Yoga for Chronic Pain Management – Breath, Movement, and Mindfulness

Backaches, stomach cramps, soreness in the calves—it seems like almost everyone in modern Western culture has some of form of pain that constantly nags them. Yoga has entered the West only in the past hundred years or so, but its focus on achieving wellness through a whole-person outlook has much to offer in this area. Yoga, in forms from Bikram to Yin to Restorative, can help practitioners manage various types of pain. All of those forms—even if rather different on the surface—emphasize breath, release of unnecessary tension, and healthy movement patterning. Those and other aspects of yoga can help individuals who suffer from chronic pain return to a better normal in their minds and bodies. 

Breath is important in managing pain because it can help bring pain into perspective, mentally and physically. A good number of peer-reviewed, empirical psychological studies have verified that pain can seem worse when anxiety rises. In the “fight-or-flight” mode, the body is extra-sensitive to sensation—including pain—as a survival mechanism. Key to reducing anxiety is finding steady, deep breathing, because this activates the parasympathetic (“cool-down,” we might call it) part of the nervous system.

That breath doesn’t necessarily have to be slow, as it should provide enough oxygen for the demands of the body’s current task. In this way a Vinyasa yoga practice might call for a quicker—yet full, sustained, and rhythmically steady—flow of breath than does a Hatha yoga class. The Kalabhati (“bellows”) breath, commonly a part of Kundalini yoga, helps practitioners develop and maintain the faster flow within that form, for instance. In any of these asana forms, practitioners can learn how to find the style of breath that suits their needs at the present moment. Practicing pranayama exercises can only enhance that learning and solidify its associated skills. Through such a process, chronic pain sufferers can learn to mindfully use their breath as a tool to ease what ails them.

Yoga can also help practitioners learn to release unnecessary tension, a main cause of chronic pain, through helping them to develop more efficient, anatomically informed movement patterns. That can take stress and strain off areas of the body that are crying out for mercy through pain (read: pain is the body’s way of saying, “Please, stop doing that, or get help to make it stop!”). For example, someone tends to hike up his/her shoulders (and as a result, tense his/her neck muscles) in Tadasana and Warrior postures. Surprise-surprise, doing so is a habit in everyday life, and he/she has chronic migraines. See a connection? A yoga instructor can notice this pattern and, through physical cueing and associated verbal instruction, help the student learn to release his/her shoulders down the back in those postures and throughout practice.

With a mindful approach and consistent self-correction, the student might just be able to carry out that new shoulder positioning off the mat, in everyday life. The neck muscles are no longer strained through having to work in ways they weren’t meant to, through staying contracted to help raise the shoulder blades. Hooray, much to the person’s relief, the headaches become much less severe and frequent. That type of process could be very helpful for those who have chronic pain from their occupational duties, such as athletes, dancers, musicians, retail workers, construction workers, mail carriers, et cetera. In similar ways, they might notice how they place a lot of strain of particular parts of their body through what they do at work day in and day out.

Learning new, healthier ways of accomplishing physical tasks can first help them to see how moving in certain ways is most likely causing, or at least significantly contributing to, their pain. New patterns can at first feel strange, but the positive difference is clear before long. A solution to—or at least lessening of—their pain is right there in those better ways of moving. More active, “yang” styles of yoga (such as Ashtanga and Power Yoga) offer ample opportunity to try out and hone improved movement patterns through many repetitions of codified postures and movement flows. For instance, it might not be too far from accurate when a student feels like that Chaturanga Dandasana has been the 30th of the class!

Yin, or relatively slower and gentler, forms of yoga (such as Restorative and Hatha) can offer students the time to approach movement in mindful ways, experience the body’s response, and react accordingly. Flying through a Sun Salutation can be exhilarating, but one can miss a perhaps subtle—but nevertheless important—physical sensation, such as a sore hamstring or tweak in the back. Taking that same sequence more slowly, or perhaps including fewer postures and movements, could allow a yogi(ni) the time and mental space to observe and appropriately react to such sensation.

Beyond these physical truths, yoga offers a mental element that can be advantageous for pain management. The yogic values of mindfulness, keeping sensation in perspective, and focusing can help people to objectively evaluate such situations, and then to make a plan for improvement and stick with it. For instance, the Niyamas focus individuals on personal observances—essential in managing pain, because it takes listening to the body’s messages to give it what it needs for the pain to diminish. Dharana challenges practitioners to truly focus, and dhayana challenges them to devote themselves to a task. All this is important for healing any ailment, but especially for something persistent and often debilitating such as chronic pain.

All in all, yoga offers physical and mental tools to help ease pain in many forms. Whether fast or slow, with goals of fitness and weight loss, or relaxation, any form of yoga can offer different—yet equally valid—types of such tools. Chronic, serious medical complications require the care of medical professionals. That being said, let’s not forget the wisdom of ancient yogis. Those tools they created are indispensable ingredients in the mix towards true sustained healing from chronic pain. 

Kathryn Boland is a third-year Master’s degree student in Dance/Movement Therapy at Lesley University (Cambridge, MA), and an E-RYT 500. She is originally from Rhode Island and attended The George Washington University (Washington, DC) for an undergraduate degree in dance (where she first encountered yoga). She has taught yoga to diverse populations in varied locations. As a dancer, she has always loved to keep moving and flowing in practicing more active Vinyasa-style forms. Her interests have recently evolved to include Yin and therapeutic yoga, and aligning those forms with Laban Movement Analysis to serve the needs of various groups (such as Alzheimer’s Disease patients, children diagnosed with ADHD, PTSD-afflicted veterans, all demographically expanding). She believes in finding the opportunity within every adversity, and doing all that she can to help others live with a bit more breath and flow!

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