Yoga for Chronic PainBy Kelly McGonigal
Most chronic pain has its roots in a physical injury or illness, but it is sustained by how that initial trauma changes not just the body but also the mind-body relationship. The complexity of chronic pain is actually good news. It means that trying to fix the body with surgeries, pain medications, or physical therapy is not your only hope. By first understanding chronic pain as a mind-body experience and then using yoga’s toolbox of healing practices—including breathing exercises and restorative poses—you can find true relief from pain and begin to reclaim your life.
The Protective Pain Response
Understanding the difference between acute pain and chronic pain will be critical to your ability to reduce and manage your pain. Let’s begin by examining the basic steps of the pain response: sensation, stress, and suffering.
The protective pain response begins when the body experiences some physical threat, such as a cut, a burn, or an inflamed muscle. This threat is detected by specialized nerves and sent through the spinal cord and up to the brain where, among other things, the threat signals are transformed into pain sensations. Emotion-processing areas of the brain also get the message, triggering a wide range of reactions, from fear to anger. Combined, your thoughts and emotions about the physical sensations of pain make up the suffering component of the full pain experience. Any kind of injury or illness, even one that is short-lived or appears to be fully healed, can change the way the nervous system processes pain.
Through the repeated experience of pain, the nervous system gets better at detecting threat and producing the protective pain response. So unfortunately, in the case of chronic pain, learning from experience and getting “better” at pain paradoxically means more pain, not less.
What you practice, you become. Learning is lifelong, and none of the changes you’ve learned have to be permanent. Your mind and body have learned how to “do” chronic pain, and your job is to teach it something new.
Unlearning Pain Through Relaxation
The best way to unlearn chronic stress and pain responses is to give the mind and body healthier responses to practice.
By helping you transform chronic pain-and-stress responses into “chronic healing” responses of mind and body, yoga helps reduce your suffering of chronic pain. Your mind and body have built-in healing responses that are just as powerful as their protective pain-and-stress responses. Relaxation specifically has been shown to be healing for chronic pain. It turns off the stress response and directs the body’s energy to growth, repair, immune function, digestion, and other self-nurturing processes. Consistent relaxation practice teaches the mind and body how to rest in a sense of safety rather than chronic emergency.
Restorative yoga turns on the healing relaxation response by combining gentle yoga poses with conscious breathing. There are several factors that make restorative yoga so relaxing. First, each pose is meant to be held for longer than a few breaths. You can stay in a restorative pose for 10 minutes or even longer. The stillness allows the body to drop even the deepest layers of tension. Second, restorative poses use props to support your body. Props can include the wall, a chair, a couch, pillows, blankets, towels, or bolsters designed especially for restorative yoga practice. The right support in a pose will make it feel effortless, so your body can fully let go.
You shouldn’t feel strong sensations of stretch or strength the way you might in a more active yoga pose. Stretching and strengthening, although healthy, are both forms of tension in the body. They are a kind of good stress on the body, asking the body to adapt to the challenges of a pose. But restorative yoga is all about letting go of tension and stress.
Although these poses may look as though you are doing nothing, this is far from the truth. Restorative yoga rests the body but engages the mind. The breathing elements of each pose make restorative yoga an active process of focusing the mind on healing thoughts, sensations, and emotions.
The order of poses presented here is just one possible sequence. As you explore the poses, you may find that your body prefers a different sequence or that you would rather stay longer in one pose than practice several poses for shorter periods. You can also integrate restorative poses into an active yoga session.
Nesting pose creates a sense of security and nurturing. It may also be a position you are comfortable sleeping in, making it an excellent posture to practice if you have insomnia or other difficulty sleeping.
Lie on your side, legs bent and drawn in toward your belly. Rest your head on a pillow, and place a pillow or a bolster between your knees. Rest your arms in whatever position feels most comfortable. If available, another bolster or pillow may be placed behind your back for an extra sense of support.
Rest in the natural rhythm of your breath, observing each inhalation and exhalation as it moves through the body. Take comfort in the simplicity and effortlessness of this action.
Supported Bound Angle Pose
This pose relaxes tension in the belly, chest, and shoulders that otherwise can restrict the breath. Lean a bolster on a block or other support (such as telephone books). Sit in front of the bolster with your legs in a diamond shape. Place a pillow or a rolled blanket under each outer thigh and knee, making sure that the legs are fully supported without a deep stretch or strain in the knees, legs, or hips. Lean back onto the bolster so that you are supported from the lower back to the back of the head. Rest your arms wherever is most comfortable.
Now notice the whole front of your body relax and gently open as you inhale. Follow this sensation and feel the ease in the front of the body as you breathe.
Supported Backbend Pose
Supported backbend is a heart-opening pose that reinforces your desire to embrace life and not let challenges—including pain—separate you from life. This pose also works magic to release chronic tension in the back and shoulders, undoing postural habits that come from spending too much time at a desk, at a computer, or driving.
Sitting, place a bolster or a stack of pillows or blankets under slightly bent knees. Place one folded pillow or rolled blanket or towel behind you; when you lie back, it should support the upper rib cage, not the lower back. If you need extra support underneath the lower rib cage and lower back, roll a small towel to support the natural curve of the spine. Place a rolled towel or a small blanket to support your head and neck at whatever height is most comfortable.
This pose improves the flow of the breath in the upper chest, rib cage, and belly. Allow yourself to feel this movement as you inhale and exhale. Imagine breathing in and out through your heart center. Visualize the movement of breath from your heart to your lungs as you inhale, and from the lungs back out through the heart center as you exhale.
Supported Forward Bend
This pose relaxes the hips and back, unraveling the stress of daily activities on the spine. Hugging a bolster and resting your head on its support provides a natural sense of security and comfort.
Sit cross-legged on the floor. Lean forward onto the support of a sofa, a chair, or a stack of pillows, blankets, or cushions. If you have a bolster, place one end in your lap and the other end on the sofa, the chair, or the stack of support. Rest your head on whatever support is available. If you are using the bolster, you can hug it in any way that feels comfortable, turning your head to the side. Be sure that whatever support you are using is high enough and sturdy enough to support you, without creating strain in the back or hips. If you feel a strong stretch that is uncomfortable to hold, you need more support.
In this pose, the belly, chest, and back all expand and contract with each breath. Feel the movement of the whole torso as you inhale and exhale. Feel your belly and chest gently press into the support of the bolster or pillows as you inhale. Let the sensation of your breath deepen the sensation of being hugged.
These simple relaxation practices will lead you on the path of ending your suffering. Yoga can teach you how to focus your mind to change your experience of physical pain. It can give you back the sense of safety, control, and courage that you need to move past your experience of chronic pain.
Kelly McGonigal is the editor in chief of the International Journal of Yoga Therapy.
This article is excerpted from her book, Yoga for Pain Relief: Simple Practices to Calm Your Mind and Heal Your Chronic Pain, which is available at Amazon.com.