International Yoga Day 2022 | Yoga for pain management: which asanas to do and how it works

Deep breathing and chanting a mantra you like can help to ease your nerves and calm the mind. (Representational image: Hope Film Photo via Unsplash)

Last March 52-year-old Shruti Pandey found that she couldn't get up from her seat after a 2.5-hour video conference. The Delhi-based lawyer and professor had been giving a lecture to students via video.

“I had acute pain in my back, and it felt like my lower back had completely seized. I used to do suryanamaskars and walk up to 15km at a go… I felt fit and healthy, and never imagined I could be incapacitated like this because of a physiological issue,” she said.

When the pain didn't subside after a couple of days, she turned to her friend Abhishek Sharma, a celebrity yoga and holistic lifestyle coach in Mumbai. “Abhishek agreed to help me deal with this acute pain without medication,” she added.

In Bengaluru, Prasanth S.A., 45, had developed a stiff neck. Prasanth said he used to "do nothing all day except sit in front of a computer or on a sofa or lie in my bed”. While Prasanth's condition was not as acute as Pandey’s, he started doing yoga three years ago on his wife's insistence. “Nothing has been a pain in the neck since I started doing yoga, and I pretty much continue to live the same life with the only difference being yoga three to four hours a week.”

Sharma, who's also the author of Fitness on the Go, said: “Yoga can be effectively used for pain management.”

Studies have shown this to be true, both in case of acute and chronic pain. A 2011 study published in the Scandinavian Journal of Caring Sciences found that people were better able to control the degree to which pain interfered with their daily life - while the sensory aspect of pain did not change, the pain became less bothersome for yoga practitioners.

Yoga leads to a greater acceptance of chronic pain rather than eliminating the pain, explained Sharma. “More than the pain itself, it is our reaction to the pain that causes us greater suffering. Yoga helps accept the pain, takes away our obsession with it and that helps in reducing the suffering a great deal,” added Sharma, who has also helped cancer patients manage their pain.

Bengaluru-based yoga teacher Karthika H.C. said that yoga helps you disconnect from the negative emotions that come with pain and that helps people cope better with the perception of pain. “In case of pain caused by autoimmune disorders, bone degeneration or ligament tears, doing sukshma vyayama (a relaxation technique involving tightening the muscles and letting go by turns) helps deal with pain. Thereafter, to manage the pain effectively, the muscles around the affected area need strengthening and need to be moved regularly to relax the painful area. This relieves the muscular stress and improves blood circulation,” he added.

Sharma suggests deep breathing practices and repetition of any mantra you like to ease your nerves and calm the mind. “Breath awareness creates a bit of a distance by diverting your mind from the pain and reduces your perceived pain. Your body’s immunity also works better to heal the pain when you do the breathing routines,” he said.

However, in case of spasm or acute pain like Pandey was facing, the only thing one should do is to rest till the pain subsides. It’s only after that happens that you can start any sort of asanas or yoga interventions. “I took complete rest for about two weeks and then started with gentle stretches under Abhishek’s watchful eyes,” recalled Pandey.

For those who suffer from back pain, Sharma’s advise is to avoid the Suryanamaskaras as that puts load on the back and could make the pain worse.

Pandey slowly moved from gentle yoga to Marjari asana, ardha and purna pawanmukta asana, and makarasana, among others and some dynamic poses as well as pranayama for deep breathing. “I improved steadily over three to four weeks and once I was back on my feet, I was completely healed,” she said.

Asanas

Marjari Asana (Cat-cow pose)

1. Go on all fours with feet hip-width apart and hands straight and shoulder-width apart.

2. Inhale, engage your core and lower your belly while lifting your tail bone (or butt) and craning your neck up along with your head and gaze up. Make sure you keep your spine long and don’t compress it. Hold posture for a few seconds.

3. Exhale and transition into the cat pose by sucking the belly in and making an arch with your spine. The neck and head turn down towards the chest and the gaze is on your knees that are planted on the floor. Hold posture for the same amount of time as you did for the first posture.

Ardha Pawanmukta Asana

1. Lie flat on the floor on your back.

2. Lift one leg and bring the knee towards your chest. Place your hands below the knee and interlock your fingers and pull the knee down to the chest. Make sure your spine is straight along the floor and your shoulders and head are also resting on the floor and not lifted. Hold posture. You will feel a stretch in your hamstring and lower back. Keep core engaged.

3. Repeat for the other leg.

Purna Pawanmukta Asana

1. Lie flat on the floor your back and bend both legs and bring the knees to your chest. Place your hands just below the knees and pull them close to your chest while keeping your core engaged and spine flat on the floor.

2. Lift your head and bring it close to the knees as you slightly raise your shoulders off the ground. Hold posture.

Makara Asana (Crocodile pose)

1. Lie flat on the floor on your belly and face down.

2. Fold your hands under your face and place the right palm over the left.

3. Place your forehead over the right palm, close your eyes and relax.

4. Your toes should be pointing outwards. Keep your breath normal. Hold posture.

Pranayama

This is a yogic technique of deep breathing alternating between deep, slow deep inhalations and slow deep exhalations. This helps syncing your breath and sets up the base of improving your yoga practice. Different coaches and schools have different kinds of pranayama and it is best to start with a guided practice of pranayama with a coach or a teacher before you do it on your own.

How it works

A lot of the pain we suffer is caused by our sedentary lifestyles, work and relationship pressures, and long hours at work. “Emotional stress manifests itself as aches in the neck and shoulders. In such cases, mere physiological movements and exercise would not help... You need to focus on the mind and let go of the stress,” said Karthika. "The alternating exercise and rest cycle that many asanas and flows of yoga include, releases the accumulated stress and muscle tension," he added.

A meta-analysis published in The Journal of Pain in 2012 probed the effectiveness of yoga interventions on pain and associated disability. The researchers found that despite limitations, there was evidence that yoga might be useful for several pain-associated disorders. They found that even short-term interventions might be effective. The study concluded that yoga is a useful supplementary approach for the management of pain and associated disability.

Not only is yoga useful in managing pain, it is preventive in nature, argues Sharma. “If you regularly and consistently do yoga the correct way, you are unlikely to experience minor niggles and pain in your day to day life. And whatever little aches that surface can easily be fixed with even a gentle session of yoga,” said Sharma.

Pandey for her part has learnt to listen to her body and has been regular in doing yoga and gentle stretches in the mornings ever since she recovered. In the year since that acute back pain left her unable to even stand, let alone walk, she hasn't had any back pain at all.

“Over the last 15 months I learnt to trust my body’s intelligence and self healing capacity and integrated morning and night time de-stressing routine and I also learned to slow down. I have been consistently doing my yoga sessions and the back pain has not recurred even once. My back has not only healed, it has become stronger. I can feel it,” said Pandey.