The Top 8 Things to Naturally Help Your Chronic Pain

How to Think, Move, and Breathe to Reduce Your Pain

Naturally Help Your Chronic Pain

In part one of this article series, you got an introduction to pain neuroscience and learned about pain and the brain’s role in it. All of the terms used in this article, such as threat value of pain and pain neurotags are defined and discussed in part one. Understanding those concepts sets the table for what you can do with them. Now, you’ll find out about the top eight pain neuroscience-informed health approaches to naturally relieve your pain through thinking, moving, and breathing. One of the best parts of these tactics is that they all cost nothing!

To get the best results with these approaches, make sure that your pain’s root causes are addressed through lifestyle changes and a Functional Medicine protocol, if necessary. These methods can help with any kind of pain, but if what’s fueling the fire of your pain isn’t dealt with, the benefits will be limited. I’ve employed all of these methods in my recovery:

Thinking

1. Education
2. Psychological reframing of threats
3. Stress management
4. Long-term view vs. Short-term view of your pain
5. Pleasurable distraction from pain

Moving

6. Movements: virtual, nerve glides, and gentle exercise
7. Teasing pain

Breathing

8. Deep breathing

Thinking

In our culture, the mind/body relationship is poorly understood. This has led to many misconceptions about pain and the mind’s role in pain, leading millions of chronic pain sufferers like you to feel helpless and sentenced to a life limited by a seemingly mysterious and patternless pain cycle or even deemed to be crazy. But we are not passively running around in our bodies, at the mercy of every sensation, thought, or emotion. We have free will and can change our focus or thinking at any time. Our brains record our every thought and experience, and we can revisit and alter those conclusions. Because of this foundation of free will and neurology discussed in part one, we can use pain neuroscience to improve our relationship with pain. These benefits all come from thinking. They are seen in the calming effect education about the subject has on the nervous system, learning how to cognitively frame threats to our health, and practicing stress management to lower nervous system arousal and release beneficial biochemicals. Also of critical importance is learning to have a long-term view, rather than a short-term view of pain to make it through high pain scenarios, and to use a pleasurable distraction from pain for pain relief and to disrupt neurological pain patterns. We can also use a proper knowledge of pain to reprogram the brain and nervous system, lower pain intensity, and lessen the frequency of pain alarm signals. This base of using thinking to your advantage is key to the five following approaches to naturally help your chronic pain.

Naturally Help Your Chronic Pain Thinking

1. Education

Naturally Help Your Chronic Pain Education

Due to the biochemical effects of lowering your fear from becoming aware of how many factors can influence your pain, simply becoming more educated about pain can naturally help your chronic pain.1 When you go from a state of thinking about your pain as unknowable and mysterious and become convinced there is a rational explanation for your pain, nerves can immediately start calming down. This has been seen in Functional MRIs. When chronic pain patients receive a pain neuroscience education, all their fears reduce, and the FMRIs show a corresponding decrease in brain inflammation and a change in pain perception.2,3,4,5 Understanding pain can reduce one’s tendency to catastrophize pain (feeling like the world ends when pain rises) and the threat value of pain.6,7,8,9 Reducing catastrophizing lowers fear and activates the naturally occurring opioids and cannabinoids in the brain, which can further calm pain.10

The good news is that if you read part one of this series, you’ve already gotten a large dose of pain education to demystify the subject. Hopefully, you’re already bringing your mind to more ease that with the knowledge of pain neuroscience, that there could be a way to help your pain, and you’re learning to observe your pain with a curious rather than fearful attitude. That skill of non-negative pain observation has the triple benefit of reducing your fear, not triggering a stress response, and can cease the triggering of the thought-based component of a pain neurotag pattern, a concept discussed in part one.11 Merely approaching observation of your pain with curiosity rather than fear can stop the pattern from triggering and start to untangle the complexity of the pain neurotag. With enough practice of training yourself with the knowledge that your chronic pain is your brain protecting you and not necessarily tissue damage, you’ll find yourself thinking like the titular character from Lawrence of Arabia and “not minding that it hurts.” Pain will be present, but without the same menace attached to it, and you’ll find pain of a five out of ten or less drifting into the background of your awareness, particularly when you integrate approach five, distraction with pleasure.

2. Psychological Reframing of Threats

Psychological reframing is another way to naturally help your chronic pain. It is a technique that consists of identifying and then changing the way situations, experiences, events, ideas, and emotions are viewed. It is the process by which such situations or thoughts are challenged and then changed. When you understand that pain is a protective alarm that the brain triggers when the data supports that you might be in danger, not that you are necessarily suffering tissue damage when it occurs, you can reframe many of your experiences with pain and properly assess their threat levels to you. For example, you can decide that it is worth trying to go for a walk that causes foot pain when you have no tests showing tissue damage to explain it, as it could be a mistaken pain pattern in the brain that can be retrained. This creates opportunities to do more despite your chronic pain and to lower your pain! As mentioned earlier, learning about pain reduces its threat value. Reducing threats to their proper level is a critical part of a mindset to conquer chronic pain. This is because reduced threats to the body will reduce the activation of every protective system that can trigger pain in the body: sympathetic, immune, endocrine, and motor.12

Once you’ve ruled out any acute dangers to your health through help from Functional Medicine, instead of the fear that: “this pain keeps getting worse, and no doctor can explain it, so it must be something horrible,” you can realize after pain education: “my brain keeps increasing the pain for any number of factors unrelated to tissue damage, such as the present circumstances and my feelings about them being similar to when I was injured. The pain neurotag has been triggered so often that the body is running this pattern with ease.” This thought will decrease the threat value in your mind associated with your pain experience. It will reduce your stressful reaction to your pain and keep you from having a flood of stress hormones which can be inflammatory and excitatory to your nervous system, as discussed in part one. Since the mind and body are connected, you can sometimes immediately shift the old negative thoughts that trigger the neurotag from a major threat that causes a stress response and inflammatory chemical release to a feeling of calm that mitigates or stops a pain response. This was the case for me regarding extreme temperature sensitivity during the worst of my fifteen years of disability from autoimmune disease. I had such negative symptoms and felt like I couldn’t handle any additional discomfort, so I always avoided showers for up to two weeks. To fix this, I shifted my thinking from how much pain and unease I would get from a hot shower to the benefits I would get from getting clean. I also realized that by avoiding a shower for so long that I was programming my brain that this was a high threat activity when it was something that would only add discomfort for an hour or two. After these mental changes, I felt improvement from my temperature sensitivity during the first shower, and within a week, the problem had improved considerably.

Sometimes, the pain patterns are deeply ingrained, and it will be difficult to convince yourself of the new conclusion immediately or to retrain every facet of a pain neurotag because there are so many areas of the brain involved in it. Completely breaking a neurotag will be discussed in a future article and is fully explored in my book, as it is a complicated subject that requires an all-out assault to undo.

Another example of reducing the threat of an experience and opening new avenues for pain relief is to reframe your circumstances concerning exercise. Exercise is almost universally painful for anyone with chronic pain, even after it has been found that movement will not cause further tissue damage. A lack of a way to move is where most chronic pain sufferers end up trapped in a downward spiral of deconditioning, atrophy, ever-increasing hypersensitivity, and lowered pain thresholds. Without knowledge of pain neuroscience, one can easily conclude: “walking makes me hurt! Anything that makes me hurt is making me worse!” Someone with knowledge of pain can instead reduce the threat value by concluding: “pain does not necessarily mean tissue damage is occurring. Perhaps I can do this activity anyway. I should try going for a three-minute walk because that will give me some endorphins and untangle the neurons stimulated by movement in this pain neurotag.” This attitude and approach applied to exercise are critical for progress with any chronic pain condition. Later in this article, you will read a fuller discussion of this topic with the revolutionary concept of teasing pain.

3. Stress Management

Stress management encompasses learning to deal with physical, chemical, and emotional stressors. A capable Functional Medicine practitioner can help with the first two kinds of stressors. The latter can be addressed through your efforts and with the help of a skilled psychologist, such as my book’s collaborator, Dr. Jim Lemons.

Emotional stress is everywhere in a chronic pain scenario, whether it’s from distress over your decreased level of function, getting no relief from your pain, social isolation, or lack of anyone understanding your pain. All of these situations can raise your pain and supercharge your nervous system. This result is thanks to fear reactions and the fight, flight, freeze stress response releasing inflammatory chemicals such as adrenaline and cortisol, two chemicals that influence pain levels and pain sensitivity directly, as discussed in part one.

Naturally Help Your Chronic Pain Journaling

Some additional solutions for these kinds of stressors are journaling, deep breathing exercises, seeking opportunities to connect with others, and learning to communicate better by appealing to rational values, such as someone’s desire for personal growth, or to be recognized for their strengths rather than fixating on their weaknesses. Journaling can help you get out of an emotional spin and to the root of what’s on your mind, to work through the whys behind your feelings, and find what values you need to resolve your situation. Deep breathing is also essential and is discussed in point eight of this article. Reaching out to others or trying to improve your current relationships can help you feel more connected, valued, and loved, all of which can start a beneficial biochemical cycle that can lower your pain through endorphin release. Communication about your pain can also help reduce your pain through stress relief. When you understand pain and can explain it to others, you open the door to them finally being able to understand what is going on with your chronic pain. When dealing with intense psychological trauma, seeing a psychotherapist can be crucial to working through it and unlocking lower pain by relieving your stress response.

Stress management is a broad topic that I devote considerable attention to in my forthcoming book with Dr. Lemons, and is a critical tool for naturally lowering your chronic pain.

4. Long-term vs. Short-Term View of Pain

When pain arises, it’s easy to get trapped in an agonizing moment, losing touch with the past or a possible future where your pain is less powerful. This power is part of the nature of intense pain–it is your brain seizing your attention to get you to address the root causes of the pain, and it can give you mind-dominating signals to get your attention to do so right then. In the grips of such intense pain, that moment can feel like the only experience you’ve ever had, and all you want is for that moment to be over with, yet you feel too terrible to take any action. This is a conundrum. It is essential to hold on to a long-term view in such moments. Doing so will keep you grounded and stop you from going on a mental loop that can increase your pain. It can keep you from obsessing and ruminating on the hopelessness about your pain, which fires up your amygdala and other reinforcers to the pain cycle, as discussed in part one.

Learning not to get caught up in that cycle is an essential skill to naturally lower your chronic pain and to master it. To do that, you need two things:

1. A plan for improvement that you trust, which you can get from an expert with knowledge of lifestyle changes, and Functional Medicine when the problems are serious enough. Trust in that plan can give you the confidence to endure and not panic when your pain rises into the red zone.

2. A way to stay calm under the pressure of intense pain, which takes knowledge of how pain works, and mental effort to train a habit to look for your progress when your pain isn’t at its highest. Pain fluctuates for everyone throughout a day and isn’t always indicative of tissue damage. That knowledge alone can keep you calm when the pain fires start. Fixating on a single high number when it isn’t something new usually isn’t helpful–it leads to catastrophic thoughts, fear, and despair, which all can increase your pain. (That said, always seek a medical opinion if it’s the first time your pain shoots up to a new level, though often, even that isn’t indicative of a new problem. Unfortunately, this is something you sometimes have to discover the hard way through surviving a lot of high pain and learning not to worry that it’s a new threat.)

Progress is your anchor to cling to when your pain is high and what you need to look for when your pain isn’t at your highest. But how do you track improvement when you hurt all the time? It is impossible to see your progress by watching your pain minute-by-minute, daily, or even weekly when you’re deep in the chronic pain cycle. The solution is to observe your activity and changes in your lifestyle for progress, not to track your pain. I had three-month periods of my recovery where through the lens of pain numbers, nothing changed. But looking at my life in terms of activity and lifestyle changes, there was no question that I had improved dramatically. Sometimes, it was an increase in the number of steps I could walk per day. Other times, it was a reduction of a medication or two. It could even be a sudden cessation of a reaction to a particular food. If you’re making progress in some area of your health across weeks or months, that can be your sign that you’re improving. That’s what you hold on to when the pain doesn’t drop. Train this mindset when your pain isn’t high so that you have the cognitive ammunition not to give in to despair when the pain rises to a 9 or 10. While it is possible to change your thinking when your pain is high, your mind is usually too occupied with the pain to effectively change your thinking. When the pain flattens you, call up the thought that pain isn’t always indicative of your progress, and remember all the wins you’ve tallied with your health.

If your pain isn’t quite that intense, then you can track your pain numbers and watch for trends across weeks and months for progress. That was a much later benchmark for me when I had gotten out of my severely impaired state. Pain is too ephemeral to make any sense out of hourly and daily fluctuations in most cases.

With this tool and the knowledge of how pain works, you can start to observe your intense pain without fear.

5. Pleasurable Distraction from Pain

Naturally Help Your Chronic Pain Pleasurable Distraction

Pleasure and distraction, when combined with observing one’s pain without negative emotions can create a powerful combination for lowering your pain and lead to healing. It was one of the most important ways I progressed with my health when so many other ways to improve were closed to me. The need for pleasure when in chronic pain is quite simple: pleasure generates endorphins, which physiologically helps your pain and brings you to a parasympathetic state, also known as the rest and digest mode. This state is where healing occurs, so it’s of paramount importance to do all you can to get into it. Conversely, fixating on your pain with a negative attitude can cause an escalation of the symptoms.13,14

But finding pleasure is difficult when you have chronic pain, especially if it’s acute. Before you can find pleasure when you’re in pain, you first have to mourn the loss of your value(s), which can take significant time and effort as you adjust for the context of where you’re at now that you have chronic pain. When you’ve lost the ability to engage in your highest values, it’s going to be hard to have the drive to seek pleasure. Suppose you used to love exercising, and now you can’t do any exercise without pain, or you lost an important relationship or a treasured job because of your poor health. In that case, you can feel too devastated to want to pursue anything else. Even just your pain can make you feel like you can’t have any happiness. If needed, seek a psychotherapist who has experience with chronic pain and chronic illness clients to help you with the process. Getting through this point is one of the hardest parts of having chronic pain or illness. It is such a vast and critical issue that I will address it in a future article and fully in my book.

It is often said that laughter is the best medicine, but happiness is ultimately more rewarding than laughter. Both states create endorphins, but there is nothing like the happiness of seeing your values in the world, achieving goals on whatever level is possible to you and having others see you for the valuable individual you are. As soon as you can, even before your mourning process ends, make an effort to pursue happiness wherever possible in your life to grant yourself a vital handhold while you’re hanging on for your life through dire pain. This effort can be much easier said than done, but when you do, you’ll be fighting your pain the entire time with endorphins and creating opportunities to heal.

If your old interests are closed to you, try out new activities. Or if you feel up to social interaction, find activities to do with friends or family or seek out new acquaintances even from your own home over the Internet. I loved epic video games, watching sports, and spending time talking with others. But my nervous system was so hypersensitive that such games caused me pain. I was in too much pain to meet anyone new, had lost all my friends, and my mind was so interrupted by pain that I couldn’t tap into my intelligence well enough to have or keep up with stimulating conversations. So I instead took up playing card games and watching older movies at low volume with my parents that weren’t as excitatory to my nervous system and had brief chats with my parents about their past so I could listen and learn more about them. That gave me something to look forward to every day that I enjoyed and also built my relationships with my parents to a wonderful level. I slowly progressed from there to the point that I could get back to all my old interests and meet new people. I had my final breakthrough to perfect health when I began scouting to move out from my parents’ house, met the best friends I’ve ever had, and saw the ideal place for me to open a business and fulfill my dream of inspiring others to become their best selves. After my move, my pain dropped to its lowest since I was a boy, and now I’m an unstoppable happy engine who makes his own values and continually seeks them from others to stay happy and motivated.

Distraction from pain is another critical puzzle piece to using pleasure to deal with discomfort. Staying busy can help you with your pain simply because doing so doesn’t give you a chance to check in with your pain as often, but there is much more to the principle than that. You only have so much mental bandwidth. If you have a single-minded drive to do something within reason of your boundaries, the distraction of the activity and the focus you’re putting on it can make what pain you do feel come off as a muted background concern. If the pain is low enough, it can vanish from your awareness. While simply distracting with work can get your mind off pain, that’s often impractical when you’re disabled from pain. It is easiest to distract from low to moderate pain, but it is still possible and beneficial to do so when your pain is high.

It is imperative that you distract from your pain in a way that isn’t fearfully fleeing from it. You need to rationally and calmly pursue a value with your distraction. If you are instead desperately escaping from your pain, that fearful mindset can push you into a stress response that raises your pain. Or worse, you can fall into a loop where you stay in pain escape mode that gets you out of touch with the rest of what you need to be doing to progress with your mental and physical health. It can be difficult to know if you are pursuing distraction in a health-promoting way, but the keys to look for are that you’re happy and you aren’t sacrificing some other part of your health to engage in the distraction.

Putting distraction together with pleasure is the best approach when you have moderate-to-severe chronic pain because you get both a respite from attention to your pain and a way to relieve it with endorphins. This approach was one of the most helpful for me throughout my recovery because I still dealt with at least moderate pain through three years of my recovery. You deserve a break from your pain and help yourself heal by doing so, so make sure pleasurable distraction is an integral part of every day. This approach is a powerful and mandatory addition to your arsenal to naturally help your chronic pain.

Moving

Naturally Help Your Chronic Pain Tai Chi Gentle Movement

Without proper movement, you can’t be healthy. Yet when you have chronic pain, it can hurt all the time just to be idle. All movement can seemingly exacerbate the pain, leaving you in a perplexing state where there appears to be no way out of the trap you’re in. These next two points are your bedrock for finding the way to not just move through your pain but to move and lower your pain.

6. Movements: Virtual, Nerve Glides, and Gentle Exercise

Moving properly when informed by pain neuroscience can naturally lower your chronic pain.15,16,17 This is because exercising slowly and gently rewires the nervous system’s pain signals, causing them to trigger less often and less potently.18 Moving this way helps pain caused by a lack of mobility or deconditioning, generates pain-relieving endorphins, and helps the nervous system reach a parasympathetic state where healing takes place. Imagined movements, nerve glides, and other gentle exercises are the beginning of properly exercising with chronic pain and unlocking these benefits.

Imagining movements gives a starting point for even the most severe chronic pain cases. Due to how pain neurotags work, as discussed in part one, imagining moving part of the body can be a critical starting place when pain is too intense from movement. Imagining a movement can activate brain areas usually activated in a pain experience but without causing pain.19 If even imagining a movement causes pain, a workaround can be to imagine moving part of the body.20 For an example of how to do this, take the case of an ankle injury. Simply walking or standing could cause too much additional pain, so you could begin to retrain the pain neurotag associated with such pressure by simply imagining standing or walking. You could use the imagined movement as a warmup or even a transition stage to trying those movements physically in the future. There are many ways to use your mind in retraining movements, including imagery, changing the environment associated with a movement, visual cues, or even moving multiple body parts at once to alter your pain responses. These ideas are discussed in my book.

Nerve glides are simple movements that elongate the segments of the peripheral nervous system. Nerves are in every part of the body and can get compressed or shortened after idleness or injury, making them cause pain on their own. Moving and lengthening these nerves can gently stretch the entire neural network throughout the body and relieve that pain. Nerve glides can also be used for areas of the body that have pain, numbness, or tingling. In addition to the pain relief from compression, these gentle movements are a great starting place for exercise to lower your overall baseline level of pain and alter pain thresholds, as seen in the next point about teasing pain. I learned about nerve glides at Dr. Lemons’s clinic and still use them each day to keep my nerves elongated even after the movements no longer lower my baseline pain.

There are nerve glides for many parts of the body, including sciatic, ulnar, radial, and median nerves. Certain nerve glides, such as a sciatic nerve glide in which you kick out a foot and tilt your head, can stretch every nerve from head to toe. Nerve glides are not for building strength but rather for gently mobilizing the body. They are a graceful fluid motion, not a static hold. During a glide, you want to be as relaxed as possible, breathing slowly and rhythmically, and they should not cause pain. If they cause pain, then stop them. As with any exercise when you have chronic pain, you should only aim for a few repetitions and see how your body responds.

For proper instruction and a program using nerve glides personalized to your health context, see a qualified physical therapist. For more information on nerve glides, this article discusses the various kinds of nerve glides and how to perform them.

Other gentle movements can help to lower pain and raise pain thresholds as well as build strength. These include, but are not limited to: walking, Tai Chi, Qi Gong, Yoga, and isometrics (static holds of movements). Some cutting-edge nervous system treatments include mirror boxing, two-point, size, and object discrimination. I have employed nearly all of these approaches in my journey back to robust health. I expand on all of these approaches in my book.

When you have chronic pain, to be successful with any of these movements and virtual movements, you need to implement them with the principle in the next point, the neuroscience of teasing pain.

7. Teasing Pain

The following is concentrated on teasing pain helping you to exercise despite your pain, but it works for retraining many circumstances with pain. Teasing pain is my favorite concept in pain neuroscience because it answers the central problem of chronic pain: “how do I do anything when everything hurts?” That question kept me trapped for over a decade. Applying this principle helped to gradually restore my nearly three inches of lost height from years of poor posture, took me from near-zero movement to sprinting and intense weightlifting sessions, and helped me to calm down the central sensitization of my nerves so I could listen to music and watch TV pain-free again.

Teasing pain uses knowledge of pain neuroscience to naturally lower your chronic pain. It means to engage in an activity that can cause you more pain but to stop short of triggering a symptom flare-up. According to David Butler and Lorimer Moseley in their book Explain Pain, a “symptom flareup in this context means an increase in pain, often sudden, that leaves you debilitated for hours, sometimes days.”21 The key word in that sentence is debilitated, which means you can’t function physically, and your thoughts are severely distracted by pain. When you have ruled out further tissue damage as the possible cause of your pain, an increase in pain is fine and expected when you have chronic pain and use the associated tissues. Ideally, you want to find ways to move that don’t cause pain or higher pain, but that is impossible if you are in constant pain. As strange as it sounds, increasing your pain can be necessary to improve your health and reduce your pain. This improvement happens because of the way the nervous system works. If you can move your body and not reach the flare-up line, the brain will rewire the nervous system to raise your threshold for firing a pain signal, for triggering pain, and from reaching a symptom flare-up.22,23 Conversely, any increased pain lasting beyond 24 hours goes into flare-up territory, which deconditions the nerves and makes the threshold for a nerve to fire a pain signal lower. The brain does this to make you feel pain earlier and easier to try to stop you from injuring yourself.24 It becomes a vicious cycle where one becomes increasingly sensitive to all activity and in more pain.25

When you successfully tease pain, it will take more movement and activity to trigger pain and a flare-up. On top of this, exercising generates pain-relieving endorphins, reconditions your tissue, and aids your muscles and fascia, as discussed in part one. So by teasing your pain with movement, you can build a benevolent cycle of your pain decreasing. When you wed this idea to lifestyle changes and a Functional Medicine protocol to address any root causes of your pain, you can unlock your full healing potential, just as I did.

To implement teasing pain, choose a gentle activity from point six that you want to do and find your baseline for what you can do that doesn’t cause a flare-up. It is best to be very detail-oriented with your movement and track the amount of time, or how far you can move so you have an exact idea, e.g., “I can walk for three minutes or 250 steps” or “do two minutes of Tai Chi” without causing a symptom flare-up. Next, incrementally increase the amount of time you spend doing that activity. Always push your boundaries when you can on a day, but with goals that slowly add to your movement. Walk another thirty seconds or forty steps, or do another thirty seconds of Tai Chi. The nervous system needs delicate shifts to rewire and does not adjust well to sudden changes.26 It is easy to want to push your boundaries when you’re getting pain relief from endorphins and you’ve had several days of success in a row, so it will take mental vigilance not to overdo and risk a flare-up. Also, be aware that certain factors on a day could cause your baseline to be lower than usual, so this is something you have to learn through trial and error, tracking your symptoms in a daily journal, and finding all your triggers. This last topic will be discussed at length in my book and future articles. With the method I developed, I only had six flare-ups during four years of recovery, whereas my previous twelve years were one long nightmare where I was in so much pain all the time that I felt like my life was a flare-up.

Breathing

Naturally Help Your Chronic Pain Deep Breathing

Breathing is something that all of us do all day throughout our lives, yet there are methods of using deep breathing to enhance our health. Deep breathing is a practice that has been recognized as beneficial for thousands of years, and in recent years, science is validating this wisdom.27,28,29 While deep breathing has many benefits for health, the focus of this article is the multiple ways it can help with pain.

8. Deep Breathing

A deep breathing practice is a must for anyone dealing with chronic pain. It’s something that you can do immediately that costs nothing to start getting pain relief and to retune your nervous system to a parasympathetic state–the best state to allow for healing.30 The first important way deep breathing helps with pain is that it generates pain-relieving endorphins. Second of all, deep breathing has also been shown to generate new brain cells in the prefrontal cortex.31 The prefrontal cortex controls your response to stressors, concentration, and memory. Strengthening your ability to concentrate makes it easier to not fixate on pain and stay out of fight, flight, freeze stress response. That means you’ll also generate fewer stress hormones and inflammation, making it simpler to enact some of the thinking adjustments in early points. Lastly, deep breathing also causes a decrease in brain cells and gray matter in the amygdala, the fear center of the brain, that controls the intensity of the fight, flight, freeze cycle discussed in part one. This lessens the intensity of pain signals and anxiety and makes it easier to concentrate.32

I recommend starting a deep breathing practice with Dr. Lemons’s recordings on Soundcloud, particularly Relaxation #2. To begin training, listen to this recording at least four times per day at first, or more often if your pain is significantly interfering with your activities. Follow Dr. Lemons’s guidance on the recording. The repetition is necessary for pain relief and for building your proficiency with it. Deep breathing is a skill, which means you will have to continue to practice it to get maximum relief. Thanks to brain cell growth in the prefrontal cortex, the more you engage in deep breathing, the more control you will gain over your concentration. The better you will be able to calm your thinking, the greater endorphin release you will experience. It can be difficult to maintain concentration if you are in high pain, as your brain turns up the volume on the alarm to try and get your attention. If you react negatively to your pain distracting you from the pain relief you desire, this can make deep breathing a frustrating experience. It is critical not to get stressed out when your mind wanders. Simply drop whatever thought led you astray and get back to thinking about your lungs. And remember that any time spent with deeper and longer respiration will be an improvement for you even if you aren’t able to concentrate on your breath much. I’ve had countless deep breathing sessions, mostly when I began and was in severe pain, where I felt like I only spent a minute or less out of fifteen on my breath, but I still got some pain relief.

Also, it is important to be patient in pursuit of your pain relief with deep breathing. The pain relief you get at first from it will not be as powerful as it can become with repetition. This means it will take some persistence on your part to get the results you want. Due to the severity and kind of pain I was in when I first engaged in deep breathing, I could immediately feel my nerve pain drop from my awareness, but the pain relief and lasting benefits didn’t come for weeks. Often, my pain came right back as soon as I stopped a deep breathing session. After months of practice, I got to the point where my pain would drop by a couple of numbers on a scale of one to ten from a five-to-fifteen-minute session, and the benefits would last after the session. Another relevant point is that if you are on narcotics or other strong pain relievers, the brain can have shut down its endorphin production to such a low level that it will take longer for deep breathing to have much effect. This is another place where approach four, having a long-term view of your pain rather than a short-term view, is vital for your success.

The mechanics and mental habits of deep breathing are also important. The best advice I have is to get into whichever position is most comfortable for you for a breathing session. Sitting or lying down is recommended, but it is contextual to your pain. I had to get into a slumped forward position sitting in a chair at first because every other posture increased my pain. There is also a lot of misleading advice on deep breathing that can lead you to think you’re not doing it right, and the experience can become an irritating one. That was my experience for years. There is no way to “empty your mind” or to have no thoughts. If you’re alive, you’re thinking. When I get into a deeply relaxing state, the audible dialogue of mental content in my mind goes idle in midsentence of a thought. I find myself thinking only of my lungs, with the kind of awareness similar to when I’m about to fall asleep–this is the kind of state you’re aiming for. I recommend focusing your attention on your lungs, as it is an area that usually isn’t painful for most people, and the rhythmic flow of inhalation and exhalation makes it an excellent place to capture and hold your awareness. If your lungs hurt, I suggest finding some area to concentrate on that doesn’t hurt so that you have no competition for your attention. In a good breathing session, I can manage to focus on my lungs nearly all of the time, but that was not always the case. I have gotten much better with practice. I have been doing daily deep breathing for over four years now, and my mind can still wander off to thoughts other than my breathing, but it doesn’t happen as often as it used to.

Deep breathing and all of its health benefits are covered completely in my book’s stress management chapter, which shows Dr. Lemons’s unique four-stage system of training yourself to effortlessly breathe deeply throughout the entire day. This example here is only one component of his effective system to naturally help your chronic pain.

Conclusion

These eight methods to naturally help your chronic pain give you an effective way to change your relationship with pain and to seize back the reins of your life. Pain medication covers up your symptoms, causes other side-effects, and mutes the pain for a time while the root causes remain to continue to wreak havoc and spread, eventually worsening your pain. Narcotic pain medication can shut down your endorphin production and make you more sensitive to pain, taking you down a dead-end road where more pain awaits you.33 The methods in this article lead to incremental improvements with zero side-effects and set up a healing environment for you to recover. Slow and steady repetition of these methods wins this marathon with chronic pain. When combined with lifestyle changes, mindset shifts, and a Functional Medicine protocol tailored to you, you have the optimal method for getting to the root causes to deal with your chronic health problems and chronic pain and achieve your best health.

There are more nuances to every point here and other ways to use pain neuroscience to improve your pain, which I expand on in my book. I also teach about pain neuroscience and other relevant topics in my health consulting service. And as an empathetic survivor of severe chronic illness and chronic pain, I partner with my coaching clients to help them implement these practices, lifestyle changes, and more. If you’re looking for one-on-one help, please check my Work with Me page. I want to see you conquer your chronic pain and chronic illnesses!

Footnotes

  1. Moseley, G.L. (2004). Evidence for a direct relationship between cognitive and physical change during an education intervention in people with chronic low back pain. European Journal of Pain, 8, 39-45.
  2. Moseley G.L. (2005). Widespread brain activity during an abdominal task markedly reduced after pain physiology education: fMRI evaluation of a single patient with chronic low back pain. Australian Journal of Physiotherapy, 51,(1) 49-52.
  3. Moseley, G.L. (2002) Combined physiotherapy and education is effective for chronic low back pain. A randomised controlled trial. Australian Journal of Physiotherapy, 48, 297-302.
  4. Louw, A. (2013). Why Do I Hurt? Minnesota: Orthopedic Physical Therapy Products. p. 36
  5. Louw, A, Deiner, I, Butler, D.S., Puentedura, E.J. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Archives of Physical Medicine and Rehabilitation Dec 2011, 92 (12), 2041-2056.
  6. Moseley, F.L. et al. (2002) A randomized controlled trial of intensive neurophysiology education in chronic low back pain. The Clinical Journal of Pain, 20, 324-330.
  7. Meeus, M.J. et al. (2010) Pain physiology education improves pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 91, 1153-1159.
  8. Clarke, C.L. et al. (2011) Pain neurophysiology education for the management of individuals with chronic low back pain: systematic review and metaanalysis. Manual Therapy, 16, 544-549.
  9. Louw, A. et al. (2011) The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Archives of Physical Medicine and Rehabilitation, 92, 2041-2056.
  10. Watson P, Kendall N. (2000). Assessing psychosocial yellow flags. In: Gifford LS, ed. Topical Issues in Pain, 2. Falmouth: CNS Press. 2000.
  11. Butler, D., & Moseley, G. L. (2003). Explain Pain, 2nd ed. Adelaide, Australia: Noigroup Publications. p. 80
  12. Butler, D., & Moseley, G. L. (2003). Explain Pain, 2nd ed. Adelaide, Australia: Noigroup Publications. p. 113
  13. Price, D.D. (2000). Psychological mechanisms of pain and analgesia. Vol. 15, Seattle: IASP Press. p. 223
  14. Kendall, N. A. S. et al. (1997). Guide to assessing psychosocial yellow flags in acute low back pain: risk factors for long term disability and work loss. Wellington: Accident Rehabilitation & Compensation Insurance Corporation of New Zealand and the National Health Committee.
  15. Butler, D., & Moseley, G. L. (2003). Explain Pain, 2nd ed. Adelaide, Australia: Noigroup Publications. p. 113
  16. Moseley, G.L. (2002) Combined physiotherapy and education is effective for chronic low back pain. A randomised controlled trial. Australian Journal of Physiotherapy 48: 297-302.
  17. Moseley, G.L. (2003) Joining forces – combining cognition-targeted motor control training with group or individual pain physiology education: a successful treatment for chronic low back pain. The Journal of Manual & Manipulative Therapy, 11, 88-94.
  18. Butler, D., & Moseley, G. L. (2003). Explain Pain, 2nd ed. Adelaide, Australia: Noigroup Publications. p. 115
  19. Butler, D., & Moseley, G. L. (2003). Explain Pain, 2nd ed. Adelaide, Australia: Noigroup Publications. p. 121
  20. Moseley, G. L. (2004). Imagined movements cause pain and swelling in a patient with complex regional pain syndrome. Neurology, 62,1644.
  21. Butler, D., & Moseley, G. L. (2003). Explain Pain, 2nd ed. Adelaide, Australia: Noigroup Publications. p. 116
  22. Butler, D., & Moseley, G. L. (2003). Explain Pain, 2nd ed. Adelaide, Australia: Noigroup Publications. p. 119
  23. Louw, A., et al. (2018). Pain Neuroscience Education, 2nd ed. p. 432-3
  24. Louw, A., et al. (2018). Pain Neuroscience Education, 2nd ed. p. 137
  25. Butler, D., & Moseley, G. L. (2003). Explain Pain, 2nd ed. Adelaide, Australia: Noigroup Publications. p. 119
  26. Butler, D., & Moseley, G. L. (2003). Explain Pain, 2nd ed. Adelaide, Australia: Noigroup Publications. p. 115
  27. Perciavalle, V., Blandini, M., Fecarotta, P., Buscemi, A., Di Corrado, D., Bertolo, L., Fichera, F., Coco, M. (2017). The role of deep breathing on stress. Neurological Science, 38(3), 451-458. doi: 10.1007/s10072-016-2790-8. Epub 2016 Dec 19. PMID: 27995346.
  28. Brown R.P., Gerbarg P.L. (2009). Yoga breathing, meditation, and longevity. Annals of the New York Academy of Sciences, 1172, 54-62. doi: 10.1111/j.1749-6632.2009.04394.x. PMID: 19735239.
  29. Manandhar, S.A., Pramanik, T. (2019). Immediate Effect of Slow Deep Breathing Exercise on Blood Pressure and Reaction Time. Mymensingh Medical Journal, 28(4), 925-929. PMID: 31599262. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31599262/
  30. Busch, V., Magerl, W., Kern, U., Haas, J., Hajak, G., Eichhammer, P. (2012). The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing–an experimental study. Pain Med, 13(2), 215-28. doi: 10.1111/j.1526-4637.2011.01243.x. Epub 2011 Sep 21. PMID: 21939499.
  31. Lazar, S.W., Kerr, C.E., Wasserman, R.H., et al. (2005). Meditation experience is associated with increased cortical thickness. Neuroreport, 16(17), 1893-1897. doi:10.1097/01.wnr.0000186598.66243.19
  32. Hölzel, B.K., Carmody, J., Vangel, M., Congleton, C., Yerramsetti, S.M., Gard, T., Lazar, S.W. (2011). Mindfulness practice leads to increases in regional brain gray matter density, Psychiatry Research: Neuroimaging, 191(1), 36-43, ISSN 0925-4927,https://doi.org/10.1016/j.pscychresns.2010.08.006.
  33. Servick, S. (2016). Why Painkillers Sometimes Make the Pain Worse. Science Mag. https://www.sciencemag.org/news/2016/11/why-painkillers-sometimes-make-pain-worse/.