October 2022

Several types of persistent pain exist. Some pain is caused by tissue damage or inflammation (e.g., tumor, infection, osteoarthritis) or nerve damage/dysfunction. These types of pain can usually be treated or managed with medical intervention. Mind-body practices like yoga can help reduce inflammation, calm the nervous system, improve mobility, and enhance quality of life for these individuals.

The type of persistent pain I want to describe here is the most common and called ‘centralized’ (neuroplastic) pain or 'mind body syndrome'.

This type of pain is generated by the central nervous system and can’t be fully explained by a structural cause. Neuroplastic pain encompasses a wide variety of pain conditions including most musculoskeletal pain (e.g., back, neck, pelvic pain, fibromyalgia, irritable bowel syndrome).  Some of the indicators are described in this self-assessment guide developed by Alan Gordon, LCSW. Where there is persistent pain, there is often anxiety. Fear and anxiety fuel pain and tension, which increase anxiety, thus creating a vicious cycle. When I had persistent foot pain, my mind would immediately go to work, generating thoughts such as “Will it get worse?”, “How will I cope with it?”, “Will this ever go away?” These thoughts increased anxiety, tension, and stress. They also served as a self-fulfilling prophecy  – resulting in more pain. This tendency is common and automatic and requires conscious effort to notice it.

Trying to think our way out of pain, avoiding it, fighting against it, or trying to subdue it are the most common strategies.

The problem is that they don’t help. 

When the brain repeats the same thing over and over, neuroplasticity develops, for better or for worse. Neuroplasticity creates new pathways in the brain through repetition and learning.

Conventional treatments such as medications can have undesirable side-effects as well as limited results because they address symptoms, and not the root cause of pain. Physical and emotional pain activate the same areas of the brain. Common painkillers and opioid medications that are used to treat pain, can also blunt emotions. Pain is an emotional experience. We also know that people with a history of trauma are more likely to experience chronic pain.

Psychotherapy and self-management programs can be helpful. However, they typically use mental strategies to change ways of thinking and focus on coping with pain and anxiety. This does not address symptoms that occur in the body. Mental strategies do not act on the way the mind and body interact to produce sensations, thoughts, and emotions. Psychotherapy methods developed in recent years have been shown to be much more effective with lasting results in the treatment of neuroplastic pain. Learning about how pain is generated by the nervous system and the emotions underlying it (the basis for a method called Emotional Awareness and Expression Therapy (EAET), was key in my own recovery.

If chronic pain is learned, it can also be unlearned.

Mind-body approaches work with the body, where symptoms of pain and anxiety are felt. Regardless of the cause of persistent pain, practices such as yoga and mindfulness strengthen awareness of the mind-body connection and can regulate our nervous system. People can become more aware of how thoughts, sensations and emotions influence their symptoms. This can lead to empowered awareness of having more control over one’s pain and anxiety.

When conventional treatment does not provide significant or lasting relief from pain and anxiety, a different approach is needed.

Complementary approaches can work alongside conventional treatments. Mind-body practices such as yoga and mindfulness are considered safe and can be adapted to a wide range of needs and abilities. Despite growing evidence about the effectiveness of mind-body approaches to pain and mental health issues, they are often a last resort. Many people are not informed about complementary health options. Accurate and evidence-based information about these options is challenging to find, unless you are willing to spend a lot of time reading research articles.  Many myths such as yoga being a religion or only flexible people do yoga create barriers.

Yoga and mindfulness can help relieve persistent pain and anxiety.

How?

• Overcome fear of movement by exploring movement that doesn’t hurt.
• Reconnects us with parts of the body that are associated with painful sensations, emotions, and thoughts.
• Switches the nervous system from a fight, flight, or freeze (sympathetic) state to a rest and digest (parasympathetic) state.
• Create a sense of safety in the nervous system to calm overactivated areas of the brain.
• Gets us out of our head (where the narrative of anxious or angry thoughts are created) and into our body.
• Awareness and being present with painful sensations decreases their intensity.
• Mindfulness and self-compassion approaches de-escalate catastrophic thinking by noticing the narrative we assign to sensations.
• Deliberately directing the focus of attention counteracts automatic thought or pain patterns, showing the brain and body a different way of being. This can create neuroplasticity.

Before I experienced chronic pain myself, I didn’t fully understand the frustration, fear, feelings of powerlessness and depression it elicits.

Now my mission is to bring hope to others who are suffering, with simple mind-body practices they can incorporate into their daily life! If this information might help someone you know, please share it with them. I am available for one-to-one consultations and offer personalized yoga sessions across North America that are tailored to individual needs, preferences and abilities.

Additional references

Bergland, C. (2015, Nov 11). The Neuroscience of Mindfulness Meditation and Pain Relief. Psychology Today.

Levine, P. (2021, Oct 30). Pain Syndromes: the hidden face of trauma. Module 4 in the Healing Trauma online course.

McGonigal, K. Yoga for pain relief: Simple practices to calm your mind and heal your chronic pain. Oakland, CA: New
Harbinger Publications, Inc.

Rimler, R. (Host). (2021, Oct 28). Chronic pain: Can our brains fix it? [audio podcast episode]. In Science Vs. Gimlet.