Chronic low back pain is one of the most common reasons patients present to primary care physicians for care. Most patients initially present with low back pain feeling that the symptom is purely physical. They are often unaware of how psychological stress is playing a role in driving the pain, along with mechanical injury. I have presented in my previous post on chronic pain as well as my podcast. In today’s post I’d like to use low back pain as an example of applying meditation to help ease the burden of back pain.
The anatomical location of the root chakra is located somewhere around the base of the spine. It is likely the energy center that governs the lumbar spine, legs and feet. This energy center is associated with our most basic needs of survival such as acquiring resources and shelter. Many of us hold stress in the lower back in the form of tight muscles and improper posture.
I have noticed similar patterns of stress related to work, finances, or the home often presenting with lower back pain. Patients will often present describing the origins of the lower back pain, then a side note of an argument at work, or defaulting on a mortgage comes in towards the end of the visit. During a typical clinic visit, I don’t often have the luxury of spending time with patients to discuss this relationship.
This month I have been discussing primarily chronic pain. We should review acute low back pain and chronic low back pain before delving into how these can be improved with the use of meditation.
Acute Low Back Pain
Acute low back pain and back pain that occurs for period of time less than 3 months. Acute low back pain tends to be associated with injury such is abrupt lifting, lifting an object that is too heavy, sudden twisting, or purchase a pain in physical activity without appropriate conditioning.
Acute muscle strain
Many individuals presenting with low back pain often or suffering from small tears in the large lumbar muscles. this can create a lot of pain with very few physical findings other than muscle spasms. This type of pain tends to resolve fairly quickly. It also doesn’t tend to cause pain radiating down either leg. This is the kind of low back pain that may occur after a sports injury or lifting large objects.
Sciatica
Sciatica is a cause of acute low back pain in which a nerve originating from the lumbar spine is being impinged by a structure in the spine. This can be from bony overgrowth or from a bulging lumbar disc. This tends to present acutely, sometimes associated with lifting or twisting, and can cause pain radiating down either leg.
Vertebral Fracture
Of all of the acute low back pathologies, this is likely to be the most serious because it implies other medical issues including severe osteoporosis. Vertebral fractures in the lumbar spine may present with a sudden onset of pain with little to no activity. The pain May radiate or may stay in one place. The pain from vertebral fractures tends to be severe and unremitting.
Chronic Low Back Pain
Chronic low back pain is typically present for at least 3 months or 6 months. Some of the issues that started as acute back pain can evolve into chronic low back pain.
Lumbar Disc Degeneration
Lumbar disc degeneration is very common cause of chronic low back pain this is an overarching description of several issues that can occur in the bony part of the spine that lead to bone growth, or bone chips that may get dislodge or displaced and cause pressure on the nerves that run down to the leg. Often people have something called facet degeneration, which is often a common target of doing steroid injections into the lower back.
Disc Herniation
Disc herniation occurs when the vertebrae put strain or stress on the vertebral disc. The vertebral disc have a consistency similar to silicone. They serve as the shock absorbers within the spine. When herniation occurs some are part of the disc is forced out of its space and can cause impingement on one of the nerves that goes down the leg.
Meditation to alleviate lower back pain
No matter what is causing the lower back pain rather it is acute or chronic, adding meditation to the treatment plan can be beneficial.
There are a variety of ways one can consider meditation. Most importantly is taking your individual limitations in your current pain level into account.
Standing meditation
Many individuals suffering from lower back pain often for relief if they’re able to stand up. Standing can be very appropriate for performing a short meditation. Keep in mind that if you suffer from balance issues or vertigo this may not be the best way to start meditating if you’re lower back is hurting.
A simple meditation can consist of standing with the feet firmly planted in barefoot if possible. Closing the eyes and inhaling the exhaling to the count of five for three minutes. Using a guided meditation while standing can be beneficial as well.
Seated meditation
Seated meditations are the most common. Seated meditations are going to be the most accessible posture as well. When getting started with meditation it may be helpful to make sure your meditation chair allows for proper alignment. Check for the following to make sure your seat will be optimal for meditation.
- Make sure your feet touch the floor. If your feet don’t touch the floor consider using a sturdy object like a large book or yoga blocks to bring the floor closer to your feet.
- Make sure your knees are at a roughly 90° angle. If they are not, consider using yoga blocks or a large book to bring the floor closer to your feet.
- Make sure the angle of your hips is roughly at 90° angles. This means that you may need to use a pillow behind your back to adjust the seat back.
- Consider a chair that does not have arm rest. armor may be helpful, but if they cause you to elevate your shoulders that will keep you from settling into a calming meditation.
Lying Down
Lying down to meditate can be very helpful if you’re suffering from fatigue related to chronic pain. Keep in mind, you’re not wanting to fall asleep. You can perform align meditation in the bed but I advise my own clients whenever possible dedicate another space where you can lie down comfortably and supported but aren’t necessarily falling asleep.
The key posture with lying down with lower back pain is that you must elevate the legs and the knees. Most causes of chronic low back pain will be made worse by laying completely flat.
Elevation can be achieved by using a couch and laying on the floor. You can also use large cushions from your couch to elevate your legs. If you have yoga equipment using your yoga bolster to go under your knees can work as well. You can also use a blanket folder to go under the knees which will allow for the lower back to relax.
Body scan meditation for lower back pain
Here is a short description of a meditation practice you can perform easily at your own pace. Once you have chosen the posture you wish to take during your meditation, set a timer for 5 minutes to start with. If you repeat the meditation feel free to add longer durations.
- Takes three breaths into the nose and out through the mouth
- Focus your attention first on your feet. Observe where your feet are in space and if they’re resting against the floor.
- Relax your feet, feel as if they are melting into the floor.
- Move your attention up to your calves. Observe where they are in space and if anything is touching them.
- Allow your calf muscles to relax and melt into the floor.
- Continue this body scan starting with your thighs and working your way up to the top of your head.
- You can pace yourself by observing each body part on an inhalation, then relaxing that body part on an exhalation.
- After scanning your body continued to inhale and exhale slowly for a few more minutes
- complete the practice by gently open your eyes and making observations of how your body is feeling
If you would like to learn more about chronic pain download the art of healing podcast from this week. It is the first part in a three-part series on chronic pain. if you’d like to be notified about upcoming episodes please submit your email below.
Chronic pain is a difficult topic. Any form of human suffering brings sadness. I feel that although there are many more rapidly changing topics going on the discussion of how we manage chronic pain always deserves attention.