Man practicing yoga forward bend - janu sirsasana.

Chronic Pain Relief: How Your Brain Processes Pain and How Yoga and Movement Can Help

By: 
Dr. Arielle Schwartz

When you sense and feel your body, you are better able to take care of yourself. It sounds simple, right? We are more likely to recognize if we feel hungry, thirsty, need to go to the bathroom, or need to rest when we are attuned to our sensations. Try it by taking a deep breath. Are you able to notice any areas of stiffness or discomfort in your body? Do you sense a desire to adjust your posture to support your spine better or to create a feeling of opening across your chest?

This may sound simple, but truth be told, for many people, it’s really not that simple, especially if you have a history of trauma or chronic pain. You might find it very difficult to tune into sensations. It might feel safer to avoid feeling your body because you never know when you might feel the next uncomfortable, aching, or burning sensation.

If you have a history of trauma or chronic pain, you may need to relearn the art of listening to your body in a safe and slow manner. This post is part one of a two-part series on chronic pain relief and explains the science behind the mind-body-pain connection. Read on to learn the role of the brain in pain, how trauma exacerbates chronic pain, and why we need to move to heal.” - Dr. Arielle Schwartz

Your Brain and Your Pain

Acute pain is initially sensed in the body through nociceptors, the sensory receptors at the end of sensory neurons specifically organized to send pain signals to the spinal cord and brain. These neuronal connections extend into the limbic centers of the brain, which attribute an emotional quality to the pain.

Sometimes there is a physical cause of chronic pain such as a bulging disc, arthritis, or an infection. It is important to recognize that not all health challenges can be changed, no matter how hard you try. In this case, you can focus on self-compassion, surrender, processing your grief about living with pain, and pain management.

However, scientists also recognize that pain, like all of our life experiences, becomes stored as a memory, a procedural memory to be more precise. Procedural memories involve brain centers that retain the sequence of motor skills and actions. Over time, these neuromuscular pathways of pain become reinforced through myelination (the fatty coating that strengthens neuronal connections). 

Woman practicing yoga seated twist pose.

Examples of procedural memories include riding a bike or tying your shoe. Once a procedural memory is learned, you no longer need to think about it. Our neural networks continue to repeat them on autopilot. But procedural memories can be resistant to change. In other words, chronic pain can start in the body but be maintained by changes in brain activity.

Why would we want to remember pain? Because the body is wired for self-protection. It is a protective response to remember previous injuries so that we can protect ourselves in the future if we face a similar threat. However, this “pain memory” can set off false alarms in which we interpret a threat when, in fact, there is no danger or if there is a minor concern, the pain response is stronger or out of proportion with the situation. Healing chronic pain involves learning how to reclaim relaxation through breath and movement, and your “pain memory” may just hold the key.

PTSD and Pain

According to Mark Grant, author of Change your Brain, Change your Pain (2016), having a history of unresolved PTSD, especially childhood abuse, is associated with higher reports of chronic pain conditions, including fibromyalgia. This may be linked to the long-term holding of tension in your body to restrict vulnerable feelings. Holding muscular tension can help you avoid sensations, and as a result, push away somatic reminders of a painful past. Or, if you live with chronic medical conditions, you may have had a history of unwanted or invasive medical interventions that have left scars on your soma and psyche.

Chronic pain can become a trauma that triggers a vicious cycle of more pain. If you have ever had a migraine or back pain, you will know what I am talking about. The slightest feeling of a headache or a twinge in your back causes a fear response. How bad will it be this time? Will I end up in bed for days? Tension builds, and you start to avoid anything that might trigger your symptoms. Your life starts to feel increasingly limited. Sometimes, it can feel safer not to feel anything. But, numbness comes with a cost.

Movement Suppression and Pain

In response to any threat, we will engage the sympathetic nervous system and initiate the fight-or-flight response. This high arousal will bring forth changes in respiration, digestion, body temperature, blood pressure, and muscle tension. Ideally, we can allow this “energy” to move us, and we can respond by shaking the body, conscious breathing, reaching the arms and legs, or stepping onto our yoga mat. Movement helps our nervous system return to homeostasis, a state of relaxation and ease facilitated by the parasympathetic nervous system.

Woman practicing yoga warrior II pose.

However, we live in a culture of stillness, and many of us have learned to override our body’s natural impulses for movement. We suppress our sensations, emotions, and movement impulses. Suppression of movements inhibits our ability to resolve the nervous system activation into homeostasis and interferes with our ability to access the parasympathetic (rest-and-digest) relaxation response. As a result, our muscles retain low levels of incomplete movements in the form of passive tension that is held without conscious awareness.

Alan Fogel, the author of the book, Body Sense (2009), identifies that long-term suppression of movement impulses has consequences on health such as chronic pain, higher levels of cardiovascular disease, higher blood pressure, higher rates of gastrointestinal diseases, respiratory diseases such as asthma, and serious autoimmune disorders. In short, when we suppress movement impulses, we impede our capacity for natural healing. What we cannot feel, we cannot heal.

Chronic Pain Relief

From a somatic therapy perspective, healing involves developing a tolerance for sensations and reclaiming healing movements or movement sequences. We increase sensory awareness by developing a capacity to stay with painful emotions and sensations without judgment. Fogel calls pain your body’s “wake-up call.” I invite you to think of pain as an opportunity to reclaim healing movement impulses that were suppressed (sometimes many years ago).

 

Also read this article from Dr. Arielle Schwartz - Vagus Nerve Yoga: A Mind-Body Approach to Wellness.

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Reprinted with permission from Dr. Arielle Schwartz.

Dr. Arielle Schwartz, yoga therapist, developed Resilience-Informed Therapy

Dr. Arielle Schwartz is a licensed clinical psychologist, wife, and mother in Boulder, CO. She offers trainings for therapists, maintains a private practice, and has passions for the outdoors, yoga, and writing. She is also the developer of Resilience-Informed Therapy which applies research on trauma recovery to form a strength-based, trauma treatment model that includes Eye Movement Desensitization and Reprocessing (EMDR), somatic (body-centered) psychology, mindfulness-based therapies, and time-tested   relational psychotherapy.