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If you’re looking for something to help you manage chronic back pain, you may want to consider giving yoga a try. That’s the advice from the American College of Physicians (ACP), which released clinical guidelines on noninvasive treatments for back pain in 2017. And it’s supported by a growing body of scientific evidence.

The ACP guidelines recommend opting for nondrug remedies first. Evidence for yoga’s benefits for back pain is as strong as that for other nondrug treatments, such as chiropractic, massage, and tai chi, according to Richard Deyo, M.D., M.P.H. (He is the Kaiser Permanente Professor of Evidence-Based Family Medicine at Oregon Health & Science University and author of a review study of nondrug therapies for back pain, which was part of the research used to set the ACP guidelines.)

Research also suggests that yoga may be just as effective as physical therapy. A study published in July 2017 in the Annals of Internal Medicine found that 12 weekly yoga classes were as effective as 15 PT visits in self-reported pain reduction and improvement of function. The positive effects of yoga and PT lasted, too: for at least a year, in both cases. 

More on Relieving Back Pain

Follow-up analyses looking at the data from the Annals study, published over the past few years, have found that yoga and PT also helped to improve participants’ sleep, reduce stress, and even (slightly) relieve symptoms of depression and anxiety

Further evidence of the potential benefits of yoga for back pain were found in a 2017 review of 12 studies by researchers from the University of Maryland School of Medicine’s Center for Integrative Medicine and from the United Kingdom and Europe. The review, published by the independent Cochrane Collaboration, found that people who did yoga saw small to moderate improvements in back function, compared with those who didn’t exercise.

Here’s the lowdown on using yoga for back pain.

Do's and Don'ts of Yoga for Back Pain

It’s important to note that all the positive research on yoga focused on people with chronic back pain.

“I suspect that truly acute back pain is the wrong time to begin a yoga program,” Deyo says. “But a mild regimen in the subacute phase [pain lasting up to 12 weeks]—that focuses on relaxation, stretching, and maintaining joint range of motion—may make sense.”

The tricky part is finding the right type of yoga for back pain, one that will help rather than potentially cause more pain. “The yoga interventions we studied in our review were designed to treat low-back pain, and the classes were taught by experienced teachers,” says L. Susan Wieland, M.P.H, Ph.D., an assistant professor at the University of Maryland’s medical school.

She suggests getting your doctor’s okay before starting a yoga program and seeking out knowledgeable teachers. (Check out the Yoga Alliance or the International Association of Yoga Therapists for instructors with advanced levels of training.)

Look for classes with words such as “gentle,” “relaxation,” and “restorative” in their title, and steer clear of those that have words like “power” and “Ashtanga"—two styles that are more vigorous—in their description.

During class, don’t be afraid to skip some postures or ask the teacher for modifications. “If something doesn’t feel intuitively good, don’t do it,” says Larry Payne, Ph.D., founder of Samata International, a yoga and health center in Los Angeles.

And make sure you use a quality yoga mat. People with back pain may want to opt for one with a higher level of cushioning, though keep in mind that a cushier mat may also feel less stable when you’re in a standing pose. For more advice on buying a yoga mat, see our guide, where CR digital members can also find our full ratings of 19 yoga mats.

A few mats from our tests that offer high levels of cushioning include the Lululemon Take Form Yoga Mat (from $130 at Lululemon), the Crown Sporting Goods 15mm Extra Thick Yoga Mat (from $25 at Walmart) and the HemingWeigh 1 Inch Thick Yoga Mat (from $30 at Amazon, Sears, and Walmart).

Three Back-Friendly Postures to Try

According to Payne, sitting too much is the biggest enemy. “That position causes people to round forward, which leads to low-back pain,” he says. “Yoga postures that make the back arch more help to reinstate the natural lumbar curve.”

Lower-back pain also tends to affect one side more than the other, so moves that address each side of the back separately can be helpful in restoring balance.

Here are three that Payne suggests making part of your daily routine:

Knee to Chest
To help tune your back before you even get out of bed, lie with one leg extended, bend the other leg, and gently pull that knee into your chest. Breathe slowly through your nose, hold for five breaths, then repeat on the other side. 

Knee to chest, a pose to try when using yoga for back pain.

Cobra
Lie on your stomach, hands on the floor with fingertips near your armpits. As you inhale to a count of five, slowly press your chest forward and up, extending your elbows only as far as you comfortably can (the straighter your arms, the more your back will arch). Hold for a moment, then lower down as you exhale to a count of five. Start with six to eight repetitions and work up to 12 to 15.

Cobra, a pose to try when using yoga for back pain.

Warrior One
Stand facing forward, legs extended so that your right foot is on the ground in front of you, left foot behind you. As you inhale, bend your front knee (your right knee should end up directly above your right ankle) and move your arms overhead. Move into and out of the pose three times, and on the third time, stay in the lunge with arms overhead, back slightly arched, and hold for five breaths. Repeat the sequence on the other side. 

Warrior One, a pose to try when using yoga for back pain.

“I think the most important thing is to start slowly, expect that some of the techniques will be challenging at first and maybe cause some temporary increase in pain,” says Roger Chou, M.D., a professor of medicine at the Oregon Health & Science University School of Medicine and lead author of the review of nondrug therapies that was used to set the ACP guidelines. “As with most movement-based therapies, once people get through the first six to eight weeks, a lot of the initial soreness goes away and they start to feel better. So don’t give up on it too quickly.”