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Pain
Everyone has experienced pain. But not everyone experiences pain the same way.
For centuries, pain was believed to be caused by damage to tissue. It was assumed that the more severe an injury, the more intense the pain would be. But now we know that pain and tissue damage do not go hand in hand.
Pain can be caused by inflammation, injury, can be a result of disease, but sometimes we experience pain with no detectable cause.
Pain that lasts for a short period of pain is called acute pain. Acute pain begins suddenly and has a clear known cause. This pain is usually sharp and persists until the cause of the pain has been detected, treated, and healed. This usually lasts a few moments, days, weeks, or possibly up to six months.
Pain that persists for more than six months is called chronic pain.
Chronic Pain
Chronic pain is pain that lasts longer than three months. This is past the time it takes for normal tissue to heal. Some chronic pain has a known cause - but doesn’t always.
According to the Cleveland Clinic: “Chronic pain is pain that is ongoing and usually lasts longer than six months. This type of pain can continue even after the injury or illness that caused it has healed or gone away. Pain signals remain active in the nervous system for weeks, months or years. Some people suffer chronic pain even when there is no past injury or apparent body damage.”
Some causes of chronic pain are:
- Headaches
- arthritis
- cancer
- nerve pain
- years of poor posture (This could manifest as back pain, neck pain, shoulder pain, etc)
- multiple sclerosis
- ulcers
- some diseases such as AIDS and gallbladder disease
- fibromyalgia
Chronic pain can also give rise to several other issues, including psychological problems like depression and anxiety, fatigue, muscle tension, limited mobility, and changes in appetite that could cause weight gain or weight loss.
Chronic pain affects up to 65% of the US population.
How Does Pain Work?
When sensory nerves receive input, they send signals to the spinal cord that travel up to the brain. The brain then sends signals back to the body, which we interpret as pain. For example if you step on a Leggo, the sensory receptors send signals up through the spinal cord to the brain where the brain then sends pain signals back which lets you know you need to move your foot.
The brain also sends signals to other parts of the brain - like the limbic system, which is the emotional center of the brain. This is why sometimes we cry, our heart rate increases, and we may even start to sweat when we experience pain.
Nociception
Pain receptors, called nociceptors, activate when you get injured and also when there’s potential for injury.
Nociception is part of the nervous system’s response to harmful or potentially harmful stimulation. Three types of stimuli can activate these receptors
- Thermal - like when you touch a hot stove
- Mechanical - like when you step on a Leggo, stretch or strain a muscle, and
- Chemical - which can refer to chemical changes like inflammation.
When these receptors send signals to the brain, the brain then determines how much pain to send to the body depending on how harmful it deems the threat.
Other Factors
Other factors can also determine how much pain is sent to the body. For example, if these receptors are activated repeatedly, the brain can decide these receptors should be more sensitive to protect the body from further injury. Over time these receptors can become so sensitive that even a light touch may induce pain. In some cases, the nerves learn to send more efficient pain signals. In this case the message is amplified - and so is the pain. This is common in people who live with chronic pain.
The longer this pain continues, the harder it is to become less sensitive.
Factors such as mood, expectations, and past experiences can also determine how painful an experience will be. If you’re in a great mood, stepping on a Leggo may not feel as painful as if it happened when you were stressed or angry. If you’re already stressed because your kid didn’t do their homework and made a huge mess, stepping on that Leggo will be much more painful.
Your support network of family and close friends can also determine your experience of pain. Adults who had little support from their family or had traumatic childhoods may be more sensitive to pain.
Yoga Breathing Exercises
Breathwork or yoga breathing exercises have been studied as a pain management tool. When a person struggles with chronic pain, their nervous system is in a reactive state. The sympathetic nervous system is activated - this is the fight or flight response. As mentioned earlier, those with chronic pain often struggle with anxiety and depression as a result of this fight or flight response being constantly activated.
Breathwork has been proven to activate the parasympathetic nervous system - this is the rest, digest, and heal part of the nervous system and the body’s relaxation response.
Through working with the breath, you can activate the parasympathetic nervous system and change your heart rate - and even alter your brain waves.
Breathing Exercises For Pain Management
Specifically, slow deep breaths activate this part of the nervous system. And the effects of breathwork can last for hours.
Some types of breathwork to use and to offer to your students are Intra-Abdominal Pressure (IAP) breathing, Ujjayi, and Nadi Shodhana
Intra-Abdominal Pressure Breathing
This breathing technique is simple enough for beginners but very effective.
Steps:
- Begin by sitting, standing, or laying down with a neutral spine - avoid rounding or arching your back.
- Inhale and inflate your belly and low back equally. Feel the pressure of the breath in your abdomen, and feel your rib cage expanding. Avoid sucking the belly in. It should feel like you’re filling up your belly like a balloon.
- Exhale slowly.
- And repeat!
Ujjayi
Ujjayi breath has the added benefit of stimulating the vagus nerve - which also affects the parasympathetic nervous system.
To practice this yoga breath, repeat the same steps as above - but add some constriction in the back of your throat. This constriction makes a sound like the ocean and can be a good anchor point for your attention.
Steps:
- Begin by sitting, standing, or laying down with a neutral spine - avoid rounding or arching your back.
- Lightly constrict the back of your throat in the same way you would when speaking in a whisper or fogging up a mirror with your breath. Inhale maintaining this constriction and inflate your belly and low back equally, as though filling up your belly like a balloon.
- Exhale slowly with this same constriction. At first it may be easier to maintain this constriction during the exhalation. For beginners, it may be easier to inhale normally and exhale with the constriction.
- Repeat for several deep breaths or several minutes.
Nadi Shodhana
Nadi Shodhana is a style of pranayama where you alternate breathing through opposite nostrils. For this breathing technique, you’ll need to inflate your belly as in IAP, but do not constrict the back of the throat.
Steps:
- Begin by sitting, standing, or laying down with a neutral spine - avoid rounding or arching your back.
- Place your dominant hand in front of your face. If you’re right handed, you’ll use your thumb to close off your right nostril, and your ring finger to close off your left. If you’re left handed, the thumb closes the left nostril and the ring finger closes off the right nostril.
- Begin by touching your thumb to your right nostril to close it off gently. Inhale through your left nostril and inflate your belly and low back equally.
- Close off your left nostril and release your finger from the right nostril. Exhale slowly through the right nostril.
- Keep the left nostril closed off as you inhale through the right side.
- Then close off the right nostril, and exhale through the left.
- This completes one round of Nadi Shodhana. Repeat seven rounds, or more if desired.
- Note: it may help to blow your nose before practicing Nadi Shodhana.