More and more scientific studies are showing that yoga can help improve medical outcomes for chronic pain patients. Excited by the findings, doctors have begun recommending yoga to help these patients. Anecdotally, however, outside of controlled studies many patients have tried yoga and have seen no improvement in their level of pain. Some even reported that yoga made their pain worse.
Why might this be, and is there anything we can do to make sure yoga is helpful and not harmful?
What Does ‘Yoga’ Mean, Anyway?
Yoga is a vast discipline with countless presentations, so what comes to mind when we hear the word ‘yoga’ may differ wildly from one person to another. The original intent of yoga practice was spiritual realization, but these days yoga might be for physical fitness, stress relief, or a fun experience with friends. It can be hard to know which, if any, of these versions of yoga would help chronic pain.
The meaning of the word ‘yoga’ is ‘to yoke’, or ‘to unite’. The practice of yoga is meant to bring union on multiple levels:
a personal level: connecting body, mind, and spirit
a social level: connecting the self to others and the environment
and an existential level: connecting the self with a higher power
More often than not, unfortunately, disconnection is chronic pain’s constant companion. It is common for people experiencing persistent pain to feel a sense of separation from their bodies or to have a distorted perception of their bodies. Living with pain can also lead to social isolation, a loss of self-identity, or life purpose.
If changing chronic pain is your goal, the yoga you practice must lead to connection, and not disconnection. Some yoga classes are more conducive to this. Below are some indicators that a class may not be ideal for helping to lower your pain level.
Signs That a Yoga Class Won’t Help Your Pain
1. It only addresses the structure and tissues of the body
A yoga class that focuses entirely on bodily alignment and increasing strength and mobility is only addressing one aspect of pain. At first glance, it may seem that pain is caused by injury to the body’s tissues. In reality, pain is produced by the nervous system in order to protect us from injury, and the nervous system is influenced by all aspects of our being: physical, mental, emotional, and spiritual.
2. The teacher uses language of fear
When pain becomes chronic, the nervous system has become overprotective, believing that you are in danger although the risk of damaging yourself may actually be low. The language a yoga teacher uses may reinforce the idea that your body is in danger and needs extra protection, encouraging your nervous system to stay in its hyper-vigilant state. Common cues such as, “If it hurts, don’t do it,” or even, “Be careful,” are intended to help you take care of yourself, but these warnings can instead increase the perception that you’re in a precarious situation.
3. The mindset is achievement-oriented
Does accomplishing the poses seem to be the purpose of the class? Is it implied that being able to do postures that require greater strength and flexibility makes you an “advanced” yoga practitioner? This type of achievement-oriented class leads us to strive for a certain outer appearance, which often comes at the expense of our inner experience. We may end up pushing ourselves beyond what’s wise in order to attain that outer appearance. Pushing too hard has an agitating effect on the nervous system, and can lead to pain flare-ups.
4. You don’t feel able to customize
Nearly all yoga teachers will tell you to do what is best for your body, but that is not always easy to do in the midst of a yoga class. If the teacher does not give options, you may not know how to make accommodations when a pose does not seem beneficial. If the teacher insists on a specific alignment, you may get the sense that you are wrong for adjusting a pose, even if you would be more at ease by changing it. And if the pace of the class is fast, you may find that you don’t have the time to figure out how to adapt the practice to your needs.
How to Make Yoga Work for You
Healing begins from a place of safety. The strategies below will help you connect more deeply to yourself during your yoga practice, which has the effect of cultivating a sense of safety in your nervous system.
1. Learn to listen to yourself
In a class setting, we can get wrapped up in trying to do exactly what the teacher says and never notice what we ourselves have to say. Become aware of the signals your body is sending you. Notice any reservations you bring into the yoga class, and what kinds of thoughts and feelings you have in response to the practice. All of these play into either soothing your nervous system or reinforcing its overprotective response.
2. Respond to the feedback you get from yourself
If your breathing is strained, see if you can calm it. If you feel tense, see if you can relax your muscles. If you cannot, take it as a reflection of your nervous system and consider adjusting the pose. If you find yourself thinking about how you will crash later because of your yoga practice, decrease your intensity or take a rest. Remember that you are in charge of your experience.
3. Adopt a mindset of openness and curiosity
You may know what effect a posture or breathing exercise is “supposed to” have. Try putting that aside and instead, ask yourself what your experience is actually like. If what you observe does not seem beneficial, try experimenting with making small changes, such as changing the position of your arms, and see what that’s like. Through exploration, you will learn to trust yourself to know what is helping you and what is not.
4. Be kind to yourself
Self-criticism can make the nervous system feel threatened in the same way as physical danger. This is why it’s important to speak to yourself with compassion and encouragement in your yoga practice. If you feel like you are falling behind, remind yourself that your journey is unique, so your yoga practice will be, too. If you accidentally push too hard and have a flare-up, remember that trial and error is part of the healing process. Affirm to yourself regularly that what you are doing is hard, but you can do it.
5. Find a teacher who understands pain
Any of the previous tips will help your yoga practice serve you better. But sometimes it’s nice to be in a class that’s already being taught this way, especially if you are new to yoga. If you can, find a teacher who has experience working with people in pain. There are some yoga teachers and yoga therapists who have special training in pain science and best practices for teaching yoga to people with chronic pain.
It can be a challenge to know if a yoga class is going to be helpful for changing your pain, but the ability to harness the power of yoga can transform your pain and your life. The key to changing pain is to foster a sense of safety in your nervous system, and yoga can help by bringing you into a deeper connection with yourself. The strategies outlined in this article are meant to help you help yourself in building safety and connection through your yoga practice. However, if you want more guidance, seek out a knowledgeable teacher experienced in working with chronic pain.