Working with Pain in Yoga

Research

Meditation reduced pain sensitivity (2011)  link

• Brain scans demonstrated that mindfulness meditation can dramatically reduce sensitivity to pain — even more so than morphine.
• Published in the Journal of Neuroscience.

Yoga reduced chronic low back pain as effectively as PT (2017)  link and link

• 320 racially diverse and predominantly low-income people with chronic low back pain
• Specially trained yoga teachers taught gentle poses, study lasted one year
• Gentle yoga was just as safe and effective for reducing chronic low back pain as physical therapy.
• “Participants in both the yoga and physical therapy groups were less likely to use pain medications at 3 months compared with the education group… Satisfaction and quality of life were similar between the physical therapy and yoga groups.”
• Conducted by Boston Medical Center researchers, with input from yoga teachers, doctors, and physical therapists.
• Learn more: Guidebook and Teacher Training Manual for Boston Medical Center Program for Back Pain

Review of all randomized control trials published: Superior results with chronic neck pain (2017)  link

• A team examined all of the published randomized controlled studies in which adults with chronic neck pain were assigned to either a yoga intervention or a control group
• Analyses revealed that yoga provides superior results to usual care in the relief of neck pain intensity and neck pain-related disability
• In addition, yoga group reported better quality of life and improved mood compared to controls. Short-term reductions in pain, disability, and negative mood were found for both movement-based, and meditation-based yoga interventions.

Significant improvements in pain levels, mood & functional capacity for those with chronic pain & depression (2020) link and link and  link

• 28 participants aged 34 to 77 years who reported having chronic pain for at least one year
• 8 weeks of instruction in a mindfulness-based stress reduction (MBSR)
• 2.5-hour weekly instruction + home sessions with a goal of 30 min per day, 6x week.
• “Small-scale study in a semi-rural population in Oregon where issues of affordability, addiction, and access to care are common.”
• “Mindfulness meditation and hatha yoga were found to benefit patients with chronic pain and depression, leading to significant improvement in pain levels, mood, and functional capacity. “
• “Chronic pain often goes hand-in-hand with depression,” says Dr. Marske, who believes meditation and yoga are viable options for those seeking pain relief without pharmaceutical treatment. “Mindfulness-based meditation and yoga can help restore both a patient’s mental and physical health and can be effective alone or in combination with other treatments such as therapy and medication.”
• Journal of the American Osteopathic Association

Randomized control trial: Mindfulness meditation reduced pain by decoupling it from the sense of self (2022) link and link and link

• Mindfulness meditation reduced pain and researchers who designed this controlled trial asked the question, “Why?”
• The research showed an interruption in the communication between areas of the brain involved in pain sensation and the sense of self.
• Although dates on links are showing 2023, the research was originally published in 2022.

Double blind randomized control trial (2016) link

• Mindfulness meditation reduced pain and researchers who designed this controlled trial asked the reason, “Why?” They hypothesized that the reason is due to “endogenous opioids” as defined here. The research proved the hypothesis wrong. Later research (see above) provided the answer.
• “The findings clearly demonstrate that mindfulness meditation eases pain through some distinct pathways that are independent of the endogenous opioid mechanisms.” (source)

Randomized control trial:  Decreased pain & fatigue in CFS (2014)  link and link

• People with chronic fatigue syndrome who were “resistant to conventional therapy.”
• Results after 9 weeks showed decreased fatigue.
• Some reported pain relief with no adverse effects.

Randomized control trial: Helps low back pain  link

• Article by Melanie Haiken, Yoga Journal includes results from a randomized, controlled clinical trial showing that yoga clearly helps those with low back pain.

Small qualitative study: Reduced pain & improved well-being in people with systemic lupus (2018)  link and link

• In “preliminary research, yoga showed qualitative improvements for women living with systemic lupus erythematosus (SLE)… Three research participants completed the eight-week (sixteen 60-minute sessions) study and reported positive outcomes, including reduced pain, increased relaxation, and improved general well-being.”
• The study was to determine feasibility of expanding the research. “Three yoga teachers living with SLE were interviewed to offer input on adapting yoga to those living with lupus, such as including restorative postures, alternatives for challenging inversions, and cooling breath practices. Some of the key features of lupus are fatigue and pain, which are episodic when the disease flares.”
• Complementary Therapies in Medicine

Postural awareness reduced chronic pain (2018) link

• 512 people with chronic pain were given a Postural Awareness Scale (PAS)
• “Improvements in postural awareness are… associated with reduced pain in patients with [chronic] pain.”

Randomized, single-blind, controlled trial: Carpal tunnel syndrome pain reduced (1995)  link

• 42 individuals with carpal tunnel syndrome, ages 24-77
• Yoga group had statistically significant improvements for grip strength and pain reduction.

Foundations & Priorities

Before embarking on particular strategies and tactics for working with pain in yoga, you may wish to consider these as foundations and priorities:

1. Learn to differentiate sensation and pain.
2. Avoid pain in practice.
3. If a student is seeking pain, help her to let this go for now. This may not be easy but seeing and experiencing success in using yoga to relieve stress may provide motivation. Perhaps over time, you may be able to gently encourage that she investigate the reasons why she has this tendency. (i.e. Is there a lack of differentiation between sensation and pain? Or is the desire for pain a response to one’s personal history?)