Yoga Teachers and Chronic Pain Education

By Kristine Kaoverii Weber | May 26, 2023

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While I love fitness and exercise, yoga is different for me. Yoga is my refuge. Even 20 years ago, when intense yoga totally dominated the landscape, and I was clueless about explaining how what I taught was useful and not some kind of watered down version of “real” yoga, I just couldn’t bring myself to join the sweat fest.

I had started my yoga teaching career in an assisted living facility, working with residents with various disease processes, and also teaching regular mat classes, primarily attended by the wisest element of every culture – middle aged and older women. 😎😍 And while I’ve gone deep into yoga therapeutics and feel comfortable in that realm, yoga for preventing disease and promoting health is what really excites me.

As the population ages and we see upticks in chronic health conditions, I believe we are going to need an increasing number of well-trained yoga teachers and therapists to cross the bridge from fitness to wellness and therapeutics.

a group practicing chair yoga

author

As Dr. Timothy McCall said, “When word gets out about how powerful these practices are, there will not be enough well-trained teachers to meet the demand.” (I’ve often remembered that quote over the years when things felt bleak in the yoga space).

There’s a good chance that some of your students are dealing with chronic pain. Last week, a study was published revealing that there are more new cases of chronic pain among US adults than other chronic health problems like diabetes, depression, or high blood pressure. The study reported that 20 percent of US adults are dealing with chronic (or what I prefer to call “persistent” pain).

A couple of things – if you love teaching slower more mindful versions of yoga practice, that’s good, because it’s the kind of yoga that can help people begin to unravel their chronic pain, it’s the kind of yoga that the world needs right now. And (as I hear myself repeat ad nauseam but feel morally obligated to do so), yoga doesn’t fix everything of course – but it can be a very useful piece of the puzzle.

Yoga teachers can begin by educating ourselves about chronic/persistent pain. Here are a few tips:

  • Persistent pain is not the same thing as acute pain. Acute pain is typically the result of a problem – injury, or a medical issue like a kidney stone. It’s tissue damage. But persistent pain is not the result of a problem. Persistent pain IS the problem. This is the first step in understanding that there are different kinds of pain. It’s such a hard shift to make that many in the medical community still struggle with it. If we are to find lasting solutions to the chronic pain crisis – and the opioid epidemic it has spawned – we must rewire our neural networks that equate pain with injury and start to see things differently.
  • Persistent pain is pain that lasts more than 3-6 months.   
  • Persistent pain is also called “Brain Pain” or “Central Sensitization.” The brain has learned to be sensitive, it has learned to be in pain. It loses its capacity to process sensations appropriately. 
  • There are no pain signaling receptors. We have danger receptors. These are called Nociceptors. Nociceptors come in a few varieties including some that sense temperature, movement, and chemicals. Nociceptors are looking out for danger, not pain. Also, you don’t have a specific “pain center” in your brain. Pain is perceived by a complex interaction of different areas of the brain – it’s also influenced by many psychological and social factors. Do you feel safe, loved, cared for, supported, resourced? Answers to these questions contribute to whether or not you feel pain.
  • To begin to unravel the wiring of persistent pain, the body needs to feel safe. Movement needs to feel safe, interesting and even fun. Adopting an attitude of curiosity about your body and movement can go a long way towards reducing feelings of fear that perpetuate the cycle of pain.
  • Chronic pain is a public health issue – it is as cultural as it is biological. People seek out solutions to their pain via medication, and this has led to an epidemic. COVID increased suicides and death by overdose by a stunning 20%. Chronic pain is not just an individual problem, it is a reflection of deep dysfunction in the culture.
  • Research suggest that people who deal with persistent pain and receive Chronic Pain Education along with treatment show better outcomes.

Yoga teachers can be supportive allies in taming this cultural crisis. You can teach your students about persistent pain and point them to resources. I recommend starting with Dr. Lorimer Moseley’s site as a beginning point. 

Yoga can be a part of the solution to chronic pain. The more yoga teachers who understand chronic pain interface with health care professionals, the more that we can utilize our skills to support those who are suffering. Has yoga helped you or your students? Please share your thoughts in the comments.

References:

  • Nahin RL, Feinberg T, Kapos FP, Terman GW. Estimated Rates of Incident and Persistent Chronic Pain Among US Adults, 2019-2020. JAMA Netw Open. 2023;6(5):e2313563. doi:10.1001/jamanetworkopen.2023.13563
  • Marris D. Theophanous K. Cabezon P. Dunlap Z. & Donaldson M. (2021). The impact of combining pain education strategies with physical therapy interventions for patients with chronic pain: a systematic review and meta-analysis of randomized controlled trials. Physiotherapy Theory and Practice 461–472. https://doi.org/10.1080/09593985.2019.1633714

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