How Does Yoga Relieve Chronic Pain?

Chronic pain triggers changes in brain structure that are linked to depression, anxiety, and impaired cognitive function. New research shows that practicing yoga has the opposite effect on the brain and can relieve chronic pain.

Chronic pain alters brain structure. Brain imaging studies have shown that chronic pain leads to changes in gray matter volume and the integrity of white matter connectivity. Gray matter is home to the neurons in specific brain regions, while white matter creates communication lines between your various brain regions.

In a recent lecture, “Effect of Environment on the Long-Term Consequences of Chronic Pain,” at the American Pain Society's(link is external) annual May 2015 meeting in Palm Springs, M. Catherine Bushnell, presented findings from cutting edge research on the ability of yoga to counteract chronic pain that she's spearheading at NIH/NCCIH.

Catherine Bushnell(link is external), PhD, is scientific director of the National Center for Complementary and Integrative Health (NCCIH) at the U.S. National Institutes of Health (NIH) where she oversees a program on the brain’s role in perceiving, modifying, and managing pain. In a press release, Bushnell summed up the findings of her research by saying, "Practicing yoga has the opposite effect on the brain as does chronic pain." 

Bushnell and her colleagues are conducting research aimed at discovering non-pharmacological treatments for pain. They've found that chronic pain can be prevented or reversed through mind-body practices. Lifestyle choices—such as practicing yoga or meditation—have been shown to reduce pain perception and offset the effects of age-related decreases in gray matter volume while helping to maintain white matter integrity. 

Reduced gray matter volume can lead to memory impairment, emotional problems, and decreased cognitive functioning. Hyper-connectivity of white matter tracts between brain areas associated with negative emotions and pain perception can hardwire these corresponding states of mind.

The researchers used diffusion tensor brain imaging to analyze gray matter volume and the integrity of white matter tracts. Bushnell hypothesizes that increased size and connectivity of the insular cortex is probably the most important brain factor regarding changes in an individual's pain tolerance and thresholds.

Yoga appears to bulk up gray matter through neurogenesis and strengthen white matter connectivity through neuroplasticity. After assessing the impact of brain anatomy on pain reduction, Bushnell believes that gray matter changes in the insula or internal structures of the cerebral cortex are the most significant players involved in chronic pain.

"Insula gray matter size correlates with pain tolerance, and increases in insula gray matter can result from ongoing yoga practice," said Bushnell. Yoga practitioners have more gray matter than controls in multiple brain regions, including those involved in pain modulation. Bushnell stated, 

Brain anatomy changes may contribute to mood disorders and other affective and cognitive comorbidities of chronic pain. The encouraging news for people with chronic pain is mind-body practices seem to exert a protective effect on brain gray matter that counteracts the neuroanatomical effects of chronic pain. Some gray matter increases in yogis correspond to duration of yoga practice, which suggests there is a causative link between yoga and gray matter increases.

Rodent studies have shown that increased levels of stress alters pain behaviors, whereas socially and physically enriched environments reduce reduce pain-related brain changes. These findings in both humans and animals indicate that the adverse effects of chronic pain can be reduced, or prevented, by altering environmental factors and making lifestyle choices that improve the pain modulatory systems in the brain.

Yoga Increases Gray Matter Brain Volume and White Matter Connectivity

Bushnell has been working with Chantal Villemure to study the benefits of yoga on chronic pain. In their recent study, they focused on people who had been practicing yoga regularly for at least six years and compared the "yogis(link is external)" to healthy people who didn't practice yoga but were matched for age, sex, education, and other exercise.

Bushnell and Villemure found dramatic differences in gray and white matter between the general population and the yoga practitioners. As Bushnell explains,

We found from brain anatomy studies that the people practicing yoga had more gray matter in a number of regions; as we get older, we lose gray matter, but we didn’t see that decrease in the yoga practitioners, which suggests that yoga may have a neuroprotective effect. When we looked at pain perception, there was a significant increase in pain tolerance in the yoga practitioners, and there was a change in pain thresholds, too.

Villemure has a theory that many of the benefits of yoga might be related to autonomic nervous system and stress reduction as it relates to chronic pain. The autonomic nervous system has two branches: the sympathetic nervous system(link is external) and the parasympathetic nervous system(link is external). Villemure is also examining how yoga practitioners might have a different method of coping with the anticipation of pain.

When most people are expecting pain, it triggers the “fight-or-flight" response of the sympathetic nervous system which causes cortisol levels to skyrocket. On the flip side, Villemure observed that when yogis anticipate pain, their parasympathetic nervous system activates. This creates a "tend-and-befriend" or "rest-and-digest" response, as opposed to a "fight-or-flight" response.

Conclusion: Yoga Is a Viable Drug-Free Treatment Option for Chronic Pain

Most of the pharmacological treatments for chronic pain are opioid based and are highly addictive. Luckily, the effectiveness of non-pharmacological interventions such as yoga and meditation have been shown to have potent pain-relieving effects on the brain. In the long run, alternative treatments for pain, such as yoga, could be more effective than pharmaceutical treatments for relieving chronic pain. 

This article originally appeared on psychologytoday.com and was written by Christopher Bergland.

Upcoming Posture & Movement Training Workshop: Alexander Technique

Re-learning to move easily & efficiently, the way we were designed to, by identifying and changing learned overcompensation habits. Unlock your body...

The Alexander Technique

...is an intelligent way to solve body problems.  Many people are mystified by their own back pain, excess tension or lack of coordination.  They often see problems in their joints or muscles as structural, unchangeable.  As an Alexander teacher, I hear clients say things like, "I've always walked like a duck," or "My posture is just like my father's."  But, as they learn the Technique, they are surprised that they really can make lasting changes in the way they walk, their degree of muscular tension or the shape of their posture.  They learn how dynamic and changeable the body really is.  They find that, by learning the Technique, they can improve their overall movement and achieve optimal health for both body and mind.
 

We all have unconscious movement habits. 

Without realizing it, we put undue pressure on ourselves.  We use more force than we need to lift a coffee pot or a weight bar.  We slouch as we sit, unaware that our way of doing things gives our bodies a certain look.  We blame body problems on activities -- carpal tunnel syndrome on computer work, tennis elbow on tennis.  But often it is how we do something that creates the problem, not the activity itself.

An Alexander Technique teacher helps you see what in your movement style contributes to your recurring difficulties -- whether it's a bad back, neck and shoulder pain, restricted breathing, perpetual exhaustion or limitations in performing a task or sport.  Analyzing your whole movement pattern -- not just your symptom -- the teacher alerts you to habits of compression in your characteristic way of sitting, standing and walking.  He or she then guides you -- with words and a gentle, encouraging touch -- to move in a freer, more integrated way. 

The Technique's basic idea is that when the neck muscles do not overwork, the head balances lightly at the top of spine.  The relationship between the head and the spine is of utmost importance.  How we manage that relationship has ramifications throughout the rest of the body.  As the boss -- good or bad -- sets the tone for an organization, the head / spine relationship -- compressed or free -- determines the quality of the body's overall coordination.  Our neuromuscular system is designed to work in concert with gravity.  Delicate poise of the head sparks the body's anti-gravity response: a natural oppositional force in the torso that easily guides us upward and invites the spine to lengthen, rather than compress, as we move.  Instead of slouching or holding ourselves in a rigid posture, we can learn to mobilize this support system and use it wherever we go -- in the car, at the computer, in the gym.

Young children have this natural poise. If you watch a toddler in action, you will see an erect spine, free joints and a large head balancing easily on a little neck.  A healthy child walks and plays with regal posture.  Barring birth defects, we all began that way.  But over the years, we often lose that spontaneity and ease.
 

Using the Alexander Technique

...you can learn to strip away harmful habits, heighten your self-awareness, and use your thought process to restore your original poise.  In a way, you are learning something that, deep down, your body already knows.  With the Alexander Technique, you come to understand much more about how your body works, and how to make it work for you.  You can tap more of your internal resources, and begin on a path to enhancing your comfort and pleasure in all your activities. (Originally written by Joan Arnold and appeared on alexandertechnique.com)

The Alexander Technique is a way to feel better, and move in a more relaxed and comfortable way... the way nature intended.

An Alexander Technique teacher helps you to identify and lose the harmful habits you have built up over a lifetime of stress and learn to move more freely.

The Alexander Technique is for you if you are ready to feel more comfortable in your own body.

The Alexander Technique can also help you if:

• You suffer from repetitive strain injury or carpal tunnel syndrome.

• You have a backache or stiff neck and shoulders.

• You become uncomfortable when sitting at your computer for long periods of time.

• You are a singer, musician, actor, dancer or athlete and feel you are not performing at your full potential.
   

Upcoming Alexander Technique Workshop

December 27, 10am - 12pm workshop*
12:30pm - 6:30pm 60 minute private lessons**

PAY BY DONATION* **
** bring with you what you want to work on, like an instrument or a movement, or discuss a posture problem or goal you'd like addressed.

Learn to move with momentum, with the natural fascial lines in your body and how to identify and unravel compensations and tensions in your musculoskeletal system that contribute / lead to chronic pain.

Performing artist, actor, singer and theatre director, Holly Cinnamon, returns to Edmonton from her theatre studies in Boston for a limited time. Sharing strategies she has applied in her personal life and career to train and fine tune her body like a musical instrument and tool.

Holly’s journey as a yogini began 8 years ago when she started attending classes at Shanti Yoga in Edmonton while studying her undergraduate degree in theatre. As a trauma survivor, Holly discovered yoga’s power to heal and free tensions and traumas from the body, allowing her to regain an ownership of her body and a sense of wholeness that she felt she had lost. From digging deeply to rediscover her own body, Holly became deeply interested in experiential anatomy - asking how we experience our structure thorough internal sensation rather than external analysis. 

An incredibly sensitive person since birth, Holly has discovered strength in sensitivity through her work as a yoga teacher. She enjoys giving her students the gift of rediscovering themselves in the present moment, freeing themselves from judgment, and finding joy in the gift of living in a body on this earth and moving with gratitude. Holly has trained in Yin Yoga with Joe Barnett, a primary teaching assistant of Paul Grilley and completed her 200-hour teacher training through YogaWorks with Catherine Munro.

Piriformis Syndrome

Piriformis syndrome is an uncommon neuromuscular disorder that is caused when the piriformis muscle compresses the sciatic nerve. The piriformis muscle is a flat, band-like muscle located in the buttocks near the top of the hip joint. This muscle is important in lower body movement because it stabilizes the hip joint and lifts and rotates the thigh away from the body. This enables us to walk, shift our weight from one foot to another, and maintain balance. It is also used in sports that involve lifting and rotating the thighs -- in short, in almost every motion of the hips and legs.

The sciatic nerve is a thick and long nerve in the body. It passes alongside or goes through the piriformis muscle, goes down the back of the leg, and eventually branches off into smaller nerves that end in the feet. Nerve compression can be caused by spasm of the piriformis muscle.

Piriformis Syndrome Signs and Symptoms

Piriformis syndrome usually starts with pain, tingling, or numbness in the buttocks. Pain can be severe and extend down the length of the sciatic nerve (called sciatica). The pain is due to the piriformis muscle compressing the sciatic nerve, such as while sitting on a car seat or running. Pain may also be triggered while climbing stairs, applying firm pressure directly over the piriformis muscle, or sitting for long periods of time. Most cases of sciatica, however, are not due to piriformis syndrome.

Piriformis Syndrome Diagnosis

There is no definitive test for piriformis syndrome. In many cases, there is a history of trauma to the area, repetitive, vigorous activity such as long-distance running, or prolonged sitting. Diagnosis of piriformis syndrome is made by the patient’s report of symptoms and by physical exam using a variety of movements to elicit pain to the piriformis muscle. In some cases, a contracted or tender piriformis muscle can be found on physical exam.

Because symptoms can be similar in other conditions, radiologic tests such as MRIs may be required to rule out other causes of sciatic nerve compression, such as a herniated disc.

Piriformis Syndrome Treatment

If pain is caused by sitting or certain activities, try to avoid positions that trigger pain. Rest, ice, and heat may help relieve symptoms. A doctor or physical therapist can suggest a program of exercises and stretches to help reduce sciatic nerve compression. Osteopathic manipulative treatment has been used to help relieve pain and increase range of motion. Some health care providers may recommend anti-inflammatory medications, muscle relaxants, or injections with a corticosteroid or anesthetic. Other therapies such as iontophoresis, which uses a mild electric current, and injection with botulinum toxin (botox) have been tried by some doctors. Using the paralytic properties of the botulinum toxin, botox injections is thought by some to relieve muscle tightness and sciatic nerve compression to minimize pain.

Surgery may be recommended as a last resort.

Prevention of Piriformis Syndrome

Since piriformis syndrome is usually caused by sports or movement that repeatedly stresses the piriformis muscle, such as running or lunging, prevention is often related to good form. Avoid running or exercising on hills or uneven surfaces. Warm up properly before activity and increase intensity gradually. Use good posture while running, walking, or exercising. If pain occurs, stop the activity and rest until pain subsides. See a health care provider as needed.

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