Anyone who has ever finished a good yoga practice knows, intuitively, that it’s good for your spine. It’s certainly hard to beat the feeling you get by the time you’re in shavasana. And no, it’s not just about lying flat on the ground. It’s a different kind of relaxation that comes only at the end of sixty (or ninety) minutes of a very deliberate sequence of postures.
That feeling is why we were particularly compelled by the perspective of neurosurgeon Sheri Dewan, who sees a lot of spines at her Chicago practice, both in her office and on her surgical table. Of course, Dr. Dewan would prefer not to need to see your spine in the latter context, if she can avoid it. And she believes yoga—Kundalini-style yoga, specifically—can be one of the more effective prophylactic tools for strengthening the spine and keeping back and neck pain at bay.
A Q&A with Sheri Dewan, MD
QWhen it comes to treating the spine, what’s in your tool kit outside of spinal surgery?A
Over the last six years, I’ve seen an increase in patients wanting more-conservative treatments for the spine. I have a lot of young women who come to see me who are very physically active and aren’t interested in aggressive spinal surgery. Instead of simply recommending an operative procedure, we go through a conservative approach.
I typically start with a referral to a licensed physical therapist, depending on the patient’s spinal pathology. Treatment might take the form of light traction, which is kind of a stretching of the spine, or electrical stimulation called TENS (transcutaneous electrical nerve stimulation). Sometimes they will use a procedure called dry needling, which is essentially placing small acupuncture-style needles into the joints of the spine—the facet joints—to break up any layers of scar tissue that may form.
If I have patients who are interested in practicing yoga, I refer them to places in the community I know do a good job, safely.
QWhat is Kundalini yoga, and why do you recommend it?A
Kundalini yoga, or spinal yoga, has been around for thousands of years. The yogi Harbhajan Singh Khalsa learned it in India and brought it to California in the late 1960s. “Kundalini” is the Sanskrit word for “coiled”: The practice is very focused on body mechanics, flexibility, core muscle strength, muscle tension, and loosening and adjusting the spine. It’s typically sixty to ninety minutes in total, with a five- to ten-minute warm-up and thirty to forty-five minutes of exercise followed by a relaxation period.
The key final point is the meditation aspect of it. When patients are dealing with chronic pain, whether it is neck pain, thoracic pain, or low-back pain, so much of it is psychological as well as physical. What I like about Kundalini-style yoga is that it not only focuses on your spine joints, your tendons, and your muscles to help relax and strengthen the whole body but then, in the end, you focus on your mind, which is also a huge component of the psychological pain that manifests as physical pain.
Some people are very inflexible to begin with, and some of my patients are in their seventies or eighties, so we need to proceed carefully. I typically recommend patients start out at a yoga center that they are comfortable with and then slowly work up to places that do more-advanced spinal yoga. But once patients have exhibited that they have the flexibility to do spinal yoga, they can even do it at home. I recommend doing it in the morning when they first wake up or even in the evening before they go to bed—once a day or twice a day, depending on their activity level and time.
QPhysiologically, how does Kundalini-style yoga affect the spine?A
Kundalini yoga focuses on opening up all your vertebral bodies. We have seven vertebral bodies in the cervical spine, then twelve in the thoracic spine, and five in the lumbar spine, and five make up the sacral spine. In a typical Kundalini practice, you are starting at the very base of the spine at the sacrum and working on stretching every level as you work up to the neck, or the cervical spine. A large component of it is rotating the joints. I tell patients that joints in the spine are just like joints in your elbows, your shoulders, your knees: You can have inflammation of the spinal joints, and they can get arthritic. People don’t conceptually think about the spine in that way, so it’s important to emphasize the inflammatory component.
We have two sets of spine joints running vertically. The whole idea of this yoga practice is to start at the base, work your way up, and slowly ease and open up the joint spaces through a process of rotation, loosening and stretching. That works to open up not only the tendons but also your muscles as you work your way up. The latter portion of Kundalini exercises strengthens the core. The abdominal core muscles tend to get very lax, and when that occurs, the lower spine doesn’t get strengthened, which can lead to chronic lower back pain.
QWhom do you recommend Kundalini yoga to?A
I recommend it to almost anyone as a prophylactic measure for spinal health. I also recommend it for postpartum women. A lot of times, those abdominal muscles become very weak after pregnancy. I have a lot of patients who come to my office while they’re pregnant and eventually end up with low-back issues and sciatic issues. I usually recommend doing pregnancy yoga during the pregnancy itself, because it’s more gentle. Kundalini yoga can be a bit harsher in its physicality.
QWhat about people who come to your practice already experiencing pain?A
I see many patients living in chronic pain. If the back pain is excruciating or severe, we do have to rely on medication management and sometimes even steroid injections for the spine. Once the patient is out of acute pain, they are able to participate, it’s good to get into a physical therapy or a yoga program moving forward. Then there’s the other category of patients, for whom we ultimately need to perform surgery.
QHow often would you need to do Kundalini yoga to reap the benefits?A
Daily. I tell patients to do it when they’re home. First thing in the morning is key: Get up and stretch the entire spine out. Start from the base of the spine and work all the way up. There have been so many studies that show that if you relax the musculature in the upper and lower back, it can really help with the psychological component of chronic pain.
When you are starting out, I recommend finding a good guided class at a Kundalini center. It’s typically a sequence of moves—I’ve been to several different centers that all practice small variations, but typically it’s a set of twenty-six to thirty poses every time that start from the base of the spine and work up sequentially.
Once you’re familiar, you pretty much j