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Yoga is reasonable alternative to physical therapy for lower back pain, say researchers

BMJ 2017; 357 doi: (Published 20 June 2017) Cite this as: BMJ 2017;357:j2964

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Wisdom of Yoga in Chronic Pain and Beyond

“The purpose of achieving equanimity through yoga is to diminish suffering” The Yoga Sutras of Patanjali, Aphorism 2, Chapter 2

Chronic back pain is increasingly becoming common especially in younger people and hence an important public health concern. The causes appear to be multi-factorial and observed to be related increasingly to work-related demands, lifestyle, posture, diet, etc. all contributing to chronic physical and psychological stress.

In a country like India which is witnessing rapid urbanization creating a highly competitive, fast-paced and demanding external environment, the youth seem to find themselves helplessly being driven to make maladaptive and irrational choices. This is only maintaining and perpetuating chronic stress related health conditions of which chronic musculo-skeletal pain disorders are increasing. This is an unfortunate trend. With particular reference to chronic pain, there are certain factors that are a pain in the neck uniquely to today’s urban youngster of India and I am sure in several other countries too.

The young Indian lives an artful life having to dodge and dive from commuting to work to managing life on shaky infrastructures full of dangerous defects put to reckless public usage by the many, disorganized mass movements in cities with even more disorganized planning and management and callous unconcern by the high and mighty. As someone wisely said in this rat race, even if you win you are still a rat! Articles like this seem to reassure us there is indeed some light at the end of the rat hole!

It is indeed heartening to read positive original research on yoga in high impact journals like the Annals of Internal Medicine and the BMJ. I am indeed grateful for this. This does have an impact on the modern youth of India who increasingly look to the West for trustworthy health information.

Yoga as a holistic preventive and curative health system is increasingly being reaffirmed and revalidated through several good scientific studies especially coming out of prestigious academic centers in the West. Several of these studies however seem to focus more on the physical aspect of yoga – the asanas or postural exercises and pranayama or breathing techniques. Some recent studies do highlight dhyana or meditation techniques.

Whereas the classical yoga of Patanjali (circa 1500 bce) has eight parts: yama or ethical observances, niyama or hygienic disciplines, asana or adaptability training, pranayama or breath regulation training, pratyahara or sensory-perceptual regulation training, dharana or focused attention training, dhyana or meditation training and samadhi or balanced mind-body state of equanimity. The classical yoga originating from the culture and civilization of the Indian sub-continent several thousand years ago developed as a holistic empowering system of wise living leading to freedom from suffering. The system was practiced widely by all strata of society. But for various reasons the practice became less prevalent over the ages.

All this appears to be changing with a revival of the classical yoga albeit through the physical aspect. With the support of the modern evidence-based medical research showing increasing interest and validating many of the ancient Eastern wisdom practices there seems to be a change in the mind-set from material reductionism to an open and integrative holism. This renaissance is a welcome trend and promises to be a great preventive and public health revolution in the making if the essence of the ancient classical yoga practice is understood and wisely adopted by the many. A heartfelt thank you indeed.

“Know well what leads you forward and what holds you back, and choose the path that leads to wisdom” – the Buddha


Büssing, A., Michalsen, A., Khalsa, S. B. S., Telles, S., & Sherman, K. J. (2012). Effects of yoga on mental and physical health: a short summary of reviews. Evidence-Based Complementary and Alternative Medicine, 2012.

Lipton, L. (2008). Using yoga to treat disease: An evidence‐based review. Journal of the American Academy of Physician Assistants, 21(2), 34-41.

Whicher, I. (1998). Yoga and freedom: a reconsideration of Patañjali's classical yoga. Philosophy East and West, 272-322.

Competing interests: No competing interests

10 August 2017
Anand Ramanujapuram
Independent Practitioner
Malleswaram, Bengaluru, India