New guidelines released by the American College of Physicians suggest that an ancient Chinese martial art can be an effective defense against back pain.

Tai chi combines slow, gentle movements with deep breathing and mental focus. It’s one of several nondrug measures—including yoga, chiropractic care, and massage—that the new guidelines recommend back-pain sufferers try before resorting to over-the-counter or prescription pain medications.

A new, nationally representative Consumer Reports survey of more than 3,500 adults who've had back pain in the last three years confirms that tai chi helps provide relief. Nearly 90 percent of respondents who used tai chi for back pain (or yoga or a similar exercise) found it helpful. In comparison, only 64 percent of people thought the advice and treatment they got from a primary-care physician or orthopedic surgeon gave them relief.

“Tai chi helps with back pain in several ways,” says Benjamin Kligler, M.D., national director of the Integrative Health Coordinating Center at the Veteran’s Health Administration. “It strengthens the muscles in your abdomen and pelvic area that are crucial to supporting the lower back; it improves your balance and flexibility; and it makes you more aware of your posture when you sit, stand, and walk.”

This gentle exercise is sometimes called “moving meditation” and the mindfulness aspects are also key to deriving benefits. You are encouraged to focus on your breathing and visualize the movement of energy or “chi” through your body.

“Stress and tension worsen pain,” says Kligler. “Any practice such as yoga or tai chi that induces relaxation and gives you some mental distance from your physical problems can help with pain.”

A Long-Term Strategy to Protect Your Back

The research used as a basis for the new guidelines involved chronic pain patients, whose pain lingered for three months or longer.

Tai chi can also help alleviate shorter-term pain as well, says Kligler, but be aware that it takes at least a few weeks to start seeing results. “Massage or acupuncture may provide more immediate relief,” he says.

When you first hurt your back is probably not the best time to start a new class in tai chi. If you are familiar with the moves, it's okay to do a few of them at home if it's comfortable for you. Otherwise, Kligler recommends just doing some gentle stretches and walking, even if it’s just around your living room. After two to four weeks, or as soon as you can stand and walk reasonably comfortably, you can try out a class.

Even if back pain recedes on its own, Kligler still encourages patients to check out tai chi if it interests them. “Back pain tends to recur unless you take steps such as strengthening your back and improving your posture,” he says. “Tai chi is a great prevention strategy.”

A Tai Chi Success Story

Thomas Sells, of Culver City, Calif., first injured his back carrying heavy packs as a combat soldier in the Vietnam War. “By 2009, my low-back pain had become so bad I could barely walk,” he says. “My surgical prognosis wasn’t great, but that was beginning to look like my only option.”

That’s when staffers at the local Veteran’s Affairs (VA) facility persuaded him to join a twice-weekly class in tai chi. “Three months in, I started to get more fluid and had far less pain,” says Sells. “I carried myself differently and began to view obstacles differently. I became calmer and less stressed.”

Today, at the age of 72, Sells studies with a grandmaster practitioner of tai chi and leads classes. Most days he describes his pain as mild to nonexistent. He’s added other exercises to his routine, including Zumba classes and hiking, but credits tai chi as the core element of his recovery.

“It’s given me back my life,” says Sells.

Finding a Tai Chi Class

If you’ve recently suffered a back injury, it’s a good idea to get checked out by your doctor before participating in any exercise class, says Linda Huang, director of the American Tai Chi and Qigong Association. Your provider may also be able to refer you to a tai chi class in your area.

Local YMCA and recreational centers often offer tai chi. You can also find a list of certified instructors who teach in your area through the American Tai Chi and Qigong Association.

If you try tai chi for back pain, Huang advises that you talk to your instructor before class about what hurts. He or she can advise you on how to make the moves comfortable for you. And listen to your body. “Tai chi’s slow, gentle movements are very safe, but if certain postures causes tension or pain, don’t do them,” says Huang.

To get the most benefit, you should be doing the movements at least twice weekly for about 45 minutes to one hour says Huang. If the class only meets once a week, she advises practicing on your own between sessions. Ask your instructor if he or she can recommend an online video or a DVD that you can follow at home.

If you’d like to get an idea of what to expect, check out this introductory video about tai chi and qigong (a similar martial art) posted by the National Institutes of Health.

Three Tai Chi Moves to Try

There are several different styles of tai chi, but they all use similar movements. A typical routine contains 24 types of movements, or forms, that flow from one to another. 

According to Huang, it's important to understand that tai chi is more than just body movements. "The breathing and meditation components are also essential, she says. "It takes practice to learn to coordinate all three elements."

Here are three "forms" that can help stretch your back and strengthen the muscles that support it. Repeat each movement several times.

people doing tai chi for back pain

Circle the globe. Hold your arms in front of you as if you were cradling a beach ball: right hand on top; left, on bottom. Relax your knees. Step slightly to the side with your right leg, shift your weight, and slowly turn your torso to the right. Breathe out as your hands holding the "ball" glide across your body. Once you reach the right side, inhale as you rotate your hands so that the left arm is now on top. Shift your weight to the left leg and exhale as you turn your torso to the left.

people doing tai chi for back pain

Push and pull. Relax your knees and raise both arms in front of you shoulder high with palms facing outward. Imagine yourself in the center of a clock; with your right leg step forward toward the two on the clock. Shift your weight and exhale as you gently push with your arms. Turn your palms inward and inhale as you pull your arms back towards you. Repeat several times on each side.

people doing tai chi for back pain

Hands waving clouds. Relax your knees and bring your right arm up and gaze at your palm. Curve your left arm in front of your waist. Step slightly to the right and shift your weight, slowly turning your torso to the right as if you were opening a sliding door. Exhale and watch your right hand as your arms follow your body. (The movement should come from your upper body, not your shoulder.)

When you reach the right side, inhale and rotate your arms so that your left arm is raised and your right arm curves naturally in front of your waist. Repeat the move, shifting your weight to your left leg and exhaling as you slowly turn your torso to the left.

Editor's Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).