When I finished wrestling in college, I suffered from chronic lower back pain as well as persistent ankle and knee pain, which felt like they would never go away. The pain started with acute injuries while training and competing, and I kept re-aggravating the injuries without giving them time to heal.
When I retired from college athletics, I would obsess over the pain, and it prevented me from doing things like exercising and being outdoors. This spiraled into poor eating habits, bad sleep, weight gain and mental health struggles.
Fortunately, a friend convinced me to try yoga. Within five months of attending classes regularly, the pain subsided. I began to forget about my back pain, I slowly returned to exercise and spent more time socializing with new friends in the yoga community. The pain that once took over my mental bandwidth was gone, I was able to think clearly, and I felt like myself again.
Acute vs. Chronic Pain
According to the Centers for Disease Control and Prevention, in 2021 an estimated 20.9% of U.S. adults, about 51.6 million people, experienced chronic pain, and roughly 17.1 million people experienced high-impact chronic pain, or chronic pain that results in substantial restriction to daily activities.
Adriaan Louw, a physical therapist and pain neuroscientist, explains that acute pain is short-lived, such as a sprained ankle or a broken leg, and for this pain, you may seek out help and you recover quickly.
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Chronic pain is more complicated. Louw defines it as pain that lasts longer than the expected amount of time it takes tissues to heal. He says that the rise of chronic pain is alarming, and that diminishing mental health is likely playing a role.
Injury and pain are not synonymous, so not everyone who sustains an injury has pain, and not everyone who is in pain has an injury. Technically, pain is defined as chronic if it has lasted for six months. However, this timeline is not necessarily a good marker because everyone’s pain, injuries and therefore timeline to expect relief is different. The biggest predictor of chronic pain is the intensity and duration of acute pain. If acute pain is rated a five or above on a ten-point scale, it’s more likely to turn into persistent pain.
When someone is experiencing chronic pain, Louw says that it’s important to first rule out definite medical problems that require surgical or pharmaceutical intervention. Diseases like rheumatoid arthritis, diabetes, depression, hypertension and cancer can cause chronic pain and need to be treated.
[Related:Ranking the Most Painful Medical Conditions]
How acute pain becomes chronic
When you experience pain, your nervous system ramps up as your brain tries to protect you. Over time, this changes the receptors in nerves and the immune response in the nervous system, and you become more sensitive. The brain becomes preoccupied with the pain you’re experiencing, and you are unable to perform functional tasks such as concentration and memory, even though there is nothing necessarily damaged. In order to heal, you need to calm your nervous system down.
These changes in the brain are known as neuroplasticity, which can cause chronic pain. However, the brain is always malleable and could shift back to feeling healthy, which is hopeful for those who are in chronic pain to find relief despite the length of time you have been in pain.
[READ: How Yoga Can Help Manage Pain and Trauma]
Yoga: Exercise, Movement and Function for Chronic Pain
I found relief through the mindful movements in yoga class, which demanded concentration. That focus combined with the meditative aspects, breathing, mindfulness and social connection helped me gradually take my mind off of my pain. There are countless modalities to distract your brain from obsessing over pain.
“There are so many non-pharmacological, non-drug treatments you can do,” Louw says. “Everyone’s pain experience is unique.”
I practiced yoga for several years before I felt confident enough to return to other activities such as running and weight training regularly. Yoga provided a no-impact, mindful, moving meditation that was safe and helped me build up to more complex movements gradually, without setbacks. Now that I feel well enough, I mix up my exercise to keep me interested and moving. Yoga can help with pain for several reasons, including that it’s a low-impact activity, can combat catastrophizing about pain and provides social support.
[READ: Mind-Blowing Benefits of Exercise: Why Exercise Is Important]
Low-impact reintroduction to activity
Scientists’ understanding of pain has shifted from being strictly biological to what is known as the “biopsychosocial model,” and it considers the health of the whole person, rather than just physiology. This paints a more complete and accurate picture of how we experience pain.
“We understand joints, muscles, tendons and ligaments really well because we studied it really well,” Louw says. “Now we know what you think and believe about your pain experience is as powerful.”
Fear and stress have have been shown to impact wound repair in experimental and clinical models. This means that psychological stress leads to clinically relevant delays in wound healing. According to Louw, worrying about the pain itself will prolong the time it takes to heal. This creates a cycle that perpetuates the pain you experience, where you fear returning back to the things you love, such as exercise, and therefore you avoid it. The problem is that avoiding exercise due to fear can make your injury worse, not better.
When you first experience acute pain, it is important to ice in the first 48 hours to calm down your system and rest if needed. But then, it is crucial to get back to the things you enjoy and return to movement and exercise as soon as possible.
Louw says that the research shows that rest doesn’t work. Instead, “Focus on function. You’ve got to move. Pump blood around the tissues. All the research says movement helps. Get yourself going as quickly as you can — little and often.”
Combat catastrophizing and trauma
When you develop a negative attitude about your pain, it dampens your brain’s capacity to produce endorphins, or brain chemicals that can make you happier. This can prolong your pain and lead to depression. Being hopeful about pain can have a profound cascade effect where you become more positive, return to exercise, introduce more bloodflow and oxygen, and then improve your sleep, all of which can help reduce pain.
If there’s a reason for your pain, like an injury, Louw says that you can worry less about the pain. “In all our brain scan research, when I teach about pain, the brain beautifully calms down. If it hurts when you move, it does not necessarily mean you are causing harm. It is likely that your tissues have healed but your nervous system is still on high alert.”
Past trauma and mental health also contribute to pain becoming persistent. Someone who focuses on what they can do involving function and goals and returns to their normal routine as soon as possible will heal faster than someone who focuses and worries about their pain.
“We are all individualized because we have different experiences, different beliefs, different upbringings, we have different things going on in our lives,” Louw says. “We must tailor-make treatment to what’s going on. What is going on in your life right now with your job? How is your football team doing this season? Those things do matter.”
When I experienced persistent pain, I also had numerous life events that were causing stress. Yoga helped keep my mind calm and the supportive community was great for making new, like-minded friends.
Yoga as social support
When I was experiencing persistent pain, I was living alone in an apartment in a city where I didn’t have many friends. Without any career job or network, I withdrew from social activity, I isolated myself, and I felt a diminished sense of self-worth. Thankfully, when I started attending yoga classes regularly, the community at the yoga studio was very welcoming, and I started to make new friends who shared an interest in staying healthy and active. It felt like a weight had been lifted off my shoulders at the same time my pain was becoming less noticeable.
A 2013 study showed that pain patients in a satisfying spousal relationship are better able to cope with daily pain flares, thereby limiting their pain-related physical disability compared to patients who were either in less satisfying relationships or unpartnered.
Louw says that there is evidence that loneliness, lack of social connection, unhealthy relationships and mental health are factors that contribute to chronic pain. Empathy, communication and meaningful connections with friends and family help to ease pain, although each individual’s experience of pain is personal. Education and maintaining a positive sense of hope that it can and will subside helps those who are suffering.
Bottom Line
At the end of the day, education about pain can help you manage your pain. Louw was the principal investigator on a study that shows how teaching those who are in pain about pain neuroscience can help. One should seek out a provider who is knowledgeable, respects and communicates with their patients to better understand their pain experience.
Since I started to learn more about my pain, when I experience a painful episode I am more calm. By educating myself about pain, I am empowered to keep working on myself, knowing that there is hope it will improve. As I am able, I return to movement, yoga and exercise, ideally in a class or with a group, as soon as possible to help bring my mind and body back to health.
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How Yoga Helps Reduce Acute and Chronic Pain originally appeared on usnews.com
