Chiropractor Says Yoga Is Best Choice for Back Pain

by Dr. Jeffery O’Guin


Consumer reports found that yoga was the most helpful and preferred option for treating back pain (Real Relief From Back Pain, June 2017). Additionally, a published study in the Annals of Internal Medicine found yoga to be equally as effective as physical therapy for back pain.

As a chiropractor and spine health specialist, I am not surprised by these findings. Extensive research is regularly showing that active therapies are usually the best option for managing back pain. I have been an advocate for yoga and have recommended it to my patients for many years. Therapies such as myofascial release and spinal manipulation were right behind yoga in effectiveness, and are additional measures to create optimal alignment, balance and symmetry. However, it is in actively being involved that has the greatest outcomes  in regard to spinal health. In this post, I am going to outline all of the reasons why yoga is so incredible for helping to manage back pain.

First, and most importantly, yoga emphasizes a relaxed mind and body. Through breathing and mindfulness, it is easier to become in tune with the body. This level of body awareness helps to achieve more relaxed and coordinated movements. Essentially, when the mind is relaxed, the body can more easily relax, making movements more fluid. This self-exploration equates to safer and more pain free ranges of motion.

Another interesting component of relaxation and the breath is their relationship to core stability. When people think about core stability, they immediately think of butts and guts. Although, the glutes and abbs are important muscles to consider, the diaphragm is frequently underestimated. The inner core is the most foundational / deepest level of core stability. It is made up of the diaphragm (muscle used mostly for breathing), transverse abdominals (side stomach muscles extremely important in rehabilitation), multifidus (deep muscles along the spine), and pelvic floor muscles (muscles that control your private parts). This inner core often needs to be awoken in people with spine pain. Diaphragmatic breathing, such as in yoga, is an excellent way to wake up this entire area. This is because of the overlapping neurological connections between the diaphragm and the rest of these important muscles.

In addition to this inner core, yoga incorporates many levels of strengthening muscles and increasing core stability. This is important because many cases of chronic and recurring back pain are due to unstable joints of the spine. Ultimately, it is the muscles that protect the spine and keep the body upright.  Without muscles, we’re all just a bag of bones with no support. The muscles of the core are especially important because the ‘Core’ is the center of gravity and foundation for all movements. Every step taken and every reach made, should begin with core muscles firing to stabilize. Then, orchestrated movements begin to ripple out to the limbs. If the core muscles do not initiate movement, or if they do it poorly, pain becomes a natural consequence.

During a typical yoga class, poses are maintained that enhance the endurance of the most important muscles for core stability. Breathing with the diaphragm is also emphasized, facilitating a deeper level of core awakening. Positions and poses are also held while muscles are stretched and lengthened. This means that the muscles are being strengthened and lengthened at the same time. This is important because it strengthens the muscles in a variety of ranges. This adds another level of stability and coordination, important for managing back pain.

Next, the slow and gentle stretches done in yoga are a great way to balance the pelvis and spine. Having tighter muscles on one side of the body than the other, creates asymmetries. Imbalances like these usually cause uncoordinated movements and sensations of ‘being out of alignment’. Also, having a misaligned pelvis can eventually cause excessive wear and tear on joints which can lead to pain. Additionally, stretching improves the ability to move throughout the day without restrictions, minimizing strains on muscles.

Finally, a group of benefits often overlooked are stress reduction and social support. Near the beginning and end of most yoga classes, a short meditation session encouraging relaxation is emphasized. Additionally, social support and building relationships is paramount for overall health. Consider that the newest model of health care is called the biopsychosocial model. This can be important because with any form of chronic pain; stress, anxiety and even depression are common. All of this makes yoga an excellent choice on multiple levels.

Although yoga is incredible for helping with back pain, a few key points should be emphasized. As a spinal health specialist, I would be negligent if I didn’t mention these. First, there are a variety of yoga classes and instructors. In the study that showed yoga to be equally as effective as physical therapy, there was a specific protocol used for helping people with back pain. In choosing a yoga class, you should always speak to someone at the studio, and let them know your interests and needs.

Next, if you have back pain that is not responding, you should absolutely see a spine health specialist. Find a chiropractor or DPT who will take the time to do a full exam and explain what’s causing your pain. Once an accurate diagnosis is made, guidelines can be given in regards to management. This should include specific stretches or exercises to focus on, but more importantly what might need to be avoided. For example, there might be one particular stretch that is actually aggravating a condition. Additionally, other therapies such as traction, spinal manipulation, or myofascial release might be necessary. Finally, managing back pain is usually multidimensional, requiring several strategies. A good physician can be a great resource, helping to evaluate and give advice every step of the way.

Originally published February 27, 2018 by Dr. Jeffery O’Guin D.C. Republished with permission.


Why Meditate?

Dhyana, the seventh of the Eight Limbs of Yoga, is meditation and concentration. The word dhyana comes from the Sanskrit word dhyai, which means “to think of.” The first six limbs prepare us for deep meditation, but we don’t have to start at limb one to gain the benefits of meditation.

Magazines, TV and internet are full of articles about meditation. I’m sure many people read these articles and are interested in learning more about meditation, but daily meditation takes time. I often hear people say something like, “I’d love to meditate but I don’t have extra time in my schedule, plus I’m pretty happy most of the time anyway, and why should I add meditation when I’m already overloaded?” 

You may want to re-think taking time to meditate when you read what I have to say: Hear me out. 

According to the American Psychological Association, chronic stress is linked to the six leading causes of death: heart disease, cancer, lung ailments, accidents, cirrhosis of the liver and suicide. And more than 75% of all physician office visits in the US are for stress-related ailments and complaints. 

We are all subject to stress. It has been estimated that stress costs $300 billion every year due to loss of productivity in the workforce, medical expenses, accidents and related social problems. 

A few common causes of stress are: 

  • loss of loved one 

  • loss of job 

  • work related issues 

  • money issues 

  • divorce 

  • marriage 

  • illness/injury — chronic or short term 

  • The list goes on and on.

Simply said, the cause of stress is not getting what we want. You may not like that definition, but if you really think about it, it’s true. Either because we did something that keeps us from getting what we want, we didn’t do something to get what we want, or circumstances out of our control interfered and we got something we didn’t want. In one form or another, we are all subject to stress. 

When we encounter a stressful situation the amygdala, an area of the brain that contributes to emotional processing, sends a distress signal to the hypothalamus. (see illustration below) 


The hypothalamus is like a command center, signaling the entire body through the autonomic nervous system. The autonomic nervous system controls things like heartbeat, blood pressure, breathing, constriction of key blood vessels and can dilate or constrict airways in the lungs. Two components of the autonomic nervous system are sympathetic and parasympathetic nervous system. The sympathetic is like hitting the gas pedal, kicking on our fight or flight response. The parasympathetic is like rest and regroup, calming the body after stressful situation has passed. 

Upon activation of the sympathetic nervous system, the adrenal glands respond by pumping the hormone epinephrine (adrenaline) into the bloodstream. Epinephrine brings on a series of physiological changes: heart rate increases, pulse and blood pressure go up, breathing rate increases, and airways in the lungs open wide allowing more oxygen to be carried to the brain increasing brain activity. Epinephrine also triggers the release of blood sugar (glucose) which, through a series of events, supplies more energy carried by the bloodstream to the body. 


Chronic low-level stress keeps what is called the HPA axis activated. The HPA axis is the networking between the hypothalamus, pituitary and adrenal glands. Chronic low-level stress results in physical problems such as heart attack, stroke and weight gain just to name a few. 

Meditation is an effective way to deal with chronic stress. Meditation has been around for thousands of years practiced in many traditions; almost every religion has a system of meditation. Currently a method of meditation with roots in Hinduism, Yoga and Buddhism called mindful meditation is the most researched and well known. Mindful meditation in the United States has increased in popularity since the mid 20th century and continues to grow to this day. 

The primary reason mindful meditation has become mainstream is because research and personal experience with mindful meditation shows that a consistent mindful meditation practiced improves physical and emotional health and changes areas of the brain (neuroplasticity) that are tuned to chronic stress response. Over a period of time the brain adapts to the HPA axis response, and the HPA axis becomes more easily activated. 

Neuroplasticity is generally accepted as one of the most significant discoveries of the 20th Century. Dr. Michael Merzenich in the 1970s was conducting experiments attempting to prove that the brain is compartmentalized and fixed. Dr. Mersenich inadvertently discovered that the brain is not compartmentalized nor is it fixed. Some areas of the brain are subject to structural change (neuroplasticity). Response mechanisms to chronic stress can be changed by using mindfulness — non-judgmental awareness in the moment. 

Functional MRI technology has verified theories regarding meditation and the brain. Using FMRI technology, researchers can see structural changes in the brain after just a few weeks of meditation. 

Additional studies have found meditation enhances our ability to empathize without taking on others’ negative energy. Also, mindful meditation increases our ability to nurture ourselves and facilitate a greater sense of well-being. Research also indicates mindful meditation increases density in gray-matter in the hippocampus, known to be important for learning and memory and structures associated with self-awareness, compassion and introspection. 

I wish much love and success to everyone who has taken the time to read this article. Please begin a regular meditation practice today. Information is everywhere, guided meditations can be found in apps and on the internet and books. 

Our website is 

We are offering meditation workshops almost monthly. 

written by Emmet Schmelig