Chronic Pain: How Yoga Can Help
When I first met Diane Dixon she had been living with constant hip pain for five years. Her doctor diagnosed her with fibromyalgia and recommended weight loss and a double hip replacement.
She needed a walker and a scooter to maintain the limited mobility she still had. When she did sleep, she slept in a lounge chair on heating pads because lying in bed caused her too much pain.
“Chronic pain affects every part of your life,” says Dixon. “Simple things such as movies were impossible because it was just too painful to walk the long hall and climb the steps to the seats. It affected me emotionally because dealing with chronic pain created depression. It affected me physically because I found myself doing less and regressing due to the pain. It affected my relationship with friends and family because they could not understand why I wouldn’t go out and have fun.”
Diane and I began private yoga sessions in her home utilizing her chair and walker as tools to help her twist and stretch. Six weeks into our sessions she was seeing improvement but needed some rest and relief.
I encouraged her to just try and get into her bed. We used her yoga bolster to prop her legs to allow her hips to rest and began a gentle pranayama practice. After about 20 minutes I turned out the lights and tiptoed out of her room.
“I just woke up,” she texted me two hours later. “That’s the first time I slept in my bed in almost four years!”
The Institute of Medicine (IOM) estimates 100 million Americans suffer from chronic pain at a cost of about $600 billion per year in medical treatments and lost productivity. A 2011 IOM committee reported to Congress that better pain management and access to pain medication is needed for those chronic pain suffers. Yet the report mentioned nothing about alternative treatments.
Multiple recent studies have shown the benefits of movement-based therapies for those suffering from chronic pain. Yoga, in particular, has been proven to alleviate both pain and depression, which often go hand in hand with chronic pain patients.
The American Pain Society recently released a study by the National Institutes of Health (NIH) explaining that imaging studies have shown both chronic pain sufferers and depressed patients have decreased gray matter in their brains.
Gray matter is simply brain tissue with numerous cell bodies. It is located in the cerebral cortex and subcortical areas. The NIH study offers evidence that yoga actually increases the gray matter in the brain, specifically in the insula or internal structures of the cerebral cortex, thus providing greater pain tolerance.
“I know most people would think the most important relief I got from yoga would be the physical relief. However, I think the emotional relief I received was just as important,” said Dixon. “With each step I improved, small as it seemed to me, I slowly began to have hope again. “
The slow rhythmic breathing of yoga helps chronic pain sufferers to reduce their stress levels, lower their heart rate and calm their autonomic nervous system. Slowing the autonomic nervous system also reduces cortisol and epinephrine levels in the body.
High amounts of cortisol and epinephrine over a long period of time can cause inflammation in the body. Inflammation leads to joint and muscle pain.
Using pranayama techniques to activate the parasympathetic nervous system will also increase the patient’s ability to deal with the stress of chronic pain, as well as the stress of having a condition that is not always believed to be true both by family members and their own doctors.
A 2009 study published in the journal, Alternative Therapies in Health and Medicine, followed 30 men and women with long-term back pain who participated in a 12-week yoga session. After the 12 weeks, the yoga students were using fewer analgesics and opioids for pain and reported greater overall improvement in the quality of life.
As Diane experienced, fibromyalgia patients, as well as others who live with chronic pain, also must live with constant fatigue from poor sleep due to the pain they are experiencing.
Yoga Nidra can be an effective tool to help induce restorative sleep. EEGs have shown that Yoga Nidra increases alpha brain waves, which in turn relaxes the nervous system.
While the medical community is slowly beginning to recognize the benefits of yoga for chronic pain, those suffering from pain must also be willing to break the cycle of inactivity. Long-term pain, combined with depression, leads many patients to a chronically sedentary lifestyle.
A less-is-more approach is best for someone beginning a yoga practice. Gentle, restorative poses, using as many props as necessary to support the body, are recommended for chronic pain students. Remembering that the student is already in sensory overload due to pain, vinyasa yoga, classes with loud music and hot yoga would not be ideal for a chronic pain sufferer.
Since beginning her yoga practice, Diane has had two hip replacements, weight loss surgery, bypass surgery, has finished a 5K and still regularly goes to the gym and practices yoga.
Even more impressive, her doctors now say she does not have fibromyalgia.
“Did I actually have it? Who knows? I had the same symptoms as fibromyalgia and those disappeared after starting yoga,” she says. “It has been years since that day I decided to try yoga. I work out three to five days a week and each time I ride the bike, I say a thank you prayer for yoga.”