Yoga Spinal Flexion Positions Can Cause Spinal Fractures in Osteoporotic Patients

Should You Tell Your Patients to Do Yoga?

Yoga is generally thought to be a “safe” exercise to increase flexibility, overall health, muscle strength, and balance.  However, some positions may not be advisable for people with low bone mass—either osteopenia or osteoporosis.  Flexion, for example, may place too much pressure on the weakened bones and lead to fracture.
woman in the child's pose, yoga exerciseSome yoga positions may not be advisable for people with low bone mass—either osteopenia or osteoporosis. Photo Source: iStock.A study published in March 2012 in the journal Pain Practice addressed this concern.  The article is “Yoga Spinal Flexion Positions and Vertebral Compression Fracture in Osteopenia or Osteoporosis of Spine:  Case Series.”  The authors wanted to “raise awareness of the effect of strenuous yoga flexion exercise” in people who have low bone mass in their spines.

There were 3 people in this study; they had low bone mass (but were otherwise healthy).  They were also all pain free, and they had recently started yoga exercises in order to improve their musculoskeletal health.

After they did spinal flexion exercises (SFE), the patients developed new pain and fractures.

Given that these 3 patients all had osteopenia, not osteoporosis, and they still experienced pain and fractures after SFE, there is some concern that this risk would be increased in patients with osteoporosis.

The authors have several recommendations given their findings in this small case series.  They write, “This finding suggests that factors other than bone mass should be considered for exercise counseling in patients with bone loss.” 

Practitioners may want to caution their osteopenic or osteoporotic patients to avoid those yoga positions that involve extreme twisting or bending.  The increased torque this can place on the weakened vertebra(e) may lead to a fracture.

It should be stressed that yoga is still an effective bone-building tool, but patients must be aware of their limits and exercise caution when doing yoga.

Updated on: 01/03/20
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