Chronic pain is a condition that effects a staggering 100 million Americans. Unlike acute pain which serves the function of signaling an imbalance or injury within the body, chronic pain lasts beyond the usual healing period to form a persistent and perhaps debilitating sensation within the nervous system.
Surpassing the definition of a symptom, chronic pain manifests as a multi-dimensional disease that harbors not only physical symptoms, but causes distress on mental and emotional planes also. It may emerge physically in the form of headaches, joint pain, backache, generalized muscle or nerve pain, among others. Often times it is a result of an initial trauma or injury, however for some sufferers there is no distinct past bodily damage that catalyzes the ongoing, resilient pain.
Emotionally, the toll of unending suffering caused by constant pain may psychologically wear down the sufferer and give rise to conditions such as stress, anger, anxiety and depression.
Chronic pain is widely accepted within the medical community as a mind-body condition, requiring attention both physically and psychologically to attack the root cause — however the underlying cause is not always clear.
In conventional medicine, an entire medley of pills from Tylenol to Vicodin are recommended to mask the pain and keep it at bay. Surgery is also often prescribed by the mainstream medical system. However these methods may be augmented, or possibly entirely brushed aside, by an ancient system that some might think is utterly archaic, though it should be noted it’s by no means underdeveloped or less effective. This system is the teachings of yoga — developed, tested and honed over thousands of years — which has only recently been thrust into the scientific limelight.
Yoga is described, eloquently and poetically, in the Bhagavad Gita as: “The discipline which serves the connection with that which causes suffering.”
When we apply this epoch-old quote to this specific topic, it falls directly in alignment with the results of extensive scientific research. Possessing the ability to relax, energize, remodel and strengthen the body and the mind, yoga offers a revolutionary treatment for those crushed by the ever present physical and psychological pressure of chronic pain.
Brain imaging studies conducted on both rats and humans have demonstrated alterations in gray matter volume and white matter integrity in certain areas of the brain triggered by the presence of chronic pain. Emerging research demonstrates that yoga offers an entirely polarizing effect on the brain in comparison to the effects of chronic pain.
Eloquently summarizing this concept, M. Catherine Bushnell, PhD, of the National Center for Complementary and Integrative Health, who co-authored a paper on the topic of increased pain tolerance in yoga practitioners, stated at the American Pain Society’s annual meeting this past May that, “Practicing yoga has the opposite effect on the brain as does chronic pain.”
Bushnell notes, “Imaging studies in multiple types of chronic pain patients show their brains differ from healthy control subjects.” She continues, “Studies of people with depression show they also have reduced gray matter, and this could contribute to the gray matter changes in pain patients who are depressed. Our research shows that gray matter loss is directly related to the pain when we take depression into account.”
Mind-body practices are displaying incredible results in easing chronic pain on all fronts: emotionally, mentally and physically. It is evident that practitioners of yoga posses increased gray matter in brain regions that are involved in pain modulation.
“Some gray matter increases in yogis correspond to duration of yoga practice, which suggests there is a caustic link between yoga and gray matter increases,” says Bushnell.
Research suggests gray matter changes within the insular and cerebral cortex have the most potent positive effect on pain management. “Insular gray matter size correlates with pain tolerance, and increases in insular gray matter can result from ongoing yoga practice,” Bushnell states.
Bushnell concludes, “The encouraging news for people with chronic pain is mind-body practices seem to exert a protective effect on brain gray matter that counteracts the neuroanatomical effects of chronic pain.”
Reset spoke with yoga teacher and spiritual psychologist Charanpal Kaur about how yoga positively effects the mind-body complex to produce effective results in terms of chronic pain. Charanpal received her Kundalini Yoga training in level 1 and 2 from Gurmukh Kaur Kaur Khalsa in Los Angeles and Rishikesh. She has also earned certification in Khalsa Way Prenatal and Yin Yoga.
Charanpal explains, “As a teacher of Kundalini Yoga, I witness the most significant transformations occur not in the body, but in the practitioner’s consciousness — particularly the subconscious mind. Chronic pain may simply be a patterning of subconscious thoughts that leave the individual in a perpetual state of pain.”
Charanpal continues, “The triggering event, or situation that induced the pain to begin with, begins a pattern whereby the mind can become compliant, or believe that the pain exists, and will persist to exist, as if the pain is the body’s natural state of being.”
Charanpal went on to describe how Kundalini yoga specifically can work to dismantle the mental patterns that may be at the root of chronic pain: “Kundalini Yoga, as taught by Yogi Bhajan, offers kriyas [movements which promote energy flow] designed to break up old patterns, or ‘demoting habits’ simply by the virtue of returning the practitioner to their natural, true state of being.
“There are many ways which help one return to, or remember, their true state of being. Pranayama [breath work], mantra [a repeated word or phrase to aid concentration], asana [the art of sitting still], mudras [spiritual gestures], etc., all help harness the mind.”
Charanpal concludes, “Thus, yoga can be viewed not just as a physical practice, but a mental and emotionally balancing way of life. Health, then, is not something that the practitioner gains. Rather, health is the state the practitioner returns to, or remembers.”
A stunningly scribed paper authored by Nandini Vallath and published by the Indian Journal of Palliative Care details how asanas, specific yogic postures including physically culturing, balancing and relaxing movements, have a positive effect on the intellectual and spiritual aspects of chronic pain.
Vallath explains how asanas effect the musculoskeletal system of those suffering from chronic pain. “Asanas are useful adjuncts in the maintenance phase for reconditioning the body, realignment of skeleton and for correction postures. It opens up the vital flow of energy through the body, which is subjectively perceived as positive sense of well-being. Well chosen culturing asanas can strengthen muscle and correct the posture. This coupled with relaxation, breaks the cycle and reverses the pain reinforcing forces.” Vallath adds, “Various asanas have compressive de-compressive effects on the blood flow and lymph flow of underlying tissues through abdominal muscular stretches and contraction in combination with appropriate spinal movements.”
As well as aiding the musculoskeletal system, asanas have a positive impact upon the body’s neuroendocrine flow. “Asanas stabilize the autonomic nervous system,” says Vallath. “They influence the endocrine system and nerve plexuses by increasing local blood flow by gravity [sarvangasana on thyroid], contraction of surrounding muscle [bhujangasana on lumbar plexus] or by pressure release [mayurasana on celiac plexus]. Studies done in regular practitioners show a decrease in cortisol and cholinesterase levels, which reflect quietening of the stress response. There is evidence of endogenous opioid release during sustained stretching of muscles.”
As well as physical flows of movement and the execution of certain postures, focus upon the breath and certain breathing techniques form another crucial pain neutralizing foundation within the practice of yoga.
Pranayama [a Sanskrit word meaning “extension of the breath”] is a yogic discipline revolving around breath work. This sub-school of yoga has also displayed solid promise in relieving some of the physical aspects of chronic pain. Vallath points out, “Pain modifies frequency, depth and patterns of respiration. This is due to pain’s emotional component as well as due to the phylogenetically acquired tendency to immobilize the affected area to avoid further injury.”
Vallath elaborates, ”In chronic pain states, breathing is invariable strained, shallow and mainly thoracic. This is perceived by the physiology as a sustained stressful state and this in turn affects other rhythmic phenomena like neuronal flow and vital cyclic rhythms with high flat cortisol levels similar to arousal response. Deep yogic breathing with prolonged exhalation relaxes most skeleton muscles.”
Pranayama also transcends the arena of physical pain and can contribute towards more positive cognitive states within sufferers of chronic pain. Our thoughts and emotions can impact our breathing pattern, yet this can also work in reverse when we apply conscious thought and action to the way we breathe.
“Researchers have demonstrated amazing correlations between electroencephalography (EEG) patterns and breath patterns,” says Vallath. “Slow breathing increases the α waves in the EEG and adding feedback of breath sounds further significantly increased it from baseline. Another study elicited a correlation between increase in α waves in the EEG and abdominal breathing, which indicates that states of consciousness could be affected by patterns of breathing. It is impossible to stay angry or anxious while breathing in a slow, deep and reflective manner. Diaphragmatic breathing is probably the single most valuable thing that a patient in chronic pain can learn on the road to recuperation”.
So there we have it, simply moving and breathing in a manner that has been skillfully developed over thousands of years offers staggeringly effective relieve for those suffering chronic pain — and is a pain management method that’s void of the potentially damaging side effects of pills and scalpels!