Yoga: The First Line Treatment for Fibromyalgia
I recently had the wonderful opportunity to attend a “Yoga for Pain” workshop with Neil Pearson, a Physiotherapist, Yoga Therapist, and Pain Specialist from BC. Neil immersed the group of us yoga teacher trainees in all the latest research in pain physiology and the evidence for using yoga as a pain management therapy. I was excited to learn that the research is so supportive that yoga is actually recommended in the treatment of fibromyalgia in the national guidelines in both Canada, and the US. Way to go, yoga!
But how does yoga help relieve pain? In a yoga class, typically there is stretching to relax tight muscles, strengthening of weaker muscles, and hopefully a focus on bringing the body into better alignment. It seems reasonable that helping the body in those ways could help ease pain, but the real pain-relieving magic comes from yoga being a body-centred awareness practice. Yoga provides an excellent framework to approach pain and train the nervous system to turn down those pain signals.
First, it is important to understand what pain really is. It is an experience. We tend to think that pain is somehow attached to the area where we experience it in our bodies, but pain actually originates in the brain. Pain does not actually equal injury. Neil had a great example to illustrate this: think of a papercut – how much pain you experience versus how much tissue damage has been done. Pain’s purpose is to provide a warning preceding real or potential danger to motivate a change in your behaviour in order to prevent that potential injury. This system works wonderfully in acute situations like rolling an ankle. The trouble comes when pain becomes chronic. Typically, tissues may seem perfectly healthy in a chronic pain situation, yet seem to be the cause of potentially debilitating pain. The nervous system is the true culprit here.
In chronic pain, the threshold for sending a pain warning signal has been lowered. So, a touch that a normal nervous system may experience as pressure would be felt as painful. Pain interferes with the normal perception of our bodies and using the body awareness practices of yoga with the functional movement work of yoga postures can effectively train the nervous system back to a normal pain threshold. Take note that having a ‘high pain threshold’ is a different idea. A high pain tolerance is probably a better way to describe those people who can be experiencing a lot of pain before they ever show signs of what they are feeling. The aim is not to trick the brain, ‘mind-over-matter’ that the pain is not really there. Instead, we want a nervous system that appropriately warns us of danger, the awareness to act appropriately according to those warnings, and a nervous system that will turn the pain signal off when the danger is past.
Tips for your yoga practice: We need to approach pain’s edge if we want to change it. Knowing that the very start of pain is always a warning and not injury, the yoga practice involves coming to the edge where pain just starts and hang out there. Practice dropping into that savasana (corpse pose) feeling of safety, relaxation, peace, quiet, and stillness and see if the experience of pain changes. With practice, you will find that the nervous system does reset that pain response threshold when it is reassured that the danger has passed.
There are numerous yoga techniques that can work toward this relaxed, body-aware and pain-free state. Neil Pearson’s patient resource book is available at the clinic and provides a wonderfully simple yet thorough education in pain physiology and what to do about it. Also available for borrow are a Gentle Yoga for Pain DVD and a Breathing Techniques CD.
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