Yoga Spinal Twist for Back Pain

You probably already know that yoga is increasingly being used to help with neck and back pain. And you may also be aware that even so, doing yoga can lead to an injury.

A woman in the supine position twists her spine by bringing her knees to one side.
cirkoglu / Shutterstock

A 2015 study published in the International Journal of Yoga says that: the risk of injury while doing yoga poses varies according to where and with whom you practice yoga. With some types of yoga — for example, Iyengar — teachers are trained to work with students who are injured or have health problems.

The key to using yoga safely, the study authors say, is for the teacher to recognize (and communicate) when the student is ready for each individual asana (pose) and for students to not to work beyond their readiness. It's also important, the authors say, to work in an "optimum" position, which is not a maximal position.

One yoga pose, in particular, that may spell trouble to your back is a spinal twist. Twisting the spine can be very relieving but it is also associated with the risk for herniated disc, sacroiliac instability, and other injuries.

If you're de-conditioned and/or you have back problems, you may want to either skip twisted poses or limit yourself to the easiest version possible. Most of the time, this will be the supine spinal twist.

It's also a good idea to ask your healthcare professionals if doing a twisting motion is appropriate for you. Some conditions might be worsened when mechanical stress in the diagonal direction (such as a twisting motion provides) affects the spine.

Supine Spinal Twist

The supine spinal twist is a rotation of the spine while lying on your back (supine refers to an on your back position). The rotation (aka, the twisting action) happens mainly at your waist, but can also be felt in areas above and below.

Starting with your knees bent, your feet flat on the floor, and your shoulders also flat on the floor, the knees are brought up, bent and then crossed over the trunk to one side. You can take your knees all the way down to the floor, but if that proves too difficult on your back, going part way is fine, too. You can even put blankets and pillows where your knees land for support.


  1. To keep your back safe, approach the pose gently.
  2. Do not force yourself into the position. Slip into the pose as your body allows you.
  3. As you bring your knees over to the side, stay aware of how your back feels. Go easier or stop if there is pain. If you feel a sharp pain, stop immediately. 

Something to think about while you are in the pose is that the relationship between your shoulders and hips are connected through your spine. To finesse the pose, consider the following:

  1. Keeping your shoulders open and wide, try to relax them as much as you can, and let the effect of that ripple down your spine.
  2. As you exhale, allow the tension in the front of your abdominal region to melt away; allow that area to become empty. This will engage more of your oblique abdominals, which are the muscles responsible for the movement of a spinal twist.
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By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.