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Citation Plastaras CT Huang LY Metzger CJ Sorosky S 2015 Yoga Therapy for Management of Neck and Low Back Pain J Yoga Phys Ther 5. 215 doi 10 4172 2157 7595 1000215,Page 2 of 5, involved only RCT from published peer reviewed journals that looked more evident in the literature In 2013 Cramer and colleagues. at yoga as a treatment for CLBP and reported outcome measures of published a RCT that evaluated the effect of Iyengar yoga compared. pain and or functional disability 8 RCT met the criteria and included with exercise on chronic nonspecific neck pain 12 The study showed. a total of 743 patients Cohen s d effect sizes were calculated and that yoga was more effective in relieving chronic nonspecific neck pain. entered in a random effects model The meta analysis concluded that than a home based exercise program Yoga reduced neck pain intensity. at post treatment yoga had a medium to large effect on functional and disability and improved health related quality of life Another RCT. disability d 0 645 and pain d 0 623 indicating that yoga may be by Michalsen and colleagues in 2012 compared a 9 week yoga program. an efficacious adjunctive treatment for CLBP The strongest and most to a self care exercise program in patients with chronic neck pain 13. consistent evidence emerged for the short term benefits of yoga on The results showed superior pain relief and functional improvements. functional disability in the yoga group, Another 2013 systematic review and meta analysis of the literature In traditional yogic practice structure is given to the practice by the. on yoga for low back pain by Cramer et al screened studies published Eight Limbs which include yama societal conduct niyama personal. through 2012 that were RCT comparing yoga to control conditions in conduct asana postures pranayama breath pratyahara control. patients with CLBP 7 The main outcome measures were pain back of the senses dharana concentration dhyana meditation and. specific disability generic disability health related quality of life and samahdi mental stillness and ultimate awareness Although asana is. global improvement Standardized mean differences SMD and 95 the primary focus of western based yoga it serves as an entry point. confidence intervals were calculated for each outcome The review to the other limbs which have demonstrated beneficial properties to. included 10 studies with 967 patients with CLBP There was strong addressing the associated symptoms of stress anxiety and depression. evidence for short term effects on pain SMD 0 48 95 CI 0 65 to that frequently accompany chronic neck and back pain Pranayama. 0 31 P 0 01 and back specific disability SMD 0 59 95 CI 0 87 breath is a powerful way to promote relaxation and a pivotal first step. to 0 30 P 0 01 There was also strong evidence for a long term effect towards relieving muscle tension Ujjayi breathing which is conscious. on pain SMD 0 33 95 CI 0 59 to 0 07 P 0 01 and moderate slow breathing using airway constriction at a rate of approximately. evidence for a long term effect on back specific disability SMD 0 35 2 4 breaths per minutes stimulates the vagus nerve which in turn. 95 CI 0 55 to 0 15 P 0 01 There was no evidence of short term promotes parasympathetic dominance and a sense of calmness 14 In. or long term effects on health related quality of life Yoga was not a novel1982 study Kabat Zinn et al demonstrated a pain reduction. associated with any serious adverse events in any of these studies score of greater than 50 in a cohort study of 51 patients suffering from. chronic low back headache neck and shoulder pain by treating them. In addition to LBP neck pain is also one of the most commonly with a 10 week stress reduction and relaxation program that included. reported symptoms seen in primary care offices 8 9 According to hatha yoga mindfulness self regulation meditation and detached. a study published in 2015 by Cohen et al neck pain has an annual observation 15 In a follow up 1987 study using the same methods of. prevalence rate exceeding 30 and is the fourth leading cause of disability stress reduction Kabat Zinn et al followed 225 subjects treated with. in the United States 10 Fejer et al reported an estimated mean lifetime 12 cycles of classes over a 4 year period 60 to 72 of subjects rated. prevalence of neck pain in the world population to be around 50 and their pain as moderately or greatly improved 30 to 55 rated their. the 1 month prevalence to be around 25 11 Because the neck has pain as greatly improved 1 to 15 reported their pain as worse. a large range of motion there is decreased stability and vulnerability 25 rated their pain as the same 86 of subjects reported they gained. to injury The large muscles that are responsible for gross movement something of lasting value At 4 years 81 of respondents reported they. include the trapezius levator scapulae sternocleidomastoid and the still meditated and 40 70 reported they still practiced yoga 16 More. splenius while the smaller muscles that are responsible for stability recently Rosenwaig and colleagues investigated the effects of 8 weeks. and fine movements include the scalenes rotatores semispinalis and of mindfulness training on 133 subjects in 2010 The intervention of. longissimus in addition the scapular stabilizers are important muscles mindfulness training included meditation techniques body scanning. in regards to neck function Patients with chronic neck pain may have breath awareness emotional awareness mindful yoga mindful eating. associated biomechanical deficits including poor posture contracted mindful walking and mindful listening Significant improvement on 6. upper neck muscles altered breathing patterns and weak scapular out of 8 Medical Outcomes Study 36 Item Short Form Health indices. stabilizers Physically yoga focuses on improving patient posture including bodily pain was demonstrated in subjects with neck or back. flexibility and strength One of the goals of the asanas is to establish pain n 35 17. a normal cervical curve or neutral cervical spine One achieves this. by cultivating a conscious awareness of alignment throughout the yoga As with any physical activity there are risks of injury to be aware. practice during all standing and sitting poses Certain muscle groups of before starting a yoga practice It was reported in a New York Times. in the upper half of the human body are prone to constant isometric article in 2012 by William Broad that even the most experienced of. contraction muscle shortening and tightness These groups include yoga practitioners injure themselves frequently due to a lack of insight. the upper neck upper trapezius and levator scapulae and the anterior into underlying weaknesses and muscular imbalances that make injury. chest pectoralis major and minor Many asanas focus on flexibility all but inevitable 18 Glenn Black a world renowned yoga instructor. and bring awareness to the upper neck muscles to reduce unconscious of greater than four decades discusses in the article how numerous. contraction Other asanas focus on lifting and opening the chest For factors that have converged over the years have heightened the risk of. good musculoskeletal health a balance of strength and flexibility is practicing yoga The most notable factor is the demographic shift in. needed The yoga asanas strengthen muscles that tend to become weak those who study the art The original practitioners of yoga were from. and deconditioned in patients that have chronic neck pain including India where sitting cross legged and squatting were part of daily life. the rhomboids and lower trapezius both of which are key muscles in many modern yoga poses stem from these basic postures Modern. spine and scapular stabilization practitioners of yoga are frequently urbanites who sit in office chairs. for prolonged periods but can only attend classes inconsistently where. Yoga s effectiveness for managing chronic neck pain is becoming they strain to contort themselves into increasingly difficult postures. J Yoga Phys Ther, ISSN 2157 7595 JYPT an open access journal Volume 5 Issue 4 1000215. Citation Plastaras CT Huang LY Metzger CJ Sorosky S 2015 Yoga Therapy for Management of Neck and Low Back Pain J Yoga Phys Ther 5. 215 doi 10 4172 2157 7595 1000215,Page 3 of 5, despite their lack of flexibility and other physical problems In addition dizziness or gait instability should also seek medical evaluation and. with the growth of popularity of yoga there is now an abundance of clearance before starting a yoga routine Historical risk factors for. studios lead by part time instructors who lack the deeper training vertebrobasilar insufficiency include patients with neck pain who also. necessary to recognize when students are headed toward injury report dizziness lightheadedness nystagmus face paresthesias or. blurred vision The most common reported cause of sudden onset. In 2012 Corroller et al performed a retrospective review of vertebrobasilar insufficiency is trauma especially following a high. radiology database of a tertiary care center over a 9 year period to velocity trauma with a whiplash mechanism 21 Individuals at risk for. assess yoga related injuries 19 Of the 2 million reports searched 56 vertebral artery injury should be identified in order to avoid potentially. contained the term yoga 38 patients were included after duplicates harmful poses and catastrophic injuries Practitioners should seek. were excluded Injuries included partial thickness tears in the peroneus immediate medical care if they experience sudden onset headache. brevis tendon Achilles tendon and supraspinatus tendon full thickness blurred or double vision difficulty speaking or focal weakness. tears of the supraspinatus tendon medial meniscal tears acetabular. labrum tears lumbar disc annular tear with extrusion acetabular Primum non nocere or first do no harm is an adage applicable. liner displacement from hip arthroplasty hardware proximal phalanx across the health and wellness continuum from teacher to therapist to. fracture of the hallux and transient patellar dislocation The prevalence physician Individuals with a history of injury and or complex medical. of injuries is not well studied however as non life threatening problems should always seek a class with an experienced and certified. musculoskeletal injuries are more likely to present to local urgent care instructor As an extension of mindfulness individuals should receive. centers and outpatient medical offices rather than large tertiary care education and reinforcement on acknowledging and listening to. centers In addition to musculoskeletal injuries one of the more serious messages of pain or discomfort from their bodies Furthermore the use. types of injuries reported in the literature is injury to the vertebral of props and equipment can be utilized to emphasize safety and proper. artery Sudden movements in asanas involving excessive neck flexion or alignment in order to avoid overstrain and injury The authors have. extension and inversions with or without predominant weight bearing included suggested asanas to consider as well as those to avoid if there. on the head can lead to vertebral artery injuries by way of mechanical are certain spine pathologies present as well as figures demonstrating. stretching 20 These injuries include artery dissection hemorrhage a sample of yoga poses Tables 1 Figures 1 5 For patients with low. thrombus formation clots swelling stenosis constriction and stroke back pain worse in flexion it is recommended to avoid poses that might. introduce high pressures in the intervertebral disc such as bending. In general patients with a history of recent injury related to a forward with combined twist For individuals with low back pain worse. fall or motor vehicle collision should be evaluated by a health care in extension extended poses with backward bending should be avoided. professional before beginning a yoga practice In addition patients who For neck conditions end range cervical range of motion poses and. have symptoms of radicular pain numbness and or tingling weakness inversions putting biomechanical forces directly though the cervical. Postures to Avoid may aggravate, Medical Condition Recommended Postures Contraindicated Postures. Low Back Radicular Leg Pain,Paschimottanasana seated forward. Worse in Flexion ie Lumbar Disc Shalbhasana locust pose Sheershasana headstand. Herniation,Parivrtta Trikonasana revolved, Bhujangasana cobra pose Janu Sirsasana head to knee pose. triangle pose, Salamba Bhujangasana sphinx pose Utanasana standing forward fold. Bitilasana cow pose,Urdhva Mukha Svanasana upward facing dog. Setu Bandhasana bridge pose,Low Back Radicular Pain Worse. in Extension ie Spinal Stenosis Balasana child s pose Ushtrasana camel pose Chakrasana wheel pose. Zygapophysial Joint Pain, Adho Mukha Svanasana downward facing dog Dhanurasana bow pose. Prasarita Padottanasana wide legged forward fold Bhujangasana cobra pose. Paschimottanasana seated forward fold,Marjaryasana cat pose. Neck Pain ie Cervical, Degenerative Disc Disease Balasana child s pose Dhanurasana bow pose Sheershasana headstand. Zygapophysial joint pain,Urdhva Sarvangasana supported. Marjaryasana cat pose Setu Bandhasana bridge pose,shoulder stand. Bhujangasana cobra pose Ushtrasana camel pose Halasana plow pose. Ardha Matsyendrasana seated, Salamba Bhujangasana sphinx pose Chakrasana wheel pose. twisting pose,Shalbhasana locust pose,Urdhva Mukha Svanasana upward facing dog. Table 1 Neck pain from these pathologies is best managed my limiting prolonged pose at end range of cervical motion. J Yoga Phys Ther, ISSN 2157 7595 JYPT an open access journal Volume 5 Issue 4 1000215. Citation Plastaras CT Huang LY Metzger CJ Sorosky S 2015 Yoga Therapy for Management of Neck and Low Back Pain J Yoga Phys Ther 5. 215 doi 10 4172 2157 7595 1000215,Page 4 of 5, region should be avoided In the absence of any contraindications and. utilizing the proper cautions in patients with spine pain it is evident. that properly performed yoga postures are helpful in diminishing. Figure 5 Locust Pose, pain improving function and reducing stress and anxiety in patients. with chronic back and neck pain As with many treatment modalities. better controlled randomized controlled studies are needed to further. Figures 1 cow pose, evaluate the role of yoga in managing chronic back and neck pain. References, 1 Clarke TC Black LI Stussman BJ 2015 Trends in the Use of Complementary. Health Approaches Among Adults United States 2002 2012 National Health. Statistics Reports 79, 2 Peregoy JA Clarke TC Jones LI 2014 Regional Variation in Use of. Complementary Heath Approaches by U S Adults NCHS Data Brief 146. 3 Centers for Disease Control and Prevention 2010 National Ambulatory. Medical Care Survey, 4 Hoy D Bain C Williams G March L Brooks P et al 2012 A systematic review. of the global prevalence of low back pain Arthritis Rheum 64 2028 2037. 5 Tilbrook HE Cox H Hewitt CE Kang ombe AR chuang LH et al 2011 Yoga. for Chronic Low Back Pain A Randomized Trial Ann Intern Med 155 569 578. Figures 2 cobrapose 6 Holtzman S Beggs RT 2013 Yoga for chronic low back pain a meta analysis. of randomized controlled trials Pain Res Manag 18 267 272. 7 Cramer H Lauche R Haller H 2013 A systematic review and meta analysis of. yoga for low back pain Clin J Pain 29 450 460, 8 Hogg Johnson S van der Velde G Carroll LJ Holm LW Cassidy JD Guzman. J et al 2008 Bone and Joint Decade 2000 2010 Task Force on Neck Pain. and Its Associated Disorders The burden and determinants of neck pain in. the general population results of the Bone and Joint Decade 2000 2010 Task. Force on Neck Pain and Its Associated Disorders Spine Phila Pa 1976 33. 9 Guzman J Haldeman S Carroll LJ Carragee EJ Hurwitz EL Peloso P et. al 2008 Bone and Joint Decade 2000 2010 Task Force on Neck Pain and. Its Associated Disorders Clinical practice implications of the Bone and Joint. Decade 2000 2010 Task Force on Neck Pain and Its Associated Disorders. from concepts and findings to recommendations Spine Phila Pa 1976 33. Figure 3 upword dog pose 10 Cohen SP 2015 Epidemiology diagnosis and treatment of neck pain Mayo. Clin Proc 90 284, 11 Fejer R Kyvik KO Hartvigsen J 2006 The prevalence of neck pain in the. world population a systematic critical review of the literature Eur Spine J 15. 12 Cramer H Lauche R Hohmann C Ludtke R Haller H et al 2013 Randomized. controlled trial comparing yoga and home based exercise for chronic neck. pain Clin J Pain29 216 223, 13 Michaelsen A Traitteur H Ludtke R Brunnhuber S Meier L et al 2012 Yoga. for chronic neck pain a pilot randomized controlled clinical trial J Pain 13 1122. 14 Zope SA and Zope RA 2013 Sudarshan kriya yoga Breathing for health. International Journal of Yoga 6 4 10, 15 Kabat Zinn J 1982 An outpatient program in behavioral medicine for chronic. pain patients based on the practice of mindfulness meditation theoretical. Figure 4 Sphinx pose considerations and preliminary results Gen Hosp Psychiatry 4 33 47. J Yoga Phys Ther, ISSN 2157 7595 JYPT an open access journal Volume 5 Issue 4 1000215. Citation Plastaras CT Huang LY Metzger CJ Sorosky S 2015 Yoga Therapy for Management of Neck and Low Back Pain J Yoga Phys Ther 5. 215 doi 10 4172 2157 7595 1000215,Page 5 of 5, 16 Kabat Zinn J Lipwort L Burney R 1986 Four year follow up of a meditation 19 Corroller TL Vertinsky AT Hargunani R 2012 Musculoskeletal Injuries Related. based program for the self regulation of chronic pain treatment outcomes and to Yoga Imaging Observations AJR Am J Roentgenol 199 413 418. compliance Clin J Pain 2 159 173, 20 Park KW Park JS Hwang SC 2008 Vertebral Artery Dissection Natural. 17 Rosenswaig S Greeson JM Reibel DK 2010 Mindfulness based stress History Clinical Features and Therapeutic Considerations J Korean Neurosurg. reduction for chronic pain conditions variation in treatment outcomes and role Soc 44 109 115. of home meditation practice J Psychosom Res 68 29 36. 21 Childs JD Flynn TW Fritz JM Piva SR Whitman JM 2005 Screening. 18 Broad William J 2012 How Yoga Can Wreck Your Body The New York for vertebrobasilar insufficiency in patients with neck pain manual therapy. Times MM16 decision making in the presence of uncertainty J Orthop Sports Phys Ther. 35 300 306,J Yoga Phys Ther, ISSN 2157 7595 JYPT an open access journal Volume 5 Issue 4 1000215.
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