Clinical yoga can be practiced at any age, and also applied as a pain management treatment at any age. Here is Penny practicing at age 79. Several years ago, as a result of persistent shoulder pain, Penny was advised by one surgeon (rather stridently) that she needed bilateral shoulder replacements, and another "more conservative" physician recommended bilateral arthroscopy.
Clinical yoga is essentially physiotherapist instructed yoga, designed with an evidence based framework, taught individually, with a biopsychosocial focus and neuroscientific understanding. This approach to treatment is founded on an understanding of the neuroscience behind the patient-therapist relationship
Note that this consensus statement from the European League Against Rheumatism (EULAR) notes that exercise should be a mainstay of therapy for the treatment of fibromyalgia.Broadly, the group did not endorse most pharmaceutical interventions, especially drugs with a high potential for abuse.
This picture above is me practicing at my teacher’s (Kales) house today. In the context of writing about pain experience, evidence and yoga, I should point out that when I first met Kale, in 2009, I could barely move. 2 years of chronic pain, and what I now recognise as sensitisation, fear avoidance and textbook chronicity markers, I could barely even sit on the ground (hip and knee pain), my squatting ability was non existent (too stiff, too sore).
Movement, and exercise generally, are crucial aspects of effective pain management in the case of long standing pain conditions. Pain is a vital aspect of the body’s defence mechanism. However, when pain responses occur beyond normal physiological healing times, this type of pain is counterproductive.
Two things physiotherapists and patients should know. Plantar Fasciitis Management: Don’t recommend surgery to patients for plantar fasciitis before trying six months of non-operative care. With six months of consistent, non-operative, exercise based treatment, plantar fasciitis will resolve up to 97% of the time. Surgery has a much lower rate of success and has the added possibility of post-operative complications.
Educating patients about headache and its management, identifying and managing triggers (via diaries), modifying lifestyles, and understanding the importance of adopting and adhering to interventions are relevant to all persons with headache.
A recent study examined 104 systematic reviews. The study concluded that exercise therapy is effective for a wide range of chronic disorders, including: Knee osteoarthritis, Low back pain, Chronic obstructive pulmonary disease and more.
Among people with chronic low back pain, doing yoga for just 12 weeks led to greater improvements in back function than usual care, and yoga for 6 months has been linked to significantly less disability, pain, and associated depression. It’s not only back pain that stands to benefit, either.
Yoga has been found to benefit many types of pain, including that from fibromyalgia, arthritis, joint pain, and neck pain.
n the vast majority of people (<90%) LBP is benign and represents a simple muscle spasm associated with a mechanical loading incident or a muscle spasm with “central mediation” associated with psychosocial or lifestyle stresses.
Only 1 to 2% of people presenting with LBP will have a serious or systemic disorder, such as systemic inflammatory disorders, infections, spinal malignancy or spinal fracture.
Less than 5% present with significant neurological deficits such as cauda equine syndrome.
The physiotherapy profession has undergone a paradigmatic shift in recent years. In response to mounting research evidence that psychosocial issues cannot be disentangled from biomechanical factors, a conceptual ‘biopsychosocial’ model has been developed
There is an excellent research article by Eyal Lederman called the Myth Of Core Stability, which examines the dangers of reductionist “core stability programs” in treating lower back pain, and advocates holistic and balanced exercise such as yoga for prevention and treatment.
Current research suggests that a carefully adapted set of yoga poses may reduce low-back pain and improve function. Other studies also suggest that practicing yoga (as well as other forms of regular exercise) might improve quality of life; reduce stress; lower heart rate and blood pressure; help relieve anxiety, depression, and insomnia; and improve overall physical fitness, strength, and flexibility.
Chronic pain is a common and important problem, but many healthcare practitioners, even those in pain management settings, do not have a clear understanding of modern pain science. Misconceptions about pain can be a major roadblock to effective interventions, including Yoga therapy.
Back pain can be excruciating. So it seems that getting an X-ray, CT scan, or MRI to find the cause would be a good idea. But that’s usually not the case, at least at first. Here’s why.
They don’t help you get better faster. Most people with lower-back pain feel better in about a month whether they get an imaging test or not. In fact, those tests can lead to additional procedures that complicate recovery. For example, a study that looked at 1,800 people with back pain found that those who had imaging tests soon after reporting the problem fared no better and sometimes did worse than people who took simple steps like applying heat, staying active, and taking an OTC pain reliever.
A review of the evidence Spinal Fusion Surgery Epidural Cortisone Injection Yoga, Exercise and Mindfulness
Spinal Fusion: There is very little evidence that spine fusion surgery for back pain is effective. It is very expensive, often leads to complications, often requires further surgery, and is associated with increased mortality
Considering surgery for your torn meniscus? A recent study compared "sham" surgery to a real meniscectomy.
The study was reported in the New England Journal of Medicine and included 146 patients with persistent knee symptoms consistent with a meniscus tear, a proven meniscus tear on MRI and no significant arthritis, who were randomised to either "sham surgery" or surgery to remove the torn parts of the meniscus (usual practice).