Yoga Inputs in the Management of Chronic Pain: An Overview

Acharya Balkrishna^*
*Correspondence: Acharya Balkrishna, Patanjali Research Foundation, India, Email:

Introduction

Acute pain has a protective function. Chronic pain is no longer a sign of a disease. It lasts longer than natural healing times, is out of proportion to the underlying cause, is accompanied by a sensitised nervous system that prevents natural checks, and serves no beneficial function. Persistent pain patterns are caused by a variety of chemical, anatomical, pathophysiological, and genetic changes in brain circuits. It mimics the features of a sickness that necessitates specialised treatment.

Pain is defined by the International Association for the Study of Pain (IASP) as "a subjective unpleasant sensory, emotional experience caused by or explained in terms of an actual or potential damage." It qualifies the experience as subjective, unpleasant, sensory, and emotional, recognising the mind-body parts of it. The experience begins in our consciousness, then moves to the physiological and behavioural levels. This relationship knowledge can help health practitioners better understand and care for people with chronic pain [1].

Chronic Pain's Multidimensionality

Chronic pain is frequently described as comprehensive pain, which includes physical, emotional, social, and spiritual aspects. The following discussion aims to emphasise the importance of both physical and nonphysical factors in the persistence of chronic pain.

Physical: Chronic pain isn't only a symptom of anything else. It manifests as disease as a result of active processes, manifesting as a series of plastic changes that affect the length and degree of pain. Neuro-chemical and neuro-anatomical components cause central and peripheral nervous system sensitization, which leads to hyperexcitability, recruitment, and disinhibition of pathways, amplifying and perpetuating chronic pain [2].

Emotional: Chronic emotional pain impairs function and contributes to anxiety and depression. The hypothalamic-pituitary-adrenal axis, as well as the sympathetic system, is in a state of hyper arousal, and the physiology is in a condition of chronic stress. It has a negative impact on sleep, energy, and appetite. During the acute phase, high scores on a psychosocial assessment and emotional distress (Hopkin's symptom check list) were also substantially linked with non-recovery and pain persistence.

Social: Chronic pain has a negative impact on interpersonal relationships, which are an important aspect of all human social interactions. When a person is in chronic, unrelenting agony, he or she loses control of the situation, loses selfconfidence, and withdraws. Some people may become angry, confrontational, and aggressive as a result of their experiences. People close to the sick person may exhibit excessive protectiveness, avoidance, guilt, or resentment.

The chronic pain patient is always disturbed by the loss of role, the fear of dependency, and future pains. There is a feeling of loneliness and isolation. Inadequate social problem solving may have a role in the development of chronic pain, according to studies [3].

What Role do Asanas have in the Treatment of Chronic Pain?

The yogic postures, or asanas, are commonly referred to as "The Yoga" by laypeople. It is, however, only one of the eight limbs of the yoga philosophy. Asanas are divided into four categories: physical cultivation, balancing, relaxing, and meditation.

Relaxation Response

Asanas and Pranayama trigger a "relaxation response" in the neuroendocrinal system, bringing the physiological system into balance. This includes a drop in metabolism, a drop in breathing rate, a drop in blood pressure, a drop in muscle tension, a drop in heart rate, and an increase in slow brain [alpha] waves. The habitual deep muscular hypertonicity and hence the static stress on postural muscle gradually decrease as the neural discharge pattern is adjusted. With a sense of relaxation, visceral function improves, and sleep becomes deeper and more persistent. The level of exhaustion decreases [4,5].

During meditation, several subtle level notional adjustments occur, changing the context of the disease, pain, and the meaning of life. Meditation and Pranayama, as well as calming asanas, can assist people in dealing with the reactive components of chronic pain, thereby reducing anxiety and sadness.

References

1. Andrés, Jose De, and Guillermo Garcia‐Ribas. "Neurophatic pain treatment: the challenge." Pain Practice 3 (2003): 1-7.
2. Upledger A. Cranisacral therapy II: Beyond the dura. Seattle: East land Press; 1987.
3. Grotle, Margreth, Jens Ivar Brox, Bredo Glomsrød, and Jan Harald Lønn, et al. "Prognostic factors in first-time care seekers due to acute low back pain." Eur J Pain 11 (2007): 290-298.
4. Vallath, Nandini. "Perspectives on yoga inputs in the management of chronic pain." Indian J Palliat Care 16 (2010): 1.
5. Wallace, Robert Keith, Herbert Benson, and Archie F. Wilson. "A wakeful hypometabolic physiologic state." Am J Physiol-Legacy Content 221 (1971): 795-799.