Yoga For Chronic Pain

Chronic pain can lead to physical and mental consequences beyond the pain. Up to 50% of patients with long-term chronic pain can experience mood issues including anxiety and depression. Chronic pain can also impair concentration, attention, and memory, even after controlling for mood symptoms, which suggests that pain impacts cognition.

Chronic pain has been associated with structural changes in the brain. Structural magnetic resonance imaging studies (MRIs) of chronic pain patients have shown a decrease in gray matter in areas of the prefrontal cortex, insula, and anterior and midcingulate cortices-- areas associated with pain processing, regulation of mood, and cognition. It is unclear whether these brain differences are the cause or effect of chronic pain.

A recent review in Pain (April 2015) discusses the growing literature to support that mind-body practices like meditation and yoga can improve chronic pain and its negative impact on the body and mind. Several studies have shown that both experienced and beginner mind-body practitioners experience less pain when exposed to painful stimuli-- both during and outside of meditative states. Experienced yoga practitioners as well as short-term mindfulness practices have been shown to have increased ability to tolerate cold pain. Yoga has also been shown to improve conditions associated with chronic pain, including depression, anxiety, and fatigue.



There is also growing evidence that suggests the protective effects of yoga on the brain (both gray and white matter).

Yoga and meditation have also been associated with changes in the brain that appear to counter age-related decline in gray matter volume. Experienced yogis and meditators have more gray matter volume and cortical thickness in brain regions that are involved in pain processing, attention, autonomic control, and emotion regulation (including primary and secondary somatosensory cortices, insula, anterior and posterior cingulate cortices, superior and inferior parietal cortices, hippocampus, and medial prefrontal and orbitofrontal cortices). Yoga and meditation practitioners have also been found to have increased white matter connectivity throughout the entire brain (in contrast, chronic pain is associated with disrupted white matter connectivity). Even a short term intervention of 11 hours of meditation has been associated with white matter changes in areas associated with self-regulation (i.e., changes to the corona radiata, a white matter tract).

Chronic pain is challenging both because of the pain itself as well as the long-term impairment of mood and cognition. Yoga and meditation-- even short-term beginner practices-- can be effective non-pharmacological interventions to counter the long-term negative effects of chronic pain on the body, brain, and mind.

Bushnell MC, Case LK, Ceko M, Cotton VA, Gracely JL, Low LA, Pitcher MH, Villemure C. Effect of environment on the long-term consequences of chronic pain.  Pain. 2015 Apr;156 Suppl 1:S42-9. doi: 10.1097/