Yoga & Chronic Pain

As part of my studies I came across a summary of a study I want to share. It was published by the Mayo Clinic. The

original study comes from opioidlibrary.org circa 2014, and is titled “Practical Application of Yoga-based Techniques

in the Treatment of Chronic Pain”. Though too comprehensive for the purposes of this blog, here are a few excerpts

from the study:

Chronic pain affects an estimated 116 million American adults, more than the total affected by heart disease,

diabetes, and cancer combined. Chronic pain costs the nation $560-$635 billion each year in medical treatment

and lost productivity.

Pain is a major driver for physician visits, medication prescriptions, disabilities, and is a detrimental factor in quality

of life and productivity. Given the burden of pain in human lives, expense and social consequences, relieving pain

should be a national priority.

Simple pain has been defined as “a warning mechanism that helps protect an organism by influencing it to withdraw

from harmful stimuli”. Chronic pain is ongoing or recurrent pain lasting beyond the usual course of acute illness or

injury, generally more than 3-6 months and adversely affecting the individual’s well-being. Chronic pain creates

changes in the CNS (central nervous system) and accompanied by depression and/or anxiety. Chronic pain triggers

changes in the brain, which result in altered pain threshold (the brain gets “better” at feeling pain), pain intensity and

emotional affect. There are a multitude of conditions related to chronic pain. Some of the more common conditions

include the following: Chronic low back pain, Fibromyalgia, Chronic Fatigue Syndrome and Complex Regional Pain

Syndrome.

What role does yoga therapy play in chronic pain? To quote BKS Iyengar, “Yoga teaches to cure what need not be

endured and endure what cannot be cured”. Yoga is a complete “how-to-live system” originating in Asia. The

purpose is optimal physical, emotional, and spiritual health. Yoga is also defined by Timothy McCall, MD, as

follows: “Yoga is a systematic technology to improve the body, understand the mind, and free the spirit”. In

Patanjali’s Yoga Sutra, a path of 8 elements is outlined, summarizing the process and tools that can bring peace,

wisdom, and well-being. Many of these elements are used as guidelines for using Yoga in the treatment of chronic

pain and related conditions in therapeutic settings.

In a comparative study that measured the efficacy of exercise and a self-care book vs. yoga for chronic low back

pain, after 12 weeks the yoga group was better functioning (per Roland disability scale) compared to the book and

exercise group. Participants also reported less pain after 26 weeks in comparison to the exercise/book group.

Another study evaluated the effects of a comprehensive yoga intervention on fibromyalgia symptoms and coping.

Practices included gentle poses, meditation, breathing exercises, yoga-based coping techniques and group

discussions. Physiological changes which occurred that alter the pain experience included the following: decreased

SNS (Sympathetic Nervous System/“fight or flight”) activity, decreased inflammatory markers, decreased stress

markers (cortisol), and increased flexibility, strength and endurance. Behavioral changes that influence pain

include: decreased social isolation, increased social networks/activity, and increased activity at home.

Psychological changes found in women with fibromyalgia who were assigned to the multifaceted yoga program

include the following: increased awareness of mental and physical state, increased understanding of pain,

increased frequency of positive emotions, increased physical, social, and psychological resources, increased pain

acceptance, and increased self-efficacy for pain control.

Yoga therapy can be a very effective tool in reducing suffering of individuals suffering from chronic pain, anxiety and

depression, as well as fibromyalgia and many other conditions resulting in chronic pain. My personal experience

with chronic pain is what led me to this path, and therapeutic yoga practices have made such a difference for me

that I decided to become a certified yoga therapist.