A student comes up to you before class and says, “Just so you know, I’ve got a bad lower back.” I suspect most yoga teachers have experienced some version of this conversation. What happens in your head next? Perhaps you immediately start thinking about what they shouldn’t do. Forward bends? Backbends? Twists? Maybe they should keep their knees bent, engage their core more strongly or avoid rounding their spine.
I completely understand this instinct. We want to help, and when somebody tells us that something hurts, protecting that part of their body can feel like the responsible thing to do. But the more I’ve learned about low back pain, the more I’ve started wondering whether protection is always the most useful place for us to begin.
We probably know less than we think
Low back pain is extraordinarily common, yet in most cases we cannot confidently identify one particular structure responsible for it. Around 85% of low back pain has historically been classified as non-specific, meaning that it cannot be attributed to a particular pathology (Airaksinen et al. 2006). I think this creates an interesting problem for yoga teachers because our world is full of plausible structural explanations. Perhaps someone’s hamstrings are pulling on their pelvis, their hip flexors are tight, their core is weak, their sacroiliac joint is unstable, or their lumbar spine is moving too much.
Occasionally one of these observations might be relevant. The problem is that finding something interesting about a person’s body doesn’t necessarily tell us why they hurt. Pain is influenced by anatomy, but also by previous experiences, beliefs, sleep, stress, changes in activity and expectations about recovery. Once we appreciate that complexity, I think it becomes much harder to look at somebody in a yoga class and confidently explain why their back hurts.
When protection becomes part of the problem
This has made me think differently about some of the language we use around back pain. Imagine telling a student, “Be careful with forward bends,” “Try not to round your lower back,” or “Keep your core engaged to protect your spine.” None of these instructions sounds particularly alarming. In fact, they can sound reassuringly sensible. But what might the student hear? Perhaps something closer to: My back needs protecting. Rounding my spine might damage it. If I stop engaging my core, something could go wrong.
We know that beliefs and expectations can influence the experience of low back pain, and that fear and avoidance are associated with poorer outcomes (Main, Foster, and Buchbinder 2010; O’Sullivan et al. 2020). This doesn't mean that every cautious cue causes pain, of course, or that we should encourage students to ignore symptoms. I think it asks us to consider the difference between helping somebody modify a movement because it currently feels uncomfortable and teaching them that the movement itself is dangerous.
Those are very different messages.
Finding another way to move
A student might make a forward bend smaller, bend their knees, use a chair or decide not to do it at all. Another student with back pain might find that rounding their spine actually feels wonderful. The modification matters, but so does the story we attach to it. Rather than, “Don't do this because it's bad for your back,” we might say, “Let's see whether changing this makes it more comfortable.” That leaves open the possibility that their movement can change again.
This is also reflected in recent guidance from the American College of Sports Medicine. Their 2026 advice for people with low back pain is refreshingly straightforward: physical activity is important, bed rest is generally discouraged, and people should keep moving while modifying activities if symptoms worsen. I like the simplicity of that message. We can spend a lot of time debating which movements are best for a painful back, when sometimes the more useful starting point is simply finding ways for someone to remain active. This doesn't mean that every movement will feel good for every person at every moment. Pain can be very real and limiting. But perhaps discomfort gives us a reason to adjust the dose of a movement rather than automatically deciding that the movement itself is the problem.
So what is our role?
Yoga teachers are not responsible for diagnosing or treating somebody’s low back pain. There will also be situations where a student needs assessment by an appropriately qualified healthcare professional. But not being responsible for treating back pain doesn't mean we have nothing useful to offer.
Increasingly, I think one of our most valuable roles is helping people explore movement without unnecessarily increasing their fear of it. We can help somebody make a pose smaller, slower or different. We can help them find movements that feel manageable today and, when appropriate, gradually explore a little more over time. Perhaps most importantly, we can help somebody who has become nervous about their back rediscover some confidence in what their body can do.
What I like about this approach is that it removes some of the pressure from us as teachers. We don't necessarily need to work out which muscle is tight, which joint is unstable or which movement caused the problem before we can be helpful. Sometimes helping somebody discover that they can still bend, twist, breathe, walk around the room or get down onto the floor comfortably is already valuable.
The next time a student tells you they have low back pain, notice where your mind goes first. I still catch myself searching for the modification, the thing I should remove or the instruction that will make the movement safer. But I'm increasingly interested in a slightly different question: How can I help this person feel more confident moving today?
References:
Airaksinen, O., Brox, J., Cedraschi, C., Hildebrandt, J., Klaber-Moffett, J., Kovacs, F., et al. (2006). “Chapter 4. European guidelines for the management of chronic nonspecific low back pain.” European Spine Journal, 15(Suppl. 2), S192–S300.
Main, C.J., Foster, N., & Buchbinder, R. (2010). “How important are back pain beliefs and expectations for satisfactory recovery from back pain?” Best Practice & Research Clinical Rheumatology, 24(2), 205–217.
O’Sullivan, P.B., Caneiro, J.P., O’Sullivan, K., Lin, I., Bunzli, S., Wernli, K., & O’Keeffe, M. (2020). “Back to basics: 10 facts every person should know about back pain.” British Journal of Sports Medicine, 54(12), 698–699.