Chronic Pain

Pain is our nervous system’s way of grabbing our attention so we can identify and address the source of pain.  Once this has happened, usually the pain subsides.

Chronic pain works differently. Even after the source of pain has been identified and addressed, the pain may persist for weeks, months or even years.

Pain that lasts for 3 months or longer and persists beyond the acute stages of an illness or injury is defined as chronic pain. It can occur anywhere in the body and range from slightly annoying to preventing you from carrying out our day to day activities.

Pain often becomes a vicious circle: We are in pain, so we start moving less. With decreased activity, we lose mobility and strength, and then we aren’t able to do things we enjoy. This increases stress, which, in turn, creates even more tension and pain in the body. 

When we are in pain for a long time, the brain gets more efficient at sending signals of pain to the body, over time our brain may continue to send danger signals, even though there is no apparent danger.

When we are in pain for a long time, the brain gets more efficient at sending signals of pain to the body, over time our brain may continue to send danger signals, even though there is no apparent danger.

There are over 100 conditions associated with chronic pain, including:

  • Low back pain
  • Arthritis
  • Fibromyalgia
  • Premenstrual Syndrome (PMS)
  • Chronic Fatigue Syndrome (CFS)
  • Endometriosis 
  • Inflammatory Bowel Disease (IBD)
  • Interstitial Cystitis (IC)
  • Temporomandibular Joint Dysfunction (TMJ)
  • Vulvodynia

Chronic pain can be complex: 

  • you may have two or more coexisting chronic pain conditions or diagnoses,
  • you may have overlapping conditions that share symptoms,
  • the pain may be caused by an array of different factors,
  • the pain may lead to secondary symptoms or conditions such as:
    • Insomnia
    • Fatigue
    • Anxiety
    • Depression
    • Withdrawal from activity
    • Weakened immune system
    • Disability
    • Substance Use Disorder
    • Addiction

It is understood that there are physical, mental, emotional, and spiritual components that are affected by and contribute to chronic pain.  This can make chronic pain difficult to treat with conventional medicine alone. 

Chronic pain may be the result of various imbalances.  In Ayurveda it is thought a build up of toxins in the system contributes to the pain response, such as:

  • toxin accumulation in tissues, blocking circulation
  • poor nutrition
  • poor digestion
  • an imbalance of the nervous system
  • a lowering of natural resistance and immunity
  • the disruption of natural biological rhythms
  • an accumulation of physical and mental stress

Chronic pain can be exacerbated by stress.  Stress is considered to be multifaceted and may include physical, psychological, emotional and energetic components. Those with chronic pain conditions have been shown to exhibit low heart rate variability (HRV), lower GABAergic activity and low vagal tone.  Low vagal tone brings a sense of depletion, sluggish digestion, increased heart rate and difficult to manage unpredictable moods.  These conditions have shown symptom improvement in response to yoga-based interventions.

If you are managing chronic pain, it is important to have an interdisciplinary team for optimal healing, as well as love, support and community. Yoga therapy can form part of a collaborative pain management team which may include :

  • biomedical, 
  • psychosocial, 
  • complementary health, 
  • spiritual care. 

Yoga can play a significant role in managing the symptoms of chronic pain.  It is widely researched that pain can be helped by gentle physical exercise including yoga.  The National Institute for Health and Care Excellence (NICE) Guidelines include yoga as one of the recommended treatments for low back pain and sciatica. Numerous research studies have consistently shown that yoga postures (asana), breathing (pranayama) and meditation (dhyana) positively affect function and pain for those with various pain conditions, and also change their relationship to pain and how they experience it.  Mindfulness (dharana) has also been shown to have many physiological benefits. A daily mindfulness practice can promote self compassion and reduce over identification with harmful emotions, thoughts and beliefs.

A number of studies also highlight the effectiveness of yoga therapy interventions to support those with pain by discerning and alleviating the causes of suffering to improve overall quality of life.  A yoga therapist can help break the pain cycle, addressing the physical, emotional, and lifestyle aspects of pain holistically and then begin to change patterns of physical movement from painful to non-painful.

Chronic and persistent pain is one of the main reasons people look for a yoga therapist; often this can be as a last resort having tried many other approaches from complementary and Western medicine, where nothing has worked for them consistently.

Yoga therapy offers cost-effective, long-term management and self-management strategies for chronic conditions”  IAYT

Yoga therapy can be understood as a salutogenic intervention that seeks to identify the contributors to health and assist individuals in progressing toward optimal wellbeing. Yoga teaches that in adverse life situations, including chronic pain, we can connect to states of calm, equanimity, and contentment; suffering arises from forgetting this connection to such states as one misidentifies with the fluctuating stimuli of the body, mind, and environment.  The teachings and practices of yoga can support equanimity and contentment within the specific circumstances of the individual.

Yoga therapy can bridge the gap between mind and body with therapies that allow you to find an embodied sense of wholeness.  Being able to (re)discover the connection between your mind and your body can support your recovery and allow you to find your own management tools, which in turn can nurture your sense of empowerment and agency in your healing.

In gratitude and recognition of my teachers Sandi Russom & Emily Smith for their astute and informed teachings, which show up not only within this piece of writing but in my integrity as a Yoga Therapist each and every day.

Sources:

Mason H, Schnackenberg N, Monro R. The National Health Service (NHS )is gradually integrating yoga as a cost-effective, preventive and complementary treatment for a host of non-communicable diseases. Yoga and Healthcare in the United Kingdom. Int J Yoga Therap. 2017 Nov;27(1):121-126. doi: 10.17761/1531-2054-27.1.121. PMID: 29131732.

Pearson N, Prosko S, Sullivan M, Taylor MJ. White Paper: Yoga Therapy and Pain-How Yoga Therapy Serves in Comprehensive Integrative Pain Management, and How It Can Do More. Int J Yoga Therap. 2020 Jan 1;30(1):117-133. doi: 10.17761/2020-D-19-00074. PMID: 32412808.

Russom, S. (2023) ‘Chronic Pain Pathology, Treatment, and Yoga Therapy Principles’ (Lecture), YT303.05: Essential Sciences for the Yoga Therapist.  Practice School of Yoga Therapy. 11 January.

Smith, E. (2022) ‘Yoga Therapy Approach to Caring for Chronic Pain and SUD’ (Lecture), YT313.02: Yoga Therapy: Addiction & Recovery.  Practice School of Yoga Therapy. 11 November.

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