How can we use Yoga practice to reduce pain, and especially, what kind of Yoga practice? Science has been studying pain in the recent years, and the findings that come out of that research are very interesting to me, because as a Yoga therapist my first priority is to help people find relief from pain.

According to Wickipedia, Nociception (also nocioception or nociperception) is the encoding and processing of harmful stimuli in the nervous system, and, therefore, the ability of a body to sense potential harm. Let's look more closely at what pain is and who is most likely to suffer from it to a greater degree (everyone experiences pain at one point or another, and back pain is the most common complaint). At the end of this article, there is a Yoga practice I designed to help relieve back pain - keep reading!

  • Pain is produced by the brain, based on a very rapid and very comprehensive analysis of the situation. The signal from the injured site travels to the brain via the synapses, and then brain is trying to determine whether whatever is happening to you is really, truly dangerous, and if it decides that it is, there will be pain. Whether there is actual reason to feel the pain does not always correlate with the pain levels, as a matter of fact, often the level of pain does not match the injury - some people with severe injuries or damage to their body will feel little pain, whereas other people with minimal (or even no damage at all!) will report pain. In experiments, people felt pain in a plastic arm when it was made to look like it was their arm.
  • People with pain are not good at knowing where their body parts are, especially perception of the injured or damaged body part is distorted. And the opposite is true - people with great body awareness report less pain.
  • Pain is reduced when people practice sensory training, such as sensory discrimination, mirroring, left/right judgement. Here is where it is really relevant in our context - in a Yoga class you are practicing all three of those skills. You are trying to engage certain body parts in a certain way to create shapes with your body - sensory discrimination. You are trying to make it look like what the teacher is doing - mirroring, and you are also trying to stay on track with the left side/right side instructions.
  • We can become more sensitive to pain through repeated exposure, which causes our pain levels increase and persist. For example, if you had a traumatic back injury thirty years ago, if you were to do anything now that puts your back into the remotest "danger" - like a new movement, or a movement that seems similar to the one that caused the injury, you are very likely to experience pain. Or, if you've had an injury, the more you think about it, the worse it seems to hurt, and the more you distract yourself from it, the less pain you seem to experience.

In Yoga we have a great variety of movements, and the novelty of some of them is wonderful at training our body awareness. The trick is to take a movement that is habitual to you, that you feel "safe" doing, and then change it just enough for it to feel "new", but not so "new" that is triggers the "danger" response in your brain.

We have been playing with this concept in group classes this week, and having a lot of fun. By introducing a bit of novelty into your movement, you are creating an opportunity for your body to experience something it does not yet have an opinion about. And because Yoga is done in a quiet, relaxed, meditative environment, the brain is much more likely to accept new positions, angles, and movements as "safe," therefore increasing your repertoire of pain-fee movements.

In Yoga therapy we use a technique called Vinyasa Krama to gradually retrain the brain to accept movements and positions of the body that are painful, so that eventually they become pain free. In Western parlance, it has been called "nudging the edge". We reduce the amplitude of the movement that is causing pain, and trying to find the edge, so to speak, where we feel that the protective response from the body is increased. There are certain signs that you may be approaching your edge:

  • you may feel "tight", "stiff", or experience the loss of freedom of movement.
  • you may notice your breath becoming shallow, or you are holding the breath
  • you feel anxious or uncertain of going beyond that point.
  • you feel pain. But pain is a misleading sign, as it may or may not be associated with that edge. For many people, they may feel pain but still know that they are not in any danger and experience no uncertainty yet. So use the first three signs to map out the edges for yourself, with a certain understanding about the fourth criteria.

Let's design a Yoga session based on the above information. For example, if you have been to a Yoga class, you've probably done this pose, Cat&Cow. Begin in your smallest range of movement, completely pain-free and easy, and gradually build the amplitude, playing the edge.

When doing this pose, inhale as you arch the spine (cow), and exhale as you round the spine (cat). Try moving the entire spine evenly, moving from the middle of your back.

Now, to add a little novelty and to increase body awareness, try to isolate just the lower spine, and move back and fourth from the pelvis only, keeping your shoulders as still as you can.

Next try to keep your pelvis as still as you can, and move just the upper, Thoracic spine. Notice which of these movements are easier for you to do, and practice the more difficult one to get proficient in all three.

How did you do?

There is more we can try here. The next movement is more difficult and requires more coordination - the lateral one on all fours, like this:

On the exhale, bring your hip and shoulder towards each other, squeezing the side body. Keep your pelvis stacked over the knees and don't swing it side to side. Alternate direction.

Then try moving the pelvis only, keeping the shoulders as still as you can. Use your core to make the movement smooth. How is your breathing?

And finally, try to move just the shoulders, while your pelvis stays perfectly still. Interesting, right?

And finally, the most challenging of all - the jump rope. I love this spinal movement! You would be surprised how difficult it is to do if you've never done it before.

Move the spine in an arch, using the entire length of it evenly. You can inhale in neutral and go slowly around on the exhale, or do several passes around on one exhale, as you like.

Then try to keep your shoulders still and move only the pelvis. Remember to start with the smallest amplitude, and then gradually increase up to your edge. As you repeat, watch your edge shift further out.

And finally, the last version - this one was the most difficult for me! Keeping the pelvis steady, circle around with your upper back. Switch direction. Wow, right!

You can apply this approach to many Yoga movements (or any movements). I will be playing with this concept in the coming weeks. If you are interested in the science behind this thinking, you can watch the short but very informative lectures by Professor Lorimer Moseley from Australia, who is one of the leading scientists studying pain:

And also highly recommended this short lecture by Dr. Tasha Stanton, on how pain can be managed by tricking the brain. Fascinating!

Thanks for entertaining my thoughts on the matter, and I wish you a pain-free practice!