Chronic Pain Relief Through Yoga Therapy

By Christine Saari, MA, C-IAYT 

Chronic pain is a complex and often misunderstood condition that affects millions of people worldwide. Yoga therapy is emerging as an integrative approach to chronic pain management.

Unlike acute pain, which is a direct response to injury or illness, chronic pain persists for months or even years, often without a clear cause. Researchers highlight that chronic pain differs fundamentally from acute pain in how the brain processes it¹. It can manifest in various forms, including back pain, migraines, arthritis, fibromyalgia, and neuropathy. The experience of chronic pain is not just physical; it’s emotional and psychological, often leading to frustration, anxiety, and depression.

If you live with chronic pain, you know the toll it can take on every aspect of your life. Daily activities become challenging, relationships can suffer, and the constant search for relief can feel overwhelming. You may have tried numerous treatments, only to find that the pain persists, leaving you feeling isolated and defeated.

Understanding Chronic Pain: A Brain and Body Experience

One of the key insights into chronic pain is understanding that it is as much a brain experience as it is a physical one. When pain becomes chronic, the brain can get stuck in a loop that reinforces the sensation of pain². This brain loop, or “pain pathway,” occurs when the nervous system repeatedly sends pain signals, even in the absence of physical damage. Over time, the brain and nervous system become hypersensitive, making the pain experience more intense and difficult to treat. 

To effectively manage chronic pain, it’s essential to address both the physical symptoms and the brain’s role in perpetuating the pain. This requires a holistic approach that focuses on remapping the brain and rebalancing the autonomic nervous system, helping the individual to break free from the cycle of pain. 

Sources of Chronic Pain and the Impact of Stress

Chronic pain can come from two main sources and may be worsened by stress and mental health issues³. Nociceptive pain results from damage to tissues like skin or muscles and is typically felt as sharp, aching, or throbbing pain. Neuropathic pain is caused by damage or issues with the nerves themselves and often feels like burning, tingling, or shooting pain, sometimes without any clear injury. 

Additionally, people with somatic symptom disorders experience pain or other physical symptoms that are strongly influenced by their psychological state. This means their pain may be affected by how they think and feel about their symptoms, which can make the pain seem more intense or difficult to manage. Research increasingly shows that conflicting thoughts and stress can intensify pain, particularly in those with back or neck problems⁴.

Addressing chronic pain effectively requires a comprehensive approach that not only targets the physical aspects, but also considers the psychological factors that can amplify the pain experience. However, traditional pain management often falls short by focusing predominantly on medication.

Traditional Approaches and Their Limitations

Indeed, for many, the first step in managing chronic pain involves medication. Nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, opioids, and nerve pain medications are commonly prescribed to help alleviate symptoms. However, these medications come with risks. Long-term use of NSAIDs can lead to gastrointestinal issues, while opioids carry the potential for dependence and addiction. The opioid crisis has highlighted the dangers of relying on these drugs, leading many to seek alternative, non-pharmacological approaches to pain management.

Yoga Therapy: A Holistic Approach to Pain Management

Yoga therapy is uniquely suited to address the dual brain-body aspects of chronic pain. Drawing from a variety of disciplines, including psychology, neuroscience, and traditional yoga practices, yoga therapy offers a personalized approach to pain management. It goes beyond simply treating the symptoms by working to remap the brain, rebalance the autonomic nervous system, and help individuals become more present in their bodies.

In yoga therapy, the goal is not just to alleviate pain but to fundamentally change the way the brain and body experience it. Yoga techniques are selected and adapted to each individual’s condition, focusing on gentle movements, breathwork, meditation, and mindfulness. This multifaceted approach allows for a gradual reconditioning of the nervous system and rewiring of the brain, helping to reduce the intensity of pain over time.

Research Supporting Yoga Therapy for Chronic Pain

A growing body of research supports the emerging role of yoga therapy as a complementary intervention for managing chronic pain. Numerous studies have shown that yoga can reduce the perception of pain and improve quality of life in individuals with chronic conditions such as low back pain, arthritis, and fibromyalgia^{(5, 6, 7, 8)}.

A recent study by Gupta et al. (2022) emphasizes the effectiveness of yoga in reducing pain perception, enhancing functional status, and improving overall quality of life for individuals suffering from chronic non-malignant pain⁹. The study points out that yoga works by downregulating the hypothalamus-pituitary-adrenal (HPA) axis and stimulating the vagus nerve, leading to reduced stress and a decrease in the pain cascade. 

These findings bolster the argument for integrating yoga therapy into chronic pain management programs, offering patients a holistic method to manage their condition and improve their quality of life.

Innovative Approaches to Delivering and Integrating Yoga Therapy for Chronic Pain

Recent studies have explored diverse methods of delivering yoga therapy to enhance its accessibility and effectiveness in chronic pain management. One study focused on the use of telehealth for individual yoga therapy during the COVID-19 lockdown, demonstrating significant improvements in pain intensity, disability, anxiety, and depression over six weeks¹⁰. These findings suggest that telehealth-based yoga therapy could be a viable and convenient option for managing chronic pain and its psychological impacts.

Another study compared the effectiveness of delivering yoga therapy in individual, pair, and small group formats, addressing barriers such as the lack of insurance coverage¹¹. The study showed promising outcomes, highlighting the potential for broader accessibility through innovative program design.

Additionally, a white paper on yoga therapy and pain emphasizes the challenges of integrating yoga therapy into the medical system¹². It underscores yoga therapy’s ability to significantly improve function, alleviate pain, and enhance quality of life for those with musculoskeletal conditions. However, it also calls for more research to fully understand its potential and promote wider integration into pain management strategies.

All these delivery methods share a common approach: addressing chronic pain holistically through personalized and integrative yoga therapy protocols.

The Yoga Therapy Approach to Managing Chronic Pain

Yoga therapy offers a comprehensive framework for addressing chronic pain, and it is not a one-size-fits-all solution. Instead, this protocol provides an overarching approach that is tailored to each individual’s unique needs. It incorporates various strategies—such as retraining the brain, reducing the impacts of stress, addressing fear responses in the nervous system, and enhancing sensory awareness through targeted techniques—to address different aspects of pain and its effects on the brain, body, and mind. This adaptable framework allows for personalized adjustments. This ensures that the therapy aligns with each person’s specific experiences and goals for managing chronic pain.

When working with chronic pain, the primary goals of yoga therapy include:

• Remap the Brain: Techniques like quick body scans help to create new neural pathways, disrupting existing brain circuits and decreasing the brain’s focus on pain. 
• Rebalance the Autonomic Nervous System: Breathwork and pranic (energetic) practices like alternate nostril breathing, targeted breathwork, and prana nidra help to calm the nervous system and reduce stress responses such as muscular tension and that can worsen pain.
• Promote Presence: Mindfulness practices, including sound-based awareness meditations, encourage individuals to focus sensory experiences available in the present moment, helping to reduce mental suffering due to the trauma of the chronic pain experience.
• Retrain Brain-Body Communication: Gentle, small-range-of-motion movement, combined with calming breathwork, help retrain the brain by re-educating neuromuscular pathways. This combination of practices can disrupt the learned pain-movement connection. This approach not only supports nervous system relaxation, but also gradually reduces the fear associated with movement.

This personalized and multipronged approach ensures that yoga therapy addresses the complexities of chronic pain comprehensively, offering a pathway toward improved pain management and enhanced well-being.

New Options for Chronic Pain Relief with Yoga Therapy

Chronic pain is a deeply challenging condition, but it doesn’t have to define your life. Yoga therapy offers a compassionate, holistic approach that addresses both the physical and neurological aspects of pain. By working with a skilled yoga therapist, you can begin to reclaim control over your body and mind, finding relief and peace in the process. If you’re living with chronic pain, consider exploring yoga therapy as a pathway to healing and a more fulfilling life.

Contact us today to learn more about yoga therapy.

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References

1. Shirvalkar, P., Prosky, J., Chin, G., Ahmadipour, P., Sani, O. G., Desai, M., Schmitgen, A., Dawes, H., Shanechi, M. M., Starr, P. A., & Chang, E. F. (2023). First-in-human prediction of chronic pain state using intracranial neural biomarkers. Nature Neuroscience, 26(8), 1099–1110. https://doi.org/10.1038/s41593-023-01338-z
2. Kandić, M., Moliadze, V., Andoh, J., Flor, H., & Nees, F. (2021). Brain circuits involved in the development of chronic musculoskeletal pain: Evidence from non-invasive brain stimulation. Frontiers in Neurology, 12. https://doi.org/10.3389/fneur.2021.732034 
3. Crofford, L. J. (2015). Chronic pain: Where the body meets the brain. Transactions of the American Clinical and Climatological Association, 126, 167–183. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530716/ (Accessed August 15, 2024)
4. Watson, C. (2023, June 2). Thoughts inside your head can unleash physical pain, study finds. ScienceAlert. https://www.sciencealert.com/thoughts-inside-your-head-can-unleash-physical-pain-study-finds
5. Arya, S., Yadav, R. K., Venkataraman, S., Deepak, K. K., & Bhatia, R. (2022). Objective evidence for chronic back pain relief by medical yoga therapy. Frontiers in Pain Research, 3, Article 1060685. https://doi.org/10.3389/fpain.2022.1060685 
6. Evans, S., Subramanian, S., & Sternlieb, B. (2008). Yoga as treatment for chronic pain conditions: A literature review. International Journal on Disability and Human Development. Published by De Gruyter. https://doi.org/10.1515/IJDHD.2008.7.1.25 
7. Williams, K. A., Petronis, J., Smith, D., Goodrich, D., Wu, J., Ravi, N., Doyle, E. J. Jr., Juckett, R. G., Kolar, M. M., Gross, R., & Steinberg, L. (2005). Effect of Iyengar yoga therapy for chronic low back pain. Pain. https://doi.org/10.1016/j.pain.2005.02.016
8. Williams, K., Abildso, C., Steinberg, L., Doyle, E., Epstein, B., Smith, D., Hobbs, G., Gross, R., Kelley, G., & Cooper, L. (2009). Evaluation of the effectiveness and efficacy of Iyengar yoga therapy on chronic low back pain. Spine, 34(19), 2066-2076. https://doi.org/10.1097/BRS.0b013e3181b315cc 
9. Gupta, S., Gautam, S., Kumar, U., Arora, T., & Dada, R. (2022). Potential Role of Yoga Intervention in the Management of Chronic Non-malignant Pain. Evidence-Based Complementary and Alternative Medicine, 2022, Article ID 5448671. https://doi.org/10.1155/2022/5448671
10. Sharma, N., Modi, D., Nathwani, A., Pandya, B., & Joshi, J. (2020). Tele-yoga therapy for patients with chronic pain during COVID-19 lockdown: A prospective nonrandomized single arm clinical trial. Preprint. https://doi.org/10.1101/2020.07.16.20154229
11. Moonaz, S., Whitehead, A. M., Lawrence, L., Natividad, D., Kindred, D., Nielsen, A., & Teets, R. (2022). Yoga therapy DYADS: A novel approach to chronic pain management in underserved populations. Explore, 18(2), 195-199. https://doi.org/10.1016/j.explore.2020.12.002  
12. Pearson, N., Prosko, S., Sullivan, M., & Taylor, M. J. (2020). White paper: Yoga therapy and pain—How yoga therapy serves in comprehensive integrative pain management, and how it can do more. International Journal of Yoga Therapy, 30(1), 117. https://www.iayt.org