Physical 

How to Use Yoga for Chronic Pain

September 22, 2020 6 min read

Woman in workout attire doing a stretch on yoga mat

As discussed in the first installment of our yoga for common ailments series, the benefits of yoga for sleep have been well-documented in science. Yet data proves yoga to be equally as beneficial for the physical body.

Over 50 million adults in the United States live with chronic pain(1). Some instances of chronic pain are triggered by a specific injury, like a car accident, illness or infection. However, it’s also common for chronic pain to occur without evidence of a previous impairment (2).

Despite such ambiguity, chronic pain is a significant detriment to daily life. Fortunately, yoga is a promising treatment for alleviating chronic pain and its associated mental distress.

Here’s a look at the science behind this prevalent, yet misunderstood condition, and how to use yoga for chronic pain regardless of the cause.

Chronic pain versus acute pain

Pain is the primary reason people seek medical treatment. A critical sensation for survival, pain alerts us of potential bodily damage. It helps us address injuries and ailments before they manifest into larger problems.

Pain is also essential for triggering the body’s protective responses, which inspire us to take life-saving action. Without pain, we wouldn’t pull our hand away from fire, or rest on the couch after spraining an ankle(3).

Pain that arises as a result of a sudden threat or specific injury is called acute pain. Chronic pain is different. Unlike acute pain, which disappears after the injury is healed, chronic pain persists. In people with chronic pain, the nervous system continues to fire pain signals in a specific area or multiple areas, regardless of treatment.

Much remains to be discovered about chronic pain, but researchers agree on one sentiment: chronic pain is a result of dysregulation in the body’s pain management system. Specifically, chronic pain patients have increased sensitivity in pain receptors. This leads to elevated levels of persistent, untreatable pain, whether real or perceived(4).

Pain is considered chronic when it endures for longer than four months despite medical advice and treatment(5).

The complex impacts of chronic pain

Pain is a complex element of the human experience because it involves physical, psychological and social processes. Although pain is first caused by ailment, disorder or direct physical damage, it later causes disruptions to one’s social and emotional well-being.

As a result, people who experience chronic pain may not be able to pursue an ordinary life. Personal goals, social relationships and career pursuits can all be disrupted by the presence of chronic pain.

For example, someone with chronic pain may feel anxiety and fear about their persistent discomfort. They may also require additional medical care or be unable to work and engage in regular activities. These lifestyle changes may result in criticism from others, as chronic pain is often misunderstood by those who haven’t personally experienced the condition. Such social exclusion can further exacerbate the experience of chronic pain sufferers(6).

The stress and negative emotions experienced by people with chronic pain may contribute to impairments in the prefrontal cortex, which is essential for processing pain responses. As a result, theanxiety of having chronic pain can elevate the perception of pain beyond what is real, thereby increasing someone’s physical and emotional suffering(7).

Woman massaging back to ease pain

Common causes of chronic pain

Chronic pain is prevalent among individuals of all ages and there are many different reasons it occurs.

Causes of chronic pain include, but are not limited to:

  • Arthritis
  • Joint injuries
  • Autoimmune diseases
  • Cancer
  • Gastrointestinal disorders
  • Infectious diseases
  • Neuropathy(8)

People may also be predisposed to genetic diseases or disorders that cause chronic pain. Women are more likely to experience chronic pain that is severe. At the same time, women are also less likely to seek treatment for chronic pain.

This prevalence of pain among women is likely due to the fact that common conditions which cause chronic pain, including fibromyalgia, irritable bowel syndrome, pelvic pain, and headache, disproportionately affect women(9).

Yoga for chronic pain conditions

Chronic pain can diminish one’s quality of life, making it hard to maintain normal social and emotional relationships. Fortunately, yoga has been proven to support people with chronic pain in multiple ways.

Here’s a look at the areas where yoga has been proven beneficial for chronic pain.

Yoga for low back pain

Low back pain is experienced by nearly six million adults in the United States, making it one of the most common types of chronic pain.

It is also a leading reason why people miss work, and it affects adults of all ages and income levels(10). Low back pain occurs due to our sedentary lifestyles, and can also be caused by obesity and an unhealthy diet. Most often, low back pain is improved through regular activity.

Low back pain is one type of chronic pain for which the benefits of yoga show significant promise. In one study on adults with chronic low back pain (CLBP), multiple styles of yoga were shown to alleviate functional disability associated with CLBP(11). A consistent yoga program has also been proven to be equally as effective as physical therapy for people with chronic low back pain(12).

Another study on veterans with chronic low back pain showed a reduction in pain intensity and a correlation with reduced opioid dependency(13).

Yoga for fibromyalgia

Fibromyalgia is a common condition that causes chronic, widespread musculoskeletal pain and stiffness. There is no known reason why Fibromyalgia occurs, but multiple studies have shown that a regular yoga practice can elevate the day-to-day functioning of people with fibromyalgia(14).

The combination of relaxation, physical yoga poses, breath control and mindfulness meditation has proven effective for managing fibromyalgia symptoms, including chronic pain, energy levels and general stress management(15).

Yoga for arthritis

Arthritis is another widespread condition associated with chronic pain. Over 54 million people in the United States have some form of arthritis, and one in four people with the condition experience joint pain on a severe level(16).

Osteoarthritis is the most common form of arthritis. This type of arthritis is caused primarily by aging and is most common in people over age 40. In contrast, rheumatoid arthritis is an autoimmune disease that results from the immune system attacking healthy joint tissue. People can get rheumatoid arthritis at any age. Both types cause joint pain, and both can be alleviated through yoga.

In fact, studies show that yoga can significantly improve chronic pain from both osteoarthritis and rheumatoid arthritis(17). Yoga was also shown to improve mental health and mood in osteoarthritis patients, which can help halt the elevated pain response mechanism often triggered bystress and anxiety(18).

Two women stretching their backs on yoga mats

How to start yoga for pain relief

Chronic pain is part of a cycle to which stress and fear greatly contribute. Therefore, anything that promotes calm and relaxation holds promise for interrupting this cycle and offering pain relief(19).

Restorative yoga and yoga nidra are two practices designed to stimulate the parasympathetic nervous system and reduce the rapid brain responses responsible for prolonged chronic pain.

Restorative yoga

Restorative yoga is a practice that emphasizes optimal relaxation of body and mind. In a restorative yoga class, students will remain in a posture for a long period of time. Props such as blocks, blankets and bolsters are used to ensure comfort while fostering feelings of safety and groundedness.

Unlike hatha and vinyasa yoga classes, which improve flexibility, strength and endurance, restorative yoga is primarily concerned with stimulating the parasympathetic nervous system. As a result, restorative yoga increases blood flow, elevates mood, lowers heart rate and calms the mind(20).

For example, a restorative yoga pose called Viparita Karani, or legs up the wall, can reduce stress while relieving pain in the lower body. Specifically, this pose helps promote the circulation of blood and lymph through the body. An increase in circulation helps reduce swelling,inflammation and pain in the low back, knees, ankles and legs(21).

Yoga nidra

Yoga nidra is another yogic practice that’s been proven to reduce chronic pain. Despite the name, yoga nidra is not a physical practice, but rather a method of mindfulness meditation. Yoga nidra uses guided relaxation techniques and breathwork to alleviate stressful and anxious thoughts.

In a study on combat veterans with traumatic brain injuries, Integrative Restoration Yoga Nidra (iRest®) was shown to decrease both pain intensity and pain interference. Specifically, the study’s participants experienced a decrease in both back pain and musculoskeletal pain(22).

Yoga nidra is an accessible mindfulness technique that all ages and abilities can try. Yoga nidra can be done just before bed to improve sleep quality, but it can be practiced at any time of day.

In summary

Scientists know that people with chronic pain have an abnormal pain response in the nervous system. Still, chronic pain is a complex, individual experience that can result from a variety of injuries and illnesses.

A large body of research on chronic pain conditions has proven yoga to be an effective treatment. Yoga combines physical elements with stress-relief and mindfulness, making it a powerful antidote for the dynamic physiological and psychological systems that contribute to chronic pain.

Find out more about using yoga to alleviate common ailments in our next article in this series, which explores how to use yoga for digestion.

MichellePolizzi, Contributing Writer, Physician’s Choice