Note: WordPress doesn’t like it if I try to put quotation marks in a title, but understand that by “facts” I mean generally agreed upon beliefs about reality.
Recently, I taught a 3 week series about yoga and chronic pain. I posted last week about the conversation we had regarding the relationship between chronic pain and the klesas. What follows in this post are some of the basic points we considered in the first week about the connection between chronic pain and yoga.
- Pain has a function – when we experience sensation that is perceived as pain, the body ramps up the sympathetic nervous system, which prepares us to fight or flee. This is utterly functional in some situations (you are being chased by an angry rabid badger), but less when the threat is your everyday bodily experience.
- 75-90 million Americans are believed to experience chronic pain.
- Chronic pain is the # 1 complaint of older Americans (1/5 on painkillers regularly).
- Woman have higher rates of chronic pain, but they seek help more and respond more quickly to interventions.
- Men have (or report) lower rates, but they get worse before seeking help and are less likely to seek multiple ways to manage pain.
- Estrogen seems to somehow be related to pain, with some studies suggesting it might increase our ability to “recognize” pain.
- Studies suggest that chronic pain may decrease the immune response, effectively causing those who are in pain to also become ill more frequently.
- When one has chronic pain, the process of neuropasticity (nervous system “learning” to respond to a stimuli more effectively) creates a wind-up effect whereby the body increases the intensity of pain signals and responds to smaller/lesser stimuli more strongly.
- Additionally, when pain is ongoing, the brain actually undergoes neuronal changes that permanently change pain response. This creates a situation where boundaries between sensation, stress, pain become blurred.
Common co-morbid issues with chronic pain
- Insomnia/sleep disturbance (over 65% of people with chronic pain report sleep problems)
- Lower endorphins (meaning less feeling of happiness, peacefulness)
- Allodynia – pain from stimuli not normally painful
- Side effects from pain medications – addiction, nausea, constipation, respiratory depression
Yoga can help!
Benefits of meditation
- Through meditation, we learn to engage in svadyaya (self study) and are better able to see the difference between suffering and pain.
- Mindful meditation helps us increase awareness of all physical sensation, including feelings of comfort and ease which are always being experienced by some part of the body, even if it’s just the little toe on the left foot.
- Meditation appears to increase activation of left prefrontal cortex, which is the area of the brain associated with happiness and equanimity.
- Meditation has been shown to reduces transmission of pain signals from thalamus to higher brain centers.
- Because meditation can change our response to sensation, and because of the idea of neuroplasticity, we can teach the brain a new response to sensation.
Benefits of pranayama
- Deep and regular breathing increases parasympathetic nerve response, thus reducing the sympathetic response and shifting the body away from flight/flight.
- Pranayama can increased oxygenation. Decreased oxygenation of the body is a problem for individuals experiencing stress, like chronic pain.
- Pranayama brings our focus to the breath over pain or other body sensations, and this can provide space for meditation and calm. As we are able to get some distance from pain, we might be able to understand our responses better.
Benefits of asana
- Exercise, including asana, lowers stress. Since stress creates muscle spasms and increases pain, it follows that exercise can decrease pain.
- Asana promotes flexibility in muscle, reducing pain due to tightness.
- Asana can strengthen muscles, providing better support for joints.
- Attention to alignment in asana helps us reduce pain due to compression/alignment issues.
- Exercise creates an increase in endorphins, and thereby happiness, equanimity, and pain relief.
- Regular exercise improves sleep.
- Asana practice can change our relationship with sensation, such that we don’t automatically evaluate all uncomfortable sensations as pain.
- Ongoing work with asana can help us to revise our understanding of body, seeing what it is capable of doing and how amazing it is, rather than focusing on what it can’t do or how bad it feels.