Pain Management: Integrating Yoga and Meditation

Updated: Aug 15, 2021

Pain is a universal experience that no one is immune from, though the degree and intensity differ. Discomfort describes the most common symptom that causes patients to seek medical attention. The feeling of pain is an alert system the body uses to signal impending or actual damage. Pain is described by the International Association for the Study of Pain, (IASP), as “Pain is an unpleasant sensory or emotional experience associated with actual or potential tissue damage.” Pain is a subjective experience that differs from person to person influenced by personality, beliefs, attitudes, culture, expectations, and social factors.

“The proper management of pain remains, after all, the most important obligation, the main objective, and the crowning achievement of every physician.”

- Dr. John J. Bonica Anesthesiologist and Founder of IASP

There are different classifications and categories of pain. Fundamentally, the two basic types are neuropathic and nociceptive pain. Other classifications based on pain duration are acute and chronic pain. Regardless of the type, going through pain is depressing and stressful. Pain has an emotional nature and tolerance level that differs from person to person. Within the tolerance level, an individual can withstand the painful experience. However, above this level the experience becomes unbearable. In view of this, ensuring that patients’ pain does not exceed its tolerance level is the primary task of all physicians and the health care system.


The Pain Brain

There are all types of injuries and pain, both inner and outer. As humans, we experience physical, emotional, behavioral, and spiritual pain and trauma while we are here. Eckhart Tolle refers to the pain-body a term for the build-up of emotional and spiritual distress that people possess in their energy field.

Dr. Peter Abaci, MD is one of the world’s leading experts in pain. He is the Medical Director and Cofounder of the San Francisco Bay Area Pain & Wellness Center and the author of “Take Charge of Your Chronic Pain: The Latest Research, Cutting-Edge Tools, and Alternative Treatments for Feeling Better” and the host of Health Revolution.

“I like to view pain as an experience, and it helps to understand this experience by what I refer to as the pain brain and pain body. The pain brain refers to a wholesale set of structural and functional changes that take place when pain persists.”

Based on the pain mechanism of action, pain consciousness originates in the cerebral cortex of the nervous system. Stimuli resulting from tissue injury activate pain nerve fibers (nociceptors). These nociceptors, in turn, send information to the spinal cord dorsal horn, then progress to the brainstem and ultimately to the cerebral cortex. “Another key part of the pain experience is the activation of glial cells in the nervous system, which seem to help perpetuate the pain response.”

Neuroplasticity

Neuroplasticity refers to how the brain evolves and changes based on a whole host of factors, and we see that the experience of pain leads to a number of neuroplastic changes throughout the nervous system that helps us understand different aspects of the pain experience, like depression, anxiety, sleeplessness, isolation, and motivational changes.

“All of these changes, in turn, are in constant communication with what is going in the body, leading to changes in how the body moves and functions, sometimes in very profound ways. When this “pain body” starts to shut down, then a person’s quality of life and ability to function goes down. This, in turn, communicates back to the brain, and as the two communicate back and forth, both the physical function gets more inhibited, and the actual pain becomes more debilitating” are according to Dr. Abaci.


Dr. Abaci says, “There are many different factors that contribute to getting stuck. We know that our attitudes and thoughts about a situation play an important role.”

Research has found that people who catastrophize the trauma pain event have longer lasting and more intense pain, and stronger medication use.

Physical factors play an important role as well. For example, studies have shown that bed rest is not helpful after a back injury and may slow the recovery process. Sometimes movement and exercise, when done appropriately, helps break the cycle.

Certainly, our emotions weigh heavily in the recovery process. Symptoms of trauma or hyper-arousal can set in. In order to help the person get unstuck and move forward, the treatment plan addresses these elements.

Physicians use different strategies in managing patients’ pain depending on the type. Findings show that Americans spends an average of $14 billion yearly on conventional pain medication drugs. The use of medication such as over-the-counter drugs and non-steroidal anti-inflammatory drugs (NSAID’s) can be effective pain relievers, especially for acute pain. However, for chronic pain management, their use can result in unwanted side effects.

“For many Americans who suffer from chronic pain, medication