Why yoga for chronic pain?
We wanted to share the evolving understanding about chronic pain and the role yoga can play. This is important to us because we meet many people who are affected by this and who often feel misunderstood and alone.
Chronic pain is complex so it can be helpful to start with a definition. The Australian Neuro Orthopaedic Institute, which has carried out pioneering work in explaining pain, summarises the concept of pain in the following way:
“Pain is an unpleasant feeling that is felt somewhere in the body and urges us to protect that bodily location. Pain is one of the many protective mechanisms. Others include movement, immune, cognitive, endocrine and autonomic. Pain is the only protective mechanism we are necessarily aware of and compels us to do something to protect the painful bit”
It can be useful to understand pain as a protector and know that without it we would not survive for very long at all! What makes chronic pain tricky (pain that carries on for longer than 12 weeks despite medication or treatment) is that it involves this mechanism becoming highly protective. The body and mind love a pattern and so as it experiences this ‘pattern’ again and again it gets really good at pain! Not only this, chronic pain arises and is maintained by a complex interaction of biological, emotional, cognitive, behavioural and social factors. So it often needs a multifaceted approach.
Chronic pain and fear are good allies and so it is common that people avoid movement, often due to memories that moving causes more pain. Sadly, this can actually worsen the problem, weakening muscles and affecting sufferers psychologically. It can also lead to people struggling to engage in activities that are meaningful to them and can lead to isolation. So it is no wonder that this can lead people to feel both highly anxious, low in mood and hopeless.
So where does yoga fit it?
Yoga understands the interconnection between our body, thoughts, sensations, emotions and experience of pain. It is an embodied practice that approaches chronic pain from both physiologically and psychologically perspectives, which growing research supports. Not only that, there is also evidence that shows yoga can help individuals deal with the emotional dimensions of chronic pain, reducing anxiety and depression and improving the quality of life.
The experience of chronic pain increases stress levels in the body, in an attempt to protect itself from these threat signals. Yoga uses a soft edge approach to movement, perhaps visualising the movement first, before easing into the position. This uses a paced approach and allows time to explore what feels supportive and so reducing the risk of triggering the threat system. This can support people to learn to reconnect with their body and take an active role in managing chronic pain to re-engage in what is meaningful to them.
This approach alongside slowing down the breath supports desensitisation of the autonomic nervous system and counterbalances this state of high alert by activating the vagus nerve, the down regulating branch of this system. It is the exhale that is linked to the calming part of the nervous system (parasympathetic) and so we can find great benefit from extending the exhale.
Over time, yoga practice improves strength and flexibility, as well as establishing a greater body-mind awareness. The yoga practice invites participants to explore how we notice what is happening in the body, from a narrow focus on the pain to a wider focus integrating the whole body, offering the possibility to zoom out of the pain. When we become aware of
What and how we are noticing we can start to integrate the mindfulness principles of non-judging, patience, beginner's mind, trust, non-striving and accepting.
Yoga philosophy teaches us that we are more than just our physical body and more than just our mind, it views the whole being within the web of life. We can tune into more subtle layers than just those we are consciously aware of. Yoga means union, this invites us to explore ways to integrate the body as a whole, the parts of the body that experience pain, the parts that do not. Recognising that you are not your pain.
We practise yoga in a group, creating a sense of community and belonging, providing an opportunity to connect and practise with others in a similar position to themselves. So together we practice on our mat, which is our training ground and then take this wisdom into day to day life.