Guidelines released in early 2017 by the American College of Physicians suggest that trying yoga for back pain is a good move, and research published in the past year and a half bolster the ACP’s recommendations. 

The guidelines recommend opting for nondrug remedies first, and 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.)

And in a recent nationally representative survey from the Consumer Reports National Research Center of more than 3,500 adults, yoga (and tai chi, or the like) was helpful to almost 90 percent of the back-pain suffers who tried it. In comparison, 75 percent of people who saw a primary care doctor said the advice or treatment they received gave them relief.

More on Relieving Back Pain

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: The effects were seen in both after a year and at similar levels. 

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.

Today, on International Yoga Day, 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.

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. Breathing 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.”