One of the things that has surprised me the most over the last few years of working with hundreds of students and clients is how many people face high levels of pain as a daily experience in their lives. Having experienced intermittent and debilitating back pain over a particularly stressful 5-year period, I am familiar with the way that being in pain affects every aspect of your life. From sleep, to work, to relationships and overall wellbeing, pain can make being a human a much more challenging experience! In my life, pain has always been something that arises, can be treated, and then goes away. But for many students and clients, managing pain is a daily and unremitting task on their “to do” list.
As I looked into this further, I realised there’s no wonder that my teaching work has introduced me to so many people experiencing chronic pain; a 2019 NHS Survey found that around 15.5 million people in England (34% of the population) have chronic pain. The NHS defines it as “pain that continues for longer than 3 months, either as part of another health condition, or despite investigations and treatment.” Sometimes there are obvious reasons or triggers, but often there is no known cause and no effective treatment. For many people, pain can start in one place and then move to other parts of the body for no identifiable reason.
Something that has been heartening to witness is that many students who come to a class, course or 121 session have reported that their pain has reduced or even temporarily ceased when they engage mindfully with yoga. I have also seen a huge difference in the students who attend regular weekly classes to those who occasionally drop in or who have joined me for a time-limited course. Regular yoga practitioners report less pain during pre-class check-ins and where they do have pain, it tends to be temporary or intermittent. This is supported by a range of research studies that have found yoga can decrease disability caused by pain, improve daily function, increase psychosocial well-being and even reduce levels of pain experienced.
So why might yoga be so helpful? There are 4 main things I have observed:
Gentle movement – Maintaining mobility without exacerbating pain can be a challenge. Many types of exercise can increase tension in the body or trigger an activated/stressed state which may increase pain. Yet keeping the body mobile is essential to ensure that it doesn’t become weak, stiff and immobile; all things that will ultimately lead to more pain. Many students have come to yoga unsure if they will “be able to do it” and understandably anxious that it may increase their pain. However, people often feedback that they are amazed at what they have been able to do and the increased mobility and relaxation they feel as a result. This is because gentle yoga emphasises the importance of working within a range that doesn’t exacerbate pain and works collaboratively with the body rather than against it.
Deeper breathing – Breathing is hugely impacted by experiences of chronic pain. This makes sense. When the body is experiencing pain, there is a natural protective bracing that happens, which often impacts posture (more rounded shoulders and curved lower back and a closing in of the torso) and has a knock-on effect on breathing (with less space for the diaphragm to lead the breathing, it can become shallow and fast). The irony is that this “protective posture” and faster shallow breathing actually trigger more stress in the body as it goes into a more activated fight/flight response, something which is associated with increasing anxiety and can lead to more pain. When the body is invited to open and release and practices are engaged to encourage breathing more diaphragmatically, the reverse cascade happens. Tension is released, the relaxation response is triggered, and anxiety reduces.
Relaxation – Creating relaxation in a body bracing against pain may feel like an impossible task. Luckily, yoga and mindfulness have a huge range of techniques that can support engagement of the “relaxation response” so each person can find the one that will work for them. For some people, gentle movement and deeper breathing may bring about a sense of relaxation, especially if the movements involves stretching out tense muscles. Other options include grounding practices and chanting as well as doing a “body scan,” where attention is moved around the body, sometimes inviting relaxation of each part. A variation of this from mindfulness teachings include specific meditations for pain, where attention is taken to the edge of pain and then to neutral or pleasant sensations, which are invited to expand.
Curiosity and kindness – Movement, breathing and relaxation have proven to be really helpful, but the most essential thing I have observed has been bringing an attitude of curiosity and kindness to all other practices and to the experience of pain more generally. We live in a culture where there is often high value in “keeping going” and “pushing through.” I know from my past experiences of pain that this is something I always did until the pain got so bad that I simply had to stop. I resonate with the saying “listen to your body when it whispers, so it doesn’t have to scream.” I used to make my body scream because I never listed to its whispers. Now I guide students and clients to bring a sense of curiosity to their experience, perhaps gently resting a hand on the painful area and asking “what do you need?” or “what are you trying to tell me?” Usual answers we have found are “breathe,” “rest,” “slow down.” And frequently if this gentle advice is heeded, the body can immediately turn down the volume on the pain.
Pain can be caused by so many different things and related to many physical and mental health conditions. Each person’s experience of pain will be different and the exact formular for working skillfully with the pain will be unique to every person. Yet despite these differences, my work and personal experience has shown that the first step to understanding pain is to learn to listen to it. I went to a gym class recently where the instructor said, “your only enemy is that person in the mirror.” I found it so jarring because it highlighted the toxic soup that we’re all swimming in and that is at the root of so many mental health challenges. We treat our body like an enemy. We fight it. We make it into a battleground. We push it and force it and judge it and get frustrated with it. What if instead of a battleground, we treated our body like the miraculous ecosystem it is? Gave it nourishment, hydration, rest, play, movement and care. What if we listened to its whispers and let is guide us with its wisdom? I think if more of us did this, we would live in a very different world.
