https://youtu.be/0pYtbSdelHc

Connecting Pain + Breath

Imagine being in the dentist’s chair and making a conscious effort to breathe through the drilling, poking, and prodding instead of tightening up to bear the pain. While we have an instinct to hold our breath when in pain, research suggests this is exactly what we should not do. In this article, I share the science of how breathing can reduce your pain and, conversely, how pain can disturb your breathing. When you hold your breath or rapidly breathe, the fight or flight nervous system is activated: your blood vessels constrict, muscles tighten, and pain and tension worsen. During a painful experience, it is important to open the blood vessels so the muscles can relax, toxins can be removed, and nutrients for healing can reach the area of pain.

In a review of 31 studies on pain, researchers concluded that pain will naturally alter healthy breathing patterns by increasing breath frequency and how much air we breathe in. They also confirmed that slow, long, and paced breathing is linked to a reduction of perceived pain. 

In a study published in 2020, 48 volunteers were divided into four groups. Group 1 did paced breathing. Group 2 did unpaced breathing. Group 3 did slow, deep breathing: 6 breaths per minute with a longer inhale than exhale. Group 4 did not have a set breath-per-minute pace, but they also did slow, deep breathing with a longer exhale than inhale. All the groups except Group 2, with an unpaced breathing pattern, experienced pain reduction. The slow, deep breathing with longer exhales reduced pain significantly more than the other groups, suggesting that deep breathing with a longer exhalation than inhalation is the most effective way to breathe away your pain. 

While many of these studies on breathing away pain were done on chronic pain, a 2022 meta-analysis that screened over 11,000 studies found that slow, deep breathing was very effective in reducing pain in burn patients. They also found evidence that slow, deep breathing could reduce acute or severe pain from, say, a trauma. 

Amping Up the Benefits with Awareness 

Mindfulness meditation has been shown to reduce pain in a variety of conditions including fibromyalgia, migraines, chronic pelvic pain, IBS, and more. Mindfulness meditation has been shown in numerous studies to reduce chronic pain and improve quality of life. In an 8-week study, pain reduction improvements from mindfulness were still sustained after 3 years. 

Ayurveda combines awareness with breath followed by meditation for a more comprehensive approach to pain support. This approach of being aware of the breath and the body sensations has been shown to manage pain as well as depression and anxiety symptoms according to the Mayo Clinic. 

Ayurvedic Breathing Practices For Pain

See video above for details.

1. One Minute Meditation with Active Self Awareness

• Practice 30 seconds of bellows breath followed by 30 seconds of sitting still with eyes closed in meditation. 
• During the meditation, bring awareness to the area of the body in pain during the inhalation and picture releasing the pain during the exhalation. This can be practiced while sitting or lying down. 
• Try practicing 2-10 times per day.

See also One-Minute Meditation

2. Slow Alternate Nostril Breathing with Breath Holds

• You can practice slow alternate nostril breathing with or without using your fingers to close the nostrils. To emphasize self-awareness and the feeling of the breath moving through the inside of the nostrils, you’ll want to alternate pinching each nostril closed.
• Bring your middle finger and index finger in to your right palm. Bring your thumb up next to your right nostril and your ring finger up next to your left nostril. Use your thumb to close your right nostril, leaving your ring finger gently resting on the outside of the left nostril.
• Close your eyes and breathe in, deeply but slowly, through the right nostril for a count of 4, 6, or 8 (depending on what feels most natural without any strain).
• Hold that inhaled breath in for the 4, 6, or 8 counts (depending on what feels most natural without any strain).
• Switch nostrils: close the left nostril with your ring finger, and open the right nostril by releasing your thumb from it. Slowly breathe out of the left nostril for 4, 6, or 8 counts, being careful not to strain yourself.
• Hold breath gently at the bottom of the exhaled breath in for 4, 6, or 8 counts.
• Breathe in through the right nostril, keeping the left nostril closed, for a count of 4, 6, or 8. Hold that breath in for the same amount of counts.
• Hold at the top of the inhaled breath for 4, 6, or 8 counts.
• If and when it is comfortable – extend exhale and exhale hold.

See also Podcast Episode 134: The Science and Yoga of Alternate Nostril Breathing

3. Bring Awareness to Alternate Nostril Breathing

• During your deep slow long nose breathing, consciously feel into an area of pain during the inhale counts.
• With each exhale, relax the area. Picture the breath leaving and releasing the pain.

4. Put it All Together: Breath, Meditation, Self-Inquiry

• One Minute Meditation: 1-3 rounds.
• Slow Alternate Nostril Breathing: 5-10 minutes
  • With pain awareness during inhalation and pain release during extended exhale. Maintain a 4, 6, or 8 count with breath holds at the top and bottom of the breath.
• Silent Meditation: 5-10 minutes
  • Maintain a natural deep and slow inhalation with a comfortable extended exhale. With each slow inhale, bring awareness to areas of pain. With each slow exhale, feel expansion and release of the pain.

Breathing Awareness Exercises for Specific Areas of Pain

See video above for details.

1. General discomfort
   • Practice long, slow lateral breathing during stretching practices
   • Poses such as Child’s pose, Sphinx, Bridge, Twist, and Camel.
   • Bring awareness to areas (marma points) of stretch or area of pain.
2. Lower back pain
   • Slow breathing during quad lunge, squat, and piriformis stretch.
3. Mid back pain
   • Sit up against a wall, Back bends with breathing and awareness for mid back pain.
4. Neck or shoulder
   • Use a yoga strap for a trapezius stretch. Engage with slow, deep breathing.

See also The Ancient Science of Inflammation + Pain Management: Understanding the Causes of Imbalance