Pain is a universal experience that no one is immune from, though the degree and intensity differ. Discomfort describes the most common symptom that causes patients to seek medical attention. The feeling of pain is an alert system the body uses to signal impending or actual damage. Pain is described by the International Association for the Study of Pain, (IASP), as “Pain is an unpleasant sensory or emotional experience associated with actual or potential tissue damage.” Pain is a subjective experience that differs from person to person influenced by personality, beliefs, attitudes, culture, expectations, and social factors.
“The proper management of pain remains, after all, the most important obligation, the main objective, and the crowning achievement of every physician.”
- Dr. John J. Bonica Anesthesiologist and Founder of IASP
There are different classifications and categories of pain. Fundamentally, the two basic types are neuropathic and nociceptive pain. Other classifications based on pain duration are acute and chronic pain. Regardless of the type, going through pain is depressing and stressful. Pain has an emotional nature and tolerance level that differs from person to person. Within the tolerance level, an individual can withstand the painful experience. However, above this level the experience becomes unbearable. In view of this, ensuring that patients’ pain does not exceed its tolerance level is the primary task of all physicians and the health care system.
The Pain Brain
There are all types of injuries and pain, both inner and outer. As humans, we experience physical, emotional, behavioral, and spiritual pain and trauma while we are here. Eckhart Tolle refers to the pain-body a term for the build-up of emotional and spiritual distress that people possess in their energy field.
Dr. Peter Abaci, MD is one of the world’s leading experts in pain. He is the Medical Director and Cofounder of the San Francisco Bay Area Pain & Wellness Center and the author of “Take Charge of Your Chronic Pain: The Latest Research, Cutting-Edge Tools, and Alternative Treatments for Feeling Better” and the host of Health Revolution.
“I like to view pain as an experience, and it helps to understand this experience by what I refer to as the pain brain and pain body. The pain brain refers to a wholesale set of structural and functional changes that take place when pain persists.”
Based on the pain mechanism of action, pain consciousness originates in the cerebral cortex of the nervous system. Stimuli resulting from tissue injury activate pain nerve fibers (nociceptors). These nociceptors, in turn, send information to the spinal cord dorsal horn, then progress to the brainstem and ultimately to the cerebral cortex. “Another key part of the pain experience is the activation of glial cells in the nervous system, which seem to help perpetuate the pain response.”
Neuroplasticity
Neuroplasticity refers to how the brain evolves and changes based on a whole host of factors, and we see that the experience of pain leads to a number of neuroplastic changes throughout the nervous system that helps us understand different aspects of the pain experience, like depression, anxiety, sleeplessness, isolation, and motivational changes.
“All of these changes, in turn, are in constant communication with what is going in the body, leading to changes in how the body moves and functions, sometimes in very profound ways. When this “pain body” starts to shut down, then a person’s quality of life and ability to function goes down. This, in turn, communicates back to the brain, and as the two communicate back and forth, both the physical function gets more inhibited, and the actual pain becomes more debilitating” are according to Dr. Abaci.
Dr. Abaci says, “There are many different factors that contribute to getting stuck. We know that our attitudes and thoughts about a situation play an important role.”
Research has found that people who catastrophize the trauma pain event have longer lasting and more intense pain, and stronger medication use.
Physical factors play an important role as well. For example, studies have shown that bed rest is not helpful after a back injury and may slow the recovery process. Sometimes movement and exercise, when done appropriately, helps break the cycle.
Certainly, our emotions weigh heavily in the recovery process. Symptoms of trauma or hyper-arousal can set in. In order to help the person get unstuck and move forward, the treatment plan addresses these elements.
Physicians use different strategies in managing patients’ pain depending on the type. Findings show that Americans spends an average of $14 billion yearly on conventional pain medication drugs. The use of medication such as over-the-counter drugs and non-steroidal anti-inflammatory drugs (NSAID’s) can be effective pain relievers, especially for acute pain. However, for chronic pain management, their use can result in unwanted side effects.
“For many Americans who suffer from chronic pain, medications may not completely relieve pain and can produce unwanted side effects. As a result, many people may turn to non-drug approaches to help manage their pain.”
- Richard L. Nahin (Ph.D., NCCIH’s lead epidemiologist)
The last few decades, we have witnessed advancements in how to manage pain effectively using alternative and complementary medicine. Alternative medicine compared to traditional medicine offers numerous benefits. One is drug addiction prevention. Addiction rates for chronic pain patients are higher to certain classifications of drugs, for example, opioids. Subsequently, many physicians are embracing the use of natural pain relief options, such as yoga and meditation, as pain relief management.
The Effectiveness of Yoga and Medication in Pain Management
The prevalence of chronic pain among Americans is a serious concern. Reports from the US Centers for Disease Control and Prevention, (CDC), show that 50 million American adults have chronic pain. With 20 million among these adults, suffering from high-impact chronic pain severe enough to interfere with their activities of daily living.
“Managing chronic pain effectively involves a team that includes doctors, physical therapists and others, and activities like yoga or meditation.”
- Dr. Mark Bicket (Johns Hopkins University, Baltimore)
According to the Harvard Medical School, the benefits of yoga are in the mind-body and exercise practice. This involves the use of meditation, breath control, and movements to stretch and strengthen muscles. Yoga compared to other exercise programs place more emphasis on mind-fitness.
Dr. Abaci agrees, “Yoga and meditation fit nicely into this model of the pain brain and the pain body. Both help to rewire some of these problematic neuroplastic brain changes, resulting in a variety of positive changes.”
These include better stress management, less hyper-arousal, better focus, and improvements in mood. Yoga and mindfulness can help the body move, grow, and release tension in ways that traditional exercise may not.
The use of meditation in managing pain is gaining more popularity because of its effectiveness as a pain management tool. Living with chronic pain is both stressful and depressing. The mind separated and apart from the body attempts to figure out solutions when the pain becomes unbearable. However, according to the National Center for Complementary and Integrative Health (NCCIH), engaging in mindfulness meditation reduces pain by bypassing the opioid receptors in the brain.
This practice, known as mindfulness meditation is a mind-body practice used to increase physical relaxation, calmness, coping skills, relief of depression, and to enhance the general well-being of the body.
Shelley Masini has a Master’s degree and is the founder of Imperfect Zen. “On a physical level, since practicing yoga, many inflammations and pains have almost gone away. Most significantly, yoga has helped me in my recovery from de Quervain’s tendinosis in my right thumb and wrist. For one year I couldn’t write, lift, or put any weight on my right hand.”
Shelley completed traditional medical therapies including two rounds of cortisone shots that failed to provide relief. “It wasn’t until I started yoga that I really felt my wrist strengthening.” Her progression is evident, as she is “now up to working on handstands".
The Yoga Medication Experience
“Yoga is not a religion. It is a science, science of well-being, science of youthfulness, science of integrating body, mind, and soul.”
– Dr. Amit Ray, Ph.D. (author, philosopher, teacher)
Yoga can relieve chronic pain conditions in people with low back pain, arthritis, migraine, fibromyalgia, and other types of chronic pain conditions as demonstrated by research findings published in the Annals of Internal Medicine. The results also reveal that people with chronic pain can experience increased mobility by engaging in a yoga class for a week compared to using standard medical care.
Dr. Abaci started to explore yoga about 13 years ago, hoping that it would help him with an aching knee. What he found was that yoga and meditation opened an entirely new world that went far beyond one particular physical injury. In fact, he considers yoga to be a form of therapy, not exercise, because of the way it helps boost well-being and decreases the stress of daily grind on a regular basis. In fact, he feels that his yoga practice has helped him be a better spouse, father, and physician. It is now, absolutely part of his week.
Pain relief led Shelley Masini to yoga and meditation. In addition, “I couldn’t focus properly on any one task or conversation. I couldn’t honor projects, work, even relationships. Yoga asks you to slow down, focus on your breath and body, and be in the moment. You start to do this with the rest of your life.”
Truthful Challenge
All new ways of thinking, practice, and habits have their challenges. Shelley Masini describes her insights during her journey.
Attention: “One challenge was pulling my eyes and attention away from Instagram and the Internet where you see picture perfect bodies and yoga poses.” It is essential to practice focus, attentiveness, care concentration, and mind interest. Once it becomes a habit, we do it automatically.
Acceptance: “I had to turn my focus inward and become okay with my own body’s shape and abilities and be willing to start on my journey exactly where I was. In yoga, you can’t compare yourself to the person in the pictures, or the person next to you, or even the person you were the last time you got on the mat.” Know that each one of you is unique and accepting who you are, always doing your best, and never comparing yourself to others is quintessential of inner and outer peace.
Patience: “Performing the physical yoga asanas, or yoga poses requires a combination of strength, flexibility, and balance. With patience, I definitely progressed in my poses, and became stronger and more flexible.”
Understanding: “Each of us comes to the mat with a different body and ability levels. We may be able to change these or we may not.” Injuries and body types guide us to accept not only ourselves but accept we can only do particular poses.
Flexibility: “Just the way my body is built I had to accept that there are certain poses that I couldn’t achieve without modification.” This flexibility transitions from the body to our mind and spirit. We start looking for the gifts and beauty.
Beauty: “Yoga is available to everyone, no matter their level or body. I have short arms, so poses like the Scale Pose in which you sit cross-legged and lift your body into the air by pushing yourself up using your arms, isn’t possible for me without modification. I use blocks under my hands to increase my arm length.” Recognizing the beauty is an accurate reflection of gratitude.
The Secret
Pain management starts with recognizing that every pain body trauma is unique and deserves customized individual medical assessment and holistic attention. Pain indicates a problem, which could lead to significant and extensive conditions if ignored. Patient-centered integrative medicine remains the primary focus. It is essential to bring relief safely and effectively.
Testimony and personal accounts are compelling reminders of the hardships we all face. Our firsthand education in the use of yoga and meditation in pain management is but one-step toward developing our tools to overcome and work through life’s difficulties.
The information provided is from different sources that are reputable and duly cited. It is only to inform and is not professional medical advice. Consult your physician provider for advice about your specific medical conditions.
Keywords Pain (97)
Pain relief (5)
Yoga (31)
Yoga asanas (1)
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Benefits of yoga (1)
Meditation (15)
Chronic pain management (2)
Natural pain relief (1)
Alternative treatment (1)
References
1. Disorders of the Nervous System; Reeves and Swenson; Chapter 19 – Pain;
https://www.dartmouth.edu/~dons/part_2/chapter_19.html
2. IASP Terminology https://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698
3. Paul Ingraham; November 2018The Basic Types of Pain;
https://www.painscience.com/articles/pain-types.php
4. Morgan Institute for Research, July 2017 What is pain tolerance and how does it work?
https://morgridge.org/blue-sky/what-is-pain-tolerance-and-how-does-it-work/
5. Pain types and classification;https://www.webmd.com/pain-management/guide/pain-types-and-classifications
6. NIH Review Finds Nondrug Approaches Effective For Treatment of Common Pain Conditions. September 2016
https://nccih.nih.gov/news/press/pain_review
7. What are the benefits of alternative medicines? ; Amber Keefer
https://www.livestrong.com/article/121642-benefits-alternative-medicines/
8. Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016; Morbidity and Mortality Weekly Report; September 2018.
https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm
9. Yoga for pain relief; Harvard Health Publishing; April 2015
https://www.health.harvard.edu/alternative-and-complementary-medicine/yoga-for-pain-relief
10. Harvard key; Harvard University
http://annals.org.ezp-prod1.hul.harvard.edu/article.aspx?articleid=1033130
11. Meditation: Benefits for People with Arthritis; Arthritis foundation
12. Dr Wen Chen; March 2016; Mindfulness Meditation Reduces Pain, Bypasses Opioid Receptors;
https://nccih.nih.gov/research/results/spotlight/mindfulness-meditation-pain
Author Dr. Diana Rangaves is Doctor of Pharmacy (Pharm D) graduate from the University of California, San Francisco and specializes in pharmacotherapy management. Diana has a broad range of acute clinical background and ambulatory care. She was an academic college professor; teaching critical thinking, ethics, pharmacology, addiction, behavior patterns, pharmacy, and nursing. As a Clinical Pharmacist, she focuses on chronic or disease state management. She currently serves as Clinical Director for ARISE Africa Foundation, which specializes in adult education and the reduction of STD/HIV in Nigeria. She has published several books and has articles in numerous venues. She is the cofounder of Axion Technologies, and founder of Clinical Consultant Services , and Diana Rangaves.com