• Chronic pain is complex, and can have both psychological causes and symptoms

  • Yoga teacher and educator Heather Mason explores how yoga can help relieve chronic pain

  • We have therapists and counsellors who specialise in supporting people with chronic pain – find yours here

Chronic pain is a complex and often life-changing issue, and one for which there is no easy answer. The suggestion that pain is mismanaged worldwide and concerns over the efficacy and dangers of opioid medication has made questions over how we deal with pain a contentious issue. As a result, the medical and therapeutic community are exploring new ways to help support their chronic pain patients in leading a full life, with yoga therapy showing particular promise.

The problem with chronic pain

Conventional treatments for chronic pain include physical therapy, surgery and pain medication, with people’s treatment plan largely determined by the source of their pain. These treatment pathways can be highly successful, helping people to achieve a full recovery and move on in life pain-free. For others, however, there is no comprehensive solution, and their pain continues for months and even years.

This is especially true for those who suffer with chronic pain that has a hard-to-treat cause, or for whom no clear cause can be found. Unfortunately, while opioid medication is highly effective as relieving acute pain, it’s efficacy reduces as time goes on while the risk of serious addiction and withdrawal grows. Both health professionals and their patients are therefore extremely interested in the potential of new and alternative treatments to ease the experience of chronic pain.

The causes of chronic pain 

Part of the difficulty in treatment is that the underlying cause of chronic pain varies significantly from person-to-person, ranging from clear physical illness (such as endometriosis) to the truly undiagnosable (for example, in cases of chronic pain without injury). In all cases, however, there is strong psychological as well as physical element – with people living with chronic pain at greater risk of mental health issues, due in part to shared neural mechanisms between the two problems. 

Chronic pain is also an emotional problem, and can understandably cause feelings such as anger, hopelessness, sadness and anxiety. When we look at chronic pain holistically, it becomes clear that any solution which does not address the physical, emotional and psychological aspects of the issue will be incomplete.

Managing pain through yoga 

With the help of a yoga therapist (who has the training and knowledge necessary to ensure any underlying physical problems aren’t exacerbated), people living with chronic pain can use yoga to manage their symptoms and live a more pain-free life. The benefit of yoga in particular is that it combines a system of exercises and physical therapy with breathing exercises and mindfulness meditation.

As mentioned above, chronic pain has been linked to a variety of other negative health impacts, from mental ill health to cardiovascular problems. The strain that living with chronic pain causes has even been highlighted in brain imaging scans, where structural and functional changes in areas such as the prefrontal cortex and hippocampus point to the development of anxiety and depression.

People living with chronic pain experience continually elevated stress levels – a constant state of “fight or flight”. This effect is compounded by the social issues, such as isolation and loneliness, which often impact those who find themselves unable to engage in everyday life due to illness.

The physical benefits of yoga 

Evidence suggests that in many cases of chronic pain, bed rest (once widely prescribed) and avoiding movement can actually make the pain worse. The guidance of a yoga therapist can help people stretch and exercise in a safe way which won’t aggravate any underlying issues, gently improving flexibility and strength while also fostering increased mind-body awareness.

Studies exploring the use of yoga in the treatment of chronic pain have reported some promising results. These include a pilot study on low back pain where participants experienced significantly less pain in a four week follow-up than the control group, a meta-analysis that found yoga can improve daily function among people with fibromyalgia osteoporosis-related curvature of the spine, and another which found that people with osteoarthritis who practised modified Iyengar yoga classes reported significant reductions in pain.

The psychological benefits of yoga 

Yoga and mindfulness appears to have a powerfully positive impact on the way we experience pain, as well as easing the symptoms of related problems such as anxiety. Mindfulness practice in particular has been associated with increased grey matter density and reduced volume in the amygdala (the part of the brain that governs our stress response).

These positive brain changes could be responsible for the fact that even a brief introduction to mindfulness appears to change people’s perception of pain and its associated negative emotional impact. As chronic pain is linked to brain changes which could lead to anxiety and depression, yoga and mindfulness may have a protective effect on people’s mental health by soothing the sympathetic nervous system and taking people out of fight or flight mode.

More generally, participating in a yoga class and accessing the support of a yoga therapist could help those living with chronic pain connect with others who face similar changes - reducing loneliness and ensuring that people don’t become isolated. In this way, chronic pain sufferers benefit from a stress free environment where they can form social connections.

The benefits of yoga practice aren’t confined to the studio, either. Yoga therapists can empower those living with chronic pain with tools they can use throughout their lives - whether it’s a breathing exercise to calm down or simple asanas to support their physical wellbeing. Furthermore, yoga is associated with increased GABA levels - a neurochemical associated with contentment - helping to boost people’s mood and contribute to feelings of happiness.

Chronic pain is still not fully understood, and is such a varied and individualised issue that there is no silver bullet. However, using yoga as an adjunct treatment gives people another opportunity to cope with and even reduce their symptoms, and find the relief they need.

Heather Mason is the founder of The Minded Institute, who provide yoga therapy education to yoga and health professionals

Further reading

How Yin yoga supports my therapy

The impact of chronic pain on mental health

Polyvagal theory, dissociation and yoga: healing through embodiment

Try yoga nidra for a good night's sleep

What is chronic pain?