How do we make a diagnosis when someone complains of back pain? Is it based on structural anomalies seen in imaging: degeneration, bulging disc, narrowed space? The capacity of functional movement: range of movement, strength, endurance, stability? The subjective experience of pain?
A yoga approach emphasizes the functional capacity and subjective experience because it focuses on what the person can do for themselves. If we intended to do surgery, imaging is necessary. If we want to see how well the person can move, we cannot decide that from a CT scan or MRI. We must see the person move. If we want to know how a person feels, we must listen to them.
Yoga and ayurveda guide us to consider balance in the whole person.
We experience wellbeing when there is balance.
We practice disorder-prevention when we watch out for tendencies toward imbalances and take care not to worsen them.
We offer therapy when we identify imbalances and bring them back to balance.
The self-care skills and frameworks of yoga cover the spectrum from wellbeing to therapy. For instance, if your back hurts, we could teach the skills of awareness, relaxation, gentle mobilizations, better alignment, strength, stability, slowly increasing range of movement, with positive emotions and thoughts.
But you do not have to wait for back pain to arise in order to practice these skills. The same skills will also keep your back healthy, feeling good, and create a cascading positive effect on your whole-person wellbeing. These skills will also decrease the chances of developing back injuries or pain.
Therefore, the distinction between yoga and yoga therapy is fuzzy. The frameworks of yoga place well-being and ill-being on the same spectrum of qualities; our specific balance decides where we are.
Why would a person with a degenerated lumbar intervertebral disc need to practice relaxation, mindfulness, or slow breathing? Why would someone with anxiety do strength training, inversions, alternate nostril breathing, or apply oil on their head? Would someone with knee osteoarthritis or addictions also do the same?
Modern medicine increasingly shows us the mechanisms behind why all these are connected. But holistic frameworks are elusive because of the fragmentation of the diagnostic model and therapeutic interventions.
We must tailor our diagnostic models to the skills that we intend to use. If we expect to work with self-care and function, our diagnostic framework should assess our capacity for self-care and function.
A sound wellbeing and therapeutic path should cover as much of the whole person as possible. It should help us assess imbalances and guide us systematically toward effective skills to maintain or restore balance. That complete model does not exist entirely in only Eastern or Western approaches; it is by necessity a hybrid. Yoga and ayurveda, however, are one of the best foundations for such a system. That is what Svastha is about—a comprehensive, authentic, and effective system of wellbeing.