Chronic or persistent pain is debilitating and affects between 11 and 40 percent of the USA’s adult population. It is associated with depression, opioid dependency, disability, and anxiety.
Chronic pain causes significant silent suffering and impacts a myriad of life’s responsibilities:
- family relationships
- social relationships
Pain that persists is complicated and unique to each person. It often leaves those afflicted in a never ending search for the right solution to their plight.
This article explores how pain neuroscience education can help people with chronic pain make empowered choices about treatments and find their personalized path to healing.
What is Pain Neuroscience Education and How Does it Help People in Pain
Pain neuroscience education (PNE) is a therapeutic process that teaches people with chronic pain about the biology, physiology, and neurology of pain. The concepts are explained in simple terms and in a supportive manner that helps people suffering from chronic pain understand how the nervous system processes pain.
Why should any of that matter to a person in pain?
Research has shown that fear and anxiety increases when a person does not understand the source of their pain. Wondering what is wrong and worrying about symptoms lead to pain catastrophizing (imagining awful causes and consequences). This fear about pain leads to a release of inflammatory hormones in a fight or flight response that increases the level of pain experienced. It also leads to depression and reduced mobility.
Additionally, people often rely on internet search results or opinions from friends and family to self-diagnose their the cause of their pain. Scary or dramatic assumptions ratchet the anxiety level up significantly and make pain symptoms worse. This physiological response to fearful information is called the nocebo response.
Through PNE, pain sufferers learn about the central nervous system and factors that can hyper-excite their nerves. For example, a blind person purposely trains the nerves in their fingertips to be extra-sensitive for reading braille. Unfortunately, through a similar process, humans can unintentionally train their nerves to be extra-sensitive when it comes to pain. Pain can persist well after the tissues have healed.
In the PNE process, people with persistent pain begin to explore the idea that the level of pain they feel may not accurately represent the health of tissues in their bodies and that their pain may not be a result of damaged or diseased tissues. They learn how the nerves that cause pain can be re-trained to their healthy, less sensitive state. For some people, this knowledge alone is enough to reduce the pain experience immediately. With a few therapeutic techniques and regular practice, people with chronic pain can de-sensitize their pain alarm, heal their pain, and live a more fulfilling and healthy life without pills, shots, or surgery.
Why Yoga is the Perfect Companion Therapy to Pain Neuroscience Education
In today’s western culture, people view yoga as a form of exercise. Deeper consideration uncovers a wisdom tradition with a methodology of practices that lead to mindfulness and self-discovery. Yoga is an ancient but ever-evolving practical philosophy that aids practitioners in revealing the causes of physical, mental and emotional suffering and methods to ease that suffering.
The term suffering, or “duhkha” in Sanskrit, refers to a spectrum of unpleasant experiences both physical and emotional. It is also described as a feeling that arises when things are not in alignment.
The Sanskrit word “dharma” is another complex term that could fill another entire blog post. Still, a general understanding is that it refers to a balanced way of living that benefits individuals and their environment.
Yoga is the skillful action that leads to dharma and the alleviation of dhukha. By exploring our dharma, we examine how our thoughts, emotions, and behaviors can sustain balance and harmony with ourselves and our environment. Yoga teaches us to be curious and open-minded about dhukha (suffering) and explore alternative behaviors and beliefs that align with our values.
Yoga instructors guide students into poses or “asanas” in Sanskrit and encourage them to notice a variety of sensations in their bodies such as:
- Physical – spacial awareness of each body part, proper alignment, balance, tightness or flexibility, feelings of fatigue or energy.
- Mentally – emotional state, relaxed or aroused, focused or distracted.
When a person’s body is too tight to enter a pose, less intense versions are taught. Students are taught how to use aids like bolsters, blocks or straps to help them find a similar but equally beneficial pose. Yoga encourages patience over force to reach flexibility and balance.
Instructors also coordinate movements with inhales and exhales to increase students’ awareness of their physical and mental states. The deep and slow breathing techniques utilized during yoga also help activate our rest-and-digest (parasympathetic) nervous systems and reduce pain intensity.
Observing physical and mental sensations while moving our bodies into yoga poses allows us to explore concepts learned during therapeutic pain neuroscience education safely.