Yoga & Chronic Pain
By Darren Main • Spring 1999
Yoga promises many benefits, such as stress management and spiritual growth, but I believe that the benefit that attracts people to yoga most often is its effectiveness in dealing with chronic pain.
It seems few Americans live free of pain. Back and neck pains are more common than hangnails. For many, persistent pain has become such a way of life that they have long forgotten their days free of discomfort and restriction in the body. In a sense, many experience their bodies as a prison rather than as a temple.
Although yoga has become a new buzzword in the treatment of pain, it was viewed by the medical profession not so long ago as a new-age fad. It is so refreshing to see the tides turning. In any given week, I see two or three new yoga students who have sought out yoga on the advice of their doctor, chiropractor or physical therapist.
With so much interest in yoga’s ability to manage, and in some cases alleviate pain, I thought it would be appropriate to explore just how yoga works, and how it can best be used in chronic pain situations.
Yoga works on three levels. The most obvious level is the physical. Often when a new student comes into my class, his or her first comment is, “I had no idea I was so tight.” This should not be surprising when you consider the average American lifestyle. Before we can really understand why yoga works so well on pain in the body, we need to understand why so many people are in pain to begin with.
Our bodies have been evolving slowly over thousands of years. Evolution has prepared our bodies for lots of physical activity. In the early years of human history, we were hunters, actively seeking out our dinner and shelter. As we evolved, we became farmers, still requiring huge amounts of physical activity. More recently we became industrialized, again giving us more security, but still requiring constant movement.
With each of these changes, there were countless generations in which the powers that be could evolve the human body to match the evolution of our minds. Things worked fairly smoothly until our most recent evolutionary leap into the technological age.
In less than twenty-five years, not even a full generation, we have gone from doing at least some physical labor each day as a part of our work, to doing almost nothing. Keep in mind that I am sitting here typing away on my Macintosh, so I am in no way opposed to technology. Our minds have evolved far faster than our bodies. Our bodies were designed to reach and climb, to pick up rocks and build shelters—not to sit on our rumps.
Anyone who has taken a yoga class will tell you that it is anything but static. In most classes you move and stretch, you sweat and deeply work the body. It is an incredible exercise that moves the body more thoroughly than most other forms of exercise. The skeletal muscles of the body get lengthened and toned, fibrous scar tissue in the muscles gets aligned with muscle fibers for better and more efficient movement, and blood flow reaches deep into the muscles to flush out toxins and supply nutrients. Fascia, the connective tissue that encases our muscles and organs like plastic wrap, gets untangled and unstuck allowing for a wider range of motion. The internal organs get massaged and cleansed and the endocrine system gets regulated. Joints get lubricated, the nervous system gets stimulated, and the spine is encouraged to lengthen and align.
With this happening, people naturally feel better after a yoga class. Generally, a person with chronic pain will feel some instant relief. As balance is restored to the body, many forms of pain can be erased all together.
Second, yoga works at the emotional level. In the past we had a “tribe” of interconnected people who we could count on for support and emotional venting. This tribe included family, neighbors and members of our churches and synagogues. As community has diminished, family and friends have become more distant, and the avenues for emotional expression have been reduced, individuals tend to hold more in.
Because we have fewer safe and nurturing opportunities to express these emotions, they solidify and take form in the body. At first they manifest as small things like weight gain or loss, stooping posture, or a stiff neck or shoulders. Then more annoying symptoms emerge, such as muscular pain, headaches, and a weakened immune system. Eventually, these unexpressed emotions will manifest in more life-threatening ways such as cancer and heart disease. Yoga can release emotions safely and supportively. Some people will experience an emotional release during or shortly after their yoga practice. This can come in the form of tears or laughter or may just manifest itself in a general shift in one’s emotional state. Sometimes yoga just brings an overall sense of peace and wellbeing. In some strange way, the practice seems to free us from the emotional stresses we tend to hold trapped in our bodies. Letting go of pent up emotions is like releasing steam from a pressure cooker—you can’t help but feel better. Though emotions held by the body are not the cause of all chronic pain, they are often a contributing factor.
The third level which yoga affects is the psychological. Our attitude and relationship towards pain influence how intensely we experience it. In a yoga practice, we intentionally put ourselves in poses that are uncomfortable. As we breathe and relax into the pose, what was once painful and uncomfortable becomes pleasurable and joyful. What we learn is that our fear of discomfort plays a large role in how intensely we experience pain.
In our modern world we have a pill for everything and we are taught from a young age we should place as much distance as possible between ourselves and pain. Yoga teaches us to reverse that perception. Through yoga, we learn that pain is neither good nor bad, but simply the body’s way of speaking to us. We stop running from the pain.
Through the practice of yoga we begin to explore pain by moving consciously into it. We trust that our body is not our enemy and that when it screams out with pain, it is because something is wrong. By practicing yoga, we increase our awareness of the body’s feedback so it doesn’t have to scream quite so loudly to get our attention. When we pop a pill, we deny ourselves the opportunity to listen to the body, to ask what it needs, and to provide it with whatever support we can to both relieve the pain and to achieve healing.
Having established that yoga deals with pain on several levels, let’s look at how best to implement yoga in a way that is most safe and effective.
First, remember that yoga is not a cure for everything and is actually contra-indicated in a few rare circumstances. As we discussed above, pain is never without a cause, and whenever possible, the student and the teacher need to know what that cause is. One way to do this is to consult a physician. Never assume that yoga is your cure if you don’t know what is wrong.
Let’s assume you have chronic headaches. Headaches can be caused by anything, including stress, diet, vision abnormalities, allergies, or even a tumor. I’m not saying that each time you have a headache you should see a doctor, but if the headaches are chronic, severe or persistent, it is essential that you discover their cause before you start standing on your head. In most cases the physician will give the go ahead, or he or she may encourage you to modify your practice or avoid yoga all together.
Second, western medicine and eastern healing techniques work best when they are used in concert with each other. Before you decided to abandon any medication you might be taking, it is important that you consult your physician. Also, if you are being treated by a doctor or have any health issues, no matter how small they may seem to you, be sure to inform your yoga instructor.
Third, listen carefully to your inner physician and your inner yoga instructor. If you are doing something in a class that just doesn’t feel right in your body, stop. Check in with your instructor. You can usually modify your practice to support your body’s opening. If a modification can’t be made, omit that pose from your practice. Your body’s wisdom should be your first authority—neither your doctor nor your yoga instructor knows your body like you. They are simply guides helping you explore the vast territory of your body.
Fourth, give the practice a little time. Most injuries did not occur in an hour and a half, so believing all pain with be gone after one yoga class is unrealistic (though I have seen several cases where that has happened). As I mentioned above, most people will feel some relief after one class, but managing pain and staying pain-free usually involves a lifestyle change.
Fifth, find the appropriate class. If you aren’t currently practicing yoga, I would recommend a gentle or beginner class to start. Depending on your condition, you may be able to quickly move to a more challenging class. You also many want to work privately with a teacher. I also have a number of restorative classes which are perfect for chronic pain issues.
I suppose the last thing I would say, and perhaps the most important thing is this: don’t settle for a life that is filled with discomfort. Through yoga and other healing arts, I believe most pain can be reduced or alleviated completely. Take charge of pain, instead of letting it run your life. Remember that the body should be your temple, not your jail.
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