits of this practice.