Yoga for Chronic Pain, Part 3
This is Part 3 of a three-part series offering yogic tools for chronic pain. Discover the use of asana practice for pain relief in Yoga for Chronic Pain: Part 1 and explore using breathwork and meditation for pain relief in Yoga for Chronic Pain: Part 2.
In Part 1 and Part 2, we discussed yogic tools including asana, pranayama, and meditation for chronic pain. In this third and final installment, we'll explore how using sounds, as in chanting and some breathing practices, can be helpful. We'll also look at how yoga can be part of a broader holistic approach to pain management.
The Yoga of Sound
There is something about chanting that moves the spirit, especially for those yogis who gravitate toward bhakti (devotional) practices. Many people find deep healing while chanting, even in cases where an actual cure isn't possible. Other ways to touch the emotional core of bhakti yoga include prayer and worship of a saint or a deity (though there's nothing in yoga that says you have to believe in any particular religion or God to take advantage of bhakti practices).
Aside from any devotional aspect of chanting, the physical vibration of sound waves has a palpable effect on the body and mind and is of demonstrated therapeutic value. Humming, for example, has been shown in scientific studies to open the sinuses.
Looking beyond their physical effects, sound waves can also be a vehicle to bring awareness into an area of the body that may be dull. Yogis have observed that areas of dysfunction in the bodyare often cut off from full awareness. From a yogic perspective, pain is commonly related to prana, or life force, not moving well through an area—a pranic block, if you will. Prana, according to yogic teachings, follows awareness. When the breath is accompanied by the vibrations of different sounds, it can be used as a tool to direct awareness. Thus, yoga teaches, generating sounds and following the sound waves as they traverse different areas of your body can be a way to move energy that has been stagnating.
Ujjayi breathing is probably the most common example of how sound linked to breath can help bring focus. One technique that yoga teacher Ana Forrest sometimes uses is to have a student engage in louder than usual Ujjayi breathing during a pose; she then asks the student to try to direct the breath to the dull or painful area. If you try this, see if your student can use any resulting heightened awareness of the area to find opening or release (and don't be surprised if the physical release is accompanied by an emotional one).
Bhramari in Asana
Another practice I find particularly useful in heightening awareness is to practice a pose while making the "bee breath" of Bhramari. You do this simply by humming gently with each exhalation, continuing to exhale as long as is comfortable. This is a simple way to get your students to lengthen their exhalations relative to inhalations without even thinking about it (which, as we've discussed, tends to shift the nervous system to the restorative parasympathetic mode). And for students whose minds are busy or distracted by their pain—or the story they are telling themselves about their pain—the noise of Bhramari tends to drown all of that out for a while.
If you tune in, you may notice that the sound waves of Bhramari resonate all through your body right down to the tips of your toes. This palpable vibration will also resonate through normally dull areas of the body and can be a tool to try to bring them to light. For example, a student who can't sense their rhomboid muscles in the mid back may be able to feel them vibrate during Bhramari. Once they can feel the muscles, they may have more success in engaging them. You might even try a visualization exercise in which your students imagine that prana is following the vibration through those areas.
Do You Need to Chant in Sanskrit?
Chanting different sounds at different pitches and intensities has different effects on the body. While there's nothing in yoga that says that you have to chant in Sanskrit, the traditional language of most yogic chants, there may be advantages in doing so. Sanskrit was a designed language, not one that arose spontaneously, and the masters who formulated it had likely engaged in a deep study of sounds and their effects on the body and mind for generations.
Chants were designed to have different effects based on their sounds, which is one reason why good pronunciation is said to matter. Different sounds resonate maximally in different areas of the body, and this was explicitly considered in assigning meaning to words in the Sanskrit language. Thus there may be specific effects of Sanskrit chants that are connected to the different areas of the body. If you try it, you may discover, for example, that the feeling of chanting "peace, peace, peace" is very different from chanting the Sanskrit equivalent, "Shanti, Shanti, Shanti."
One final aspect of chanting that may make it particularly beneficial for your students with chronic pain is the social nature of group chanting. People in pain may restrict their activities and wind up with limited social support. Sangha, or community, can be one of the most healing elements of yoga, and singing in a kirtan can be a great way to connect and share with others.
An Integrative Approach
As powerful as yoga can be, it's usually most effective in managing chronic pain when used as a complement to other approaches, both alternative and conventional. If muscle spasms appear to be a significant contributor to pain, hot baths as well as therapeutic massage and other forms of bodywork can be helpful. For those in whom the psychological and emotional burden of chronic pain is particularly disabling, cognitive-behavior therapists can help develop strategies for coping. Acupuncture can also be healing for a wide variety of pain disorders.
If your students aren't getting satisfactory pain relief from their primary care doctors, they may benefit from consulting a pain clinic. Best is that subset of pain specialists whose expertise extends beyond drug and surgical options to encompass mind-body therapies such as yoga. Even when drugs prove necessary, yoga may allow your students to get by with smaller doses, saving them money and lowering the risk of side effects.
Keep in mind, however, that chronic pain is by definition a condition that's been present for a long time. While yoga can help enormously, it is not a quick fix. Allowing your students to taste the effects of relaxation and of calming the mind—however transient they may be initially—can motivate them to stick with their yoga practice. Encourage them to work slowly and steadily, patiently building their groove of practice and deepening it over time. That's when yoga has its greatest effects, not just in lessening pain but in improving the lives and well-being of those who live with it.
Dr. Timothy McCall is a board-certified specialist in internal medicine, Yoga Journal's Medical Editor, and the author of book Yoga as Medicine: The Yogic Prescription for Health and Healing.