Jack Noonan was 74 years old when his sciatic back pain was so bad that he couldn't walk. "I would be walking with my wife and dog, and I'd have to stop and say, 'I can't go on,'" says Noonan, now 79. "It was just the worst pain I ever had. I couldn't believe it."
Noonan's debilitating pain was costing him more than physical discomfort, it started to affect his livelihood. Knowing he would experience pain when walking, he became less active and gained weight. His pain also affected his mood as he became more irritable.
Noonan's lower-back was being compressed from age and gravity -- and a perineural cyst, a fluid-filled sac that forms near the lower, sacral area of his spine. His doctor told him the only solution for his back problem was surgery, but he was reluctant.
Avoiding Back Surgery
"I didn't want to do that," Noonan says. "I read about the surgery, and I know there can be some pretty awful consequences. I had long been a fan of physical therapy -- and yoga as well. So I knew I had resources to fall back on."
Like Noonan, many people successfully alleviate back pain with yoga, and scientific evidence suggests it works. A study on "Yoga for Military Veterans With Chronic Low Back Pain" published in the American Journal of Preventive Medicine in 2017 shows yoga improved low back pain among veterans, who also reduced their use of opioids.
It included 150 military veterans with chronic low back pain from a major Veterans Affairs Medical Centre in California. They participated in yoga classes twice weekly for 12 weeks, along with a home practice. They practiced Hatha yoga, which consisted of modifiable and accessible physical postures, movement, brief meditations and breathing techniques.
The study was conducted by Erik Groessl, professor of family medicine and public health at the University of California San Diego and director of the UCSD Health Services Research Centre.
"In general, the conclusion is that there is solid, high-quality evidence, and we conclude yoga is an effective treatment for low back pain," Groessl says. "Like any treatment, there's an individuality aspect to it, it could make some people worse, if they have a unique type of medical problem or health condition. But it will make more people better."
Groessl confirmed Noonan's scepticism that back surgery can be a gamble.
Healing Pain With Yoga
From the time Noonan was told he would need surgery, he made it his mission to fix his back with yoga, movement and exercise. It took six months of practicing yoga daily for Noonan to begin to ease his low-back pain. He stayed disciplined, made some refinements to his routine and has stuck with his yoga practice for five years now. He's lost 15 pounds, feels more youthful and avoided the back surgery he was dreading.
"It's not a quick fix," Noonan says. "And it's something I will never be able to stop because I don't want that sciatic pain ever again."
And he doesn't stop. Noonan, who lives in Philadelphia, practices the same 15 movements religiously. He does each pose for 15 breaths, which adds up to a 30 minute practice he completes twice a day, every day. Once in the morning and again in the evening.
Noonan's yoga routine consists of nine floor exercise. He starts by lying down on his back, with his feet extended straight out and stretches his neck by pressing the back of his head against a neck pillow, commonly used for neck-support while flying. He stays supine for pelvic tilts, where he arches and releases his back in cadence with his breath.
"It feels really wonderful," Noonan says. "These first two things, really get me centred. It is very important to do these things for 15 breaths."
He continues on his back with bicycle movements, hamstring and IT band stretches and a supine twist. Next, he practices boat pose, where he sits on the floor with his legs and back suspended off the floor in a V-shape with his knees bent for 15 breaths.
"I could hold a really good boat pose for 15 breaths and enjoy it," Noonan says. "It feels great to do that, on the verge of turning 80. It's so cool. It's given me terrific core strength."
He moves into a standing series that involves band work for his shoulders, chest and upper back and tree pose for stability.
"I think everybody in their 70s ought to do these stretches if they want to be flexible," Noonan says.
Yoga Instead of Opioids
In 2017, an impactful paper was published in Annals of Internal Medicine , which provides guidelines for physicians to prescribe yoga as a non-pharmacological therapy to treat low-back pain.
"Experts recommend physicians use these non-pharmacological modalities including tai-chi, acupuncture and yoga for back pain as a front-line treatment," Groessl says. "No more opioids. Use this stuff first. That's just the ultimate demonstration of how far it's gotten for back pain. And where we want to go with other conditions."
Newer research shows other secondary benefits of yoga for low-back pain, such as a decrease in fatigue, which is a common symptom of those battling chronic pain.
One National Institutes of Health pilot study that is in the process of getting published compares two types of yoga: restorative and more active hatha yoga for active-duty military with low-back and or neck pain.
"One preliminary finding, restorative yoga seemed to be attended slightly better and have slightly better effects," Groessl says. "It involved less moving, less stretching and more relaxation. At least in that population, where a lot of people are still working and are younger than our veterans, pushing to do more may not be the right approach for some."
Noonan also found a more easeful approach to his yoga practice to be most beneficial. "Less is more," Noonan says. "It's really important to go slowly and stretch, or the muscle won't stretch."
Other Benefits of Yoga
Noonan is now pain free and back doing the activities that he loves and makes him feel more like himself again. Beyond pain relief, he also notices many mental benefits.
"Being disciplined has made me much more focused and creative," Noonan says. "I can think more clearly and more imaginatively."
Now that Noonan has his back pain under control, he is setting his sights on finishing his memoir, writing another book, biking 15 miles a day and helping those in their 70s transition into their 80s without back pain and be more flexible and fit.
"Yoga has made me stronger, more optimistic, more disciplined, more open to miracles around us," Noonan says. For those looking to try yoga for back pain, he suggests, "start small. Give it time."
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