Tai Chi for Low Back Pain
Tai Chi Chuan and martial Qigong training is a potent way for people to find relief from low back pain syndromes including:
- Spinal Stenosis
- Herniated Disc (HNP)
- Bulging Disc
- Facet Syndrome
- Tension myositis syndrome
- Apophyseal osteoarthritis
- Degenerative discs
- Failed back syndrome
- "slipped disc"
- "pinched nerve"
- Myofascial Pain Syndrome
The posture and body mechanics inherent in this tradition is consistent with current thinking on prevention and treatment of low back pain via therapeutic exercise and neuromuscular reeducation. Likewise, the calming effect attributed to Tai Chi Chuan and Qigong is likely to give relief to people suffering from low back pain.
Disc degeneration is very common and this tends to increase weight bearing at the facet joints located in the back of the spine. This facet compression, in turn, may lead to degenerative joint disease. This posterior spinal element (facet) degeneration is particularly evident in the neck and low back. A forward slumped upper back/thorax exacerbates the postural dysfunction. Tai Chi Chuan instruction begins with a standing exercise called the Embrace Tree posture. By learning to flex the knees and "drop the tailbone" (rather than locking knees and arching back), tightness in the low back and chest are reduced. Elongating the back of the neck and gently tucking the chin corrects the forward head postural dysfunction. By lengthening the spine between the coccyx (tailbone) and the skull, a forward slumped posture is further addressed. Through learning to avoid bending backward in the low back, people with spinal stenosis and low back arthritis may experience significant pain relief immediately. A moderately flexed lumbar spine (not arched back) protects the disc-vertebral body unit by balancing the distribution of compressive force within the discs. Also, this flattened lumbar spine stretches the lumbodorsal fascia. Since this fascia acts on a longer lever arm relative to the center of rotation (in the discs) than erector spinae (a more superficial back muscle), this posture reduces the compressive force on the spine.
The body mechanics of this martial art can be used for functional tasks like opening a door, soothing a fussy child, and transferring a bottle of milk from the kitchen counter to the refrigerator. A key component of Tai Chi Chuan is to drive all movement in the horizontal plane via pelvic axial rotation and translation in the horizontal plane. If the pelvis rotates, the thorax rotates in the same direction and at the same time. When the thorax stops rotating, the pelvis stops rotating. The pelvis rotates on the femurs, driven by the hip rotators, including the posterior fibers of gluteus medius. In addition, Tai Chi Chuan's characteristic wide and deep stances afford a large base of support. This stable base of support is consistent with correct lifting, pushing and pulling and these stances will also tend to strengthen the legs, facilitating lumbar stabilization. Furthermore, since maintenance of postural control correlates with good outcome in subjects with low back pain, the balance improvements expected with Tai Chi Chuan training and practice should have a positive impact on low back pain.
By minimizing segmental spinal rotation, the lumbar spine is maintained in a neutral position in the horizontal plane. One advantage of this neutral spine (in all planes) is to balance the forces seen by the spinal elements. By curtailing segmental rotation, the contact stresses in the zygapophysial (facet) joints, and thereby the axial torque on the spine are decreased. One study that examined low back rotation in elite golfers concluded that subjects with low back pain tended to segmentally rotate the lumbar spine while golfers without back pain rotated the lumbar spine as a unit fixated to a rotating pelvis.
The minimization of segmental spinal rotation is facilitated by Tai Chi's diaphragmatic breath pattern by allowing transversus abdominus, the deepest abdominal muscle, to function in a more ideal length-tension relationship. There is evidence that optimal lumbar stability (core) requires coordination between the diaphragm, pelvic floor, transvesus abdominus and multifidus. Impaired diaphragmatic movement found in thoracic respiration (upper chest breathing) may reduce movement in Quadratus Lumborum and Psoas, increasing the tendency of these muscles to shorten. Tightness of Quadratus Lumborum and Psoas is implicated in low back pain and postural dysfunction. Thoracic respiration also increases sympathetic arousal leading to a stress response and generalized muscle tension.
By eliciting a relaxation response, neck and back muscles will carry less inappropriate tension, decreasing any tendency for these muscles to spasm while reducing the compressive forces on the spine. A relaxation response also improves motor control to optimize posture, alignment, breathing patterns, and muscle activity to minimize mechanical stress on the spine. The relaxation response from Tai Chi Chuan and Qigong practice offers people with chronic low back and neck pain significant symptomatic pain reduction.
Tai Chi Teacher & Holistic Physical Therapist, Bill Gallagher specialized in treating people with back pain and spinal conditions with Taijiquan, Qigong, Tuina, Osteopathy and other interventions in New York City (NYC). He sees clients in office on the Upper West Side and makes home visits to Upper East Side and Upper West Side of Manhattan.
Filed under: Tai Chi