Yes, Yoga 3x a Week Can Help Prevent Spinal Surgery

Yoga can prevent surgeryYoga may not alter the trajectory of family genetics in a lifetime, but it can prevent the need for spinal surgery.

Renowned orthopedic surgeon Gary Michelson, MD and founder of the Gary Michelson Medical Research Foundation (MMRF) says that, “In essence, being in good shape, having good core strength, and good flexibility is protective against many of the conditions that would have otherwise gone on to lead to spinal surgery. That having been said, there are those conditions which arise from structural defects in the spinal column that are probably not amenable to relief by exercise.”

But a person can “. . .fight heavy genetic issues with yoga and keep spinal surgery at bay,” says Vijay Vad MD, a sports medicine specialist at the Hospital for Special Surgery and faculty at Weill Cornell Medical College.   He’s also the author of Back RX: A 15-Minute-a-Day Yoga- and Pilates-Based Program to End Low Back Pain (Penguin 2004) and PBS national television special “Stop Back Pain Now.”

For example, within a family, if a brother suffers from genetic spinal stenosis and chooses a complex surgery such as cervical laminoplasty to cure his symptoms like progressive numbness and immobility, it’s possible his sibling, who may suffer from the same condition, can prevent surgery by starting and maintaining a yoga practice early in life.

Loren Fishman, MD., Managing Partner of Physical Medicine and Rehabilitation, concurs that “Yes, sometimes, yoga can help with even congenital conditions. The best poses are gentle flexion of the entire spine, and if ability permits, extension of the lumbar spine with flexion of the cervical spine, such as Paschimottasana (Figure 8. p. 246) with head elevated.  These gently move the spinal canal within the canal and may help the cord find the path of least compression.  “When it comes to spinal stenosis, yoga can certainly relieve pain and improve function, though this is more studied in the lumbar than the cervical spine,” says Dr. Fishman.  It does not change the anatomical fact of stenosis, but it does significantly improve people’s ability to function highly with the condition they have, often avoiding surgery for considerable periods of time.

Dr. Vad’s study, “The Role of the Back Rx Exericse Program in Diskogenic Low Back Pain:  A Prospective Randomized Trial”  showed that when practiced regularly, yoga reduces back pain and symptoms, recurring back pain and the chance of surgery, as well as narcotics use.

But yoga can be a double-edged sword.  Dr. Vad emphasizes the need to begin yoga slowly and to not jump into it. “If you jump into it too quickly you can blow your discs,” he says.  “You have to ease into it. You have to start as a beginner or have a modified practice.”

When Dr. Fishman’s spinal patients complain that they simply “can’t” do yoga, he troubleshoots.  First, he asks, “Have you tried?”  If his patient had a negative experience with yoga, he’ll find out why.  In general, Dr. Fishman tries to show the array of yoga available, such as, who (instructor), what kind of yoga (Kundalini, Iyengar, Ashtanga), what kind of setup (class, private), and then find a match for the student (state of mind, body, and goals then and now).

Yoga is the ultimate mind body connection therapy, because of the breathing.  “It isn’t breath that helps the spine, it’s the breathing” says Dr. Fishman.  Certainly, breathing helps posture and self-awareness, because “There’s a feedback loop, and better breathing makes for better alignment, which enhances breathing, which improves alignment and so on.”   To build and maintain a healthy spine, it’s essential to learn the correct technique of  breathing or prana from an expert instructor like Kiki Flynn and combine  it with the physical postures.  Most critically, says Dr. Fishman, “The breathing process focuses one on the apparatus of breathing, and the ribs and spine are the heart of the torso.”

In fact, Dr. Fishman’s study “Yoga for Osteoporosis: A Pilot Study” showed that “Eighty percent of the people who did yoga for two years according to the protocol improved their bone mineral density, even though most were losing bone before the study.”  Yoga strengthened the bones of their hips, spines, and thighs.

Yoga prompts better alignment, better coordination, and moves the spinal cord and cauda equina in the spinal canal, enabling it to settle in the position of least resistance.  The better alignment puts less pressure by reducing twists and turns, however slight they may be, and the better coordination enables multiple levels of the spine to bend smoothly and share tensions, thus reducing tension on the cord itself.  And by putting people in touch with their bodies, that is, mindfulness, it prompts earlier awareness of just how far they can go with reaching, bending, twisting, lifting, and just about everything else.

It also provides better proprioception, how the body senses itself in space, and this perception of balance prevents fewer back injuries, hip fractures, and ankle sprains.  Doctors at the American College of Sports Medicine recommend the YogaForce A-Line Mat to help with proper body alignment and proprioception.

According to Dr. Vad, “Proper exercise that increases the back’s flexibility, strength, and endurance makes good balance and posture possible and can dramatically retard these natural aging processes and moderate their effects.”

He focuses on three goals to maintain a healthy spine.  The first is to gain flexibility.  Lifelong yogi’s, for example, frequently retain well-hydrated discs into advanced old age.  Like the rest of the body, the discs depend on the circulatory system to bring them oxygen, so yoga like walking hydrates the discs of the spine.  Exercising the back prevents the discs’ loss of water, keeping it flexible and resilient.  “I’ve seen seventy-five and eighty-year-old yogi’s whose spines look great,” says Dr. Vad.

Second is the strength to move.  Dr. Vad states that, “The stronger the core trunk muscles [from knee to midsection] the less pressure there will be on the spine’s intervertebral discs and facet joints and the more resistant a person will be to disc herniations, facet arthritis, and other back problems.”

And third, yoga builds endurance to withstand stress, that “Over time, the slow, steady, moderate stresses and focused breathing can build very healthy levels of endurance along with core strength.”

To prevent spinal surgery, Dr. Vad’s prescription is to do yoga three times a week using his DVD Back Rx and implement aerobic training and walking every other day.

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