A system of self-care for managing chronic pain

I feel that it is important for me to share my yoga experience, as my own recovery gave me the motivation to become a yoga teacher. 

I started my practice about 12 years ago when I was diagnosed with CFS/FM (Chronic Fatigue Syndrome/Fibromyalgia). I felt that I was in a deep black hole: in pain, feeling depressed, scared. Yoga simply felt good for my aching body and eased my mind. Gradually, I was able to restore my health and my spirit. These are very meaningful words: ‘yoga gave me my life back and gave me a new purpose’. I know that the practice is always there for me, as it is for all of us, and is even more important at difficult times of flare-ups or other physical or emotional challenges.

We need to do our best to develop  new strategies for treating chronic pain. Hopefully soon, treatment  plans will include yoga. In this way passive management will move toward active management, i.e. taking charge and taking control. Treatments will be, and are more successful when integrating the whole person: body, mind and spirit.

"Healing is a continual movement away from fragmentation toward wholeness and connection."   ~ Dawna Markova

This quote sounds like a prescription for yoga. The word yoga means union of body, mind and spirit, which has been the focus of Yoga teachings for about 4000 years. We cannot fully restore the body without restoring the spirit. Yoga is a way to reach the spirit and the mind. It is a way to tap into the body’s natural healing ability, that tremendous internal power which we all possess.

Yoga is available for everyone, the young and old, the healthy and ill. Yoga is a process, not a destination. It is a journey, which is not always easy, but has great discoveries and rewards along the way, which include better overall health, more vitality, a clearer mind, and an improved sense of wellbeing. 

The style of yoga that I teach and practice originates from Vanda Scaravelli and Esther Myers. They created a therapeutic style of Hatha yoga - gentle, yet highly effective. As Vanda stated : "...the stress-free new yoga that works with the body to restore health, vitality and energy."

Educating and imparting knowledge are important components of treatment. Properly trained yoga teachers are able to contribute, and can work together with the patient's physician and health care team.

The yogic tools for managing chronic pain are:

  • Pranayama/loosely translated as breathing practice
  • Asana/practice of poses
  • Meditation/focused mind, focused attention

Generally speaking, over time, a well-rounded yoga practice should include all three of these components.

Pranayama is the essence of yoga, as the breath is the connecting link between body and mind. It is a way to quiet the mind, to balance and strengthen the nervous system, and to shift the focus to the more restorative parasympathetic division. Breath practice can  be done anytime, in any position. The breath is readily available to us … we can always come to our breath when we feel stressed, tense, or in pain. Due to pain and anxiety, our breathing becomes shorter and shallower, moving up higher in the chest. We usually start our practice with simple conscious breathing, to reconnect with the breath and body, by feeling and observing the breath cycle, gradually moving on to a variety of positions. Pranayama should always be done gently, without any strain or force. Some practices are helpful for relaxation, for calming the racing mind; others help with easing pain, or even generate energy. 

Our suggested breath for Asana practice is deep belly breathing. Generally speaking, the exhalation creates space, sets muscles free, breaks knots, and relieves discomfort and pain. Deep inhalation brings renewed energy, life and support. 

The next yogic tool for managing chronic pain is Asana, or the physical practice of poses. The goal of Asana practice should not be the Asana itself, but developing the necessary strength and flexibility over time to do the poses with ease. What makes Asana practice different from any other form of exercise is moving with grounding and breath. 

Our basic and most important principle of practice is "The Ground-The Breath-The Spine". There is a definite interaction and connection amongst these three elements, which are always present. This principle makes sense for everyone, both beginner and advanced student alike. Practicing from this principle provides us with a strong and stable foundation, anchoring the body and the mind, keeping us safe, secure, aligned, even when the physical practice is limited or challenging. As we establish a strong and stable foundation on the ground, as we visualize growing roots deep into the earth, our body releases. Poses become steady without effort, and muscles tone through release and extension.

The breath brings us to the state of quiet attention, the essence of yoga. As we follow the breath, the release of the exhalation balances the receptivity of the inhalation. The spine lengthens with a gentle wave-like release, bringing energy, vitality and movement to poses without force and strain. This release divides the body at the waist. The lower half is pulled into the ground, and the upper half is released toward the sky, giving lightness and freedom to the upper body. This wave-like movement can be felt throughout the entire body, gradually freeing up tight and tense parts of the body. 

The third yogic tool is Meditation, meaning focusing the mind and the attention. The focus could be the breath, body image,  awareness, sounds, visualization for health and wellbeing, pain relief, restoring energy, and many more as are widely practiced. Meditation is highly effective for decreasing anxiety, improving pain tolerance by changing perception of pain, and uplifting the mood, counteracting the harmful effects of stress. Long-term meditation appears to change the wiring of the brain and can help reduce the transmission of pain signals. As well, meditation can be freely practiced without Asana and Pranayama.

There are hundreds of Asana and Pranayama practices available. Some students find benefits from breathing or from relaxation, while others enjoy practicing a variety of poses. 

It is very important to find the right style of yoga and the right teacher as some practices are not suited for students living with pain. Consider your search a part of your path. Try different styles and different teachers. Ask questions about the type of yoga and qualification of the teacher. The studio and the teacher have to have experience in teaching students with chronic pain issues. 

A teacher  should be able to adopt and modify practices to suit different needs. Try a class ! You will know when your body says "yes" . 

There are numerous studies done about yoga for chronic pain. The most extensive study was done in 2010, and included patients with FM, Carpal Tunnel, chronic back pain, and cancer-related pain. In all study groups the main benefits were reduction of pain and functional disability, lessening of pain medications, a change in attitude toward pain and a person’s condition, and more confidence handling daily tasks.

"Yoga is the rhythm of the body, the melody of the mind, the symphony of the soul, creating the harmony of life." ~ B.K.S. Iyengar

Kathy Felkai