Doctor, Heal Thyself
For the last 22 years, I have been teaching an in-person Yoga for Back Health class in Oakland, and since the Pandemic, on Zoom, too. My motivation to work with those who are struggling with issues around the spine and back grew out my own frustration with what I had to offer back when I was a practicing Family doctor. In those days, I probably saw 3-4 patients a day with some issue around their back, be it an acute spasm in the lower back, or more chronic, persistent pain that was interfering with work, play and other aspects of daily life. My tools to help at the time were predominately the prescription pad: I could dispense medications for inflammation, pain, muscle spasms, trouble sleeping, secondary depression; I could use that same pad to refer my patients to physical therapy, and if the situation was not improving, to an orthopedic or neurosurgeon for consultation. It was also a time when a few days of bed rest was still being recommended, although we have since learned this does not help with recovery in most cases. The results of these interventions were often less than satisfying for me and my patients!
Once I started doing yoga regularly and started to learn about teachers who were offering special yoga classes for those with back issues and getting good results (improved function and better pain management, for example), such as Elise Browning-Miller in Palo Alto, CA and Julie Gudmestad in Portland, OR, I got excited about a new way of addressing this pervasive problem for adults of all ages. (Studies have shown that 90% of adults in the US will suffer at least one episode of significant back pain in their lifetimes- and I suspect the other 10% are fibbing!) Thus was born my weekly class focused on optimizing the health of the spine and back!
Fast forward to a few weeks ago when I started to notice some stiffness, soreness and slightly painful sensations in my lower back which is usually feeling pretty good. OK, so I do get some occasional pain in my right sacro-iliac joint, but this was different. It was unclear if it was related to some new activity, or an accumulation of the large amount of yoga I have been doing since the start of the pandemic, upwards of 8 classes that I now demo each week. And my weekly tennis playing, up to 3 hours a week, might be another factor to consider. Regardless of the trigger or triggers, I knew from studies on lower back pain that most cases resolve within 6 weeks regardless of intervention- a reassuring statistic, for sure. I also know from my decades of work with students with lower back issues that yoga can help speed that along. And the mainstream medical community is also starting to acknowledge the benefits of yoga for this problem, especially for persistent back pain. The American College of Physicians now recommends yoga as a first line approach to addressing back pain! Armed with this information, what have I been doing?
• First, I had to acknowledge something was different, especially after symptoms lingered beyond 2 weeks. Once I did so, I was ready to form a plan to address the issue!
• I did not stop being active…bedrest is no longer recommended for back pain, so I modified my activity so as to not aggravate my symptoms but keep moving.
• I kept doing gentle yoga, especially some “go to” poses: Reclining Vinyasa 1, Strap to Foot Pose (without the deep twist variation for now), Thread the Needle/Figure 4, Sphinx, Supported Bridge, Mountain Pose, and Arms Overhead Pose. (You can find short videos of many of these poses on my Baxter Bell Yoga YouTube Channel).
• I leaned into breath work that was calming, including gentle full equal inhalation/exhalation and extending the exhalation to be longer than the inhalation (1:2 ratio breath).
• Massage seemed like a good complement to what I was doing, so I scheduled a few sessions, which definitely helped.
• Applying arnica cream regularly, and CBD cream occasionally at bedtime also was helpful in addressing my symptoms.
• Early on, I found using a heating pad or a hot shower felt good.
• Occasional Ibuprofen when really sore was also useful!
Usually, a multi-pronged approach for addressing back pain can work nicely, and as I finish this blog post today, my back is feeling much better, with some mild stiffness and achiness lingering but greatly reduced. The trajectory of my recovery is encouraging and I am starting to do a more complete yoga practice and enjoyed some work in the yard this weekend as well.
And for those who did not know it already, you can join from anywhere in the world for my weekly Yoga for Back Health yoga classes on Zoom:
Tuesdays, 5:30-6:30pm PST
Thursdays, 2:30-3:30pm PST
Here are a few short videos of poses from my personal back health practice described above:
Reclining Vinyasa 1 for Back Care
Supported Bridge with Extended Leg (note: It's OK to keep feet in normal bridge position)
Strap to Foot Pose short video of all 4 versions on one side only (remember, I skipped the deep twist):
Thread the Needle easy version, foot on floor or low block: