Image: Shawn Rossi
When someone arrives in my studio with chronic pain, they are assessed to see what movement range they have. Part of my work as a movement specialist is to teach gentle Pilates-based movement, using adapted exercises to strengthen muscles that may have been neglected and free up the body where it has restrictions The intention is to improve confidence in moving and to extend the range of pain-free movement. At the same time, I introduce deep breathing techniques to stimulate the intercostal muscles in the ribcage. Significantly, most people experiencing chronic pain can breathe in for only two, or maybe three, seconds. Over time it becomes more normal for them to breathe in for up to five seconds. As each person is different, they set their breathing goal according to their preference, for any number of seconds up to eight. Apart from activating and strengthening the ribcage muscles, deep breathing can stimulate self-healing activity in the body through the parasympathetic nervous system. The 2009 NICE report recommends deep breathing as a way of reducing chronic low back pain, referencing plenty of evidence.
It's important that clients are medically screened to rule out serious problems, but if no issues are found then it is possible there may be a neurophysiological explanation. This means that the autonomic nervous system is out of balance. In simple terms, the autonomic nervous system has two modes of operation, and if they are not in balance the body may not produce the right environment in which to heal itself. The balance of the autonomic nervous system can be affected by many things - in particular stress. As the nervous system is operated unconsciously, it may require a different approach from the conventional biomedical one to re-balance it, and deep breathing may play a part.
In order to rebalance the autonomic nervous system, we need to understand the neurophysiology of chronic pain and how to recognise triggers that might perpetuate symptoms associated with it. This will help with pain resolution as well as improving stress resilience, which can lead to life changing results. Pain cannot be seen; it is experienced. The medical definition of chronic pain is pain that has persisted within the body for over 3 months, as opposed to pain evident for less than 3 months which is referred to as 'acute'. We expect the body to heal itself naturally in the short term. Appropriate medical intervention such as painkillers, or in some cases, surgery may be required, but in every case a balanced autonomic nervous system will help the healing process. Deep breathing can actively assist the body to achieve that balance.