Living With Chronic Pain

Breathing and Chronic Pain

Life starts with oxygen. If we don’t get enough, everything suffers. We can’t produce the energy required to fuel necessary bodily functions or remove toxins. Every breath we take defines how we’ll feel in that moment- calm and relaxed or anxious and scared. Something as simple as how we breath can impact every bodily system, amplifying or lessening pain levels.

Acute or chronic pain sets off a chain reaction in the body. Everything tenses up, causing our muscles to contract and contort into abnormal positions, putting increased pressure on our tendons, ligaments and nerves. This then increases the flow of stress hormones like cortisol into the blood. Signals are sent to the brain through the spinal cord to react in order to prevent further damage. Such as dropping the knife after we accidentally cut our finger while chopping vegetables. But with chronic pain, the spinal cord continues to respond even after the inciting event has ended. In time, more of the brain gets recruited including centers where concentration and mood reside, as well as respiration.

Those of us living with chronic pain often unconsciously hold our breaths for short periods of time. This shallow breathing pattern only allows small amounts of air into our lungs so we have to breathe faster to fulfill our oxygen needs or hyperventilate. This is the type of breathing usually seen when we are in a “fight or flight” mode which then causes a cascade of stress and anxiety producing hormones to flood the body Widespread tension results and our pain increases.

Deep breathing on the other hand, draws in fuller breaths so that the lungs can fill all the way to to the diaphragm. This improves brain oxygenation which signals the body “all is safe,” slowing the heart rate and dropping the blood pressure. The diaphragmatic muscles sits above the abdomen and enclose the lungs in a protective cradle. It, along with individual muscles between our ribs, provides oxygen rich nourishment to the entire body. Look at a baby or a child and you’ll see their abdomens rises and fall with each breath, not their chests. This is how we’re supposed to breathe. But when stressed or in chronic pain we tend to use accessory breathing muscles in the neck, shoulders and upper chest which leads to poor inhalations.

Even short term this can cause or significantly exacerbate pain by impacting: 

muscles: Diaphragmatic breathing lets the neck, shoulders and upper chest focus on their primary duties- keeping your head, the equivalent of a 10-12 pound bowling ball properly balanced!

*pH balance: Normally, the pH of blood is neutral at 7. But how we breath can change that level. Holding our breathe causes it to go down. Fast, shallow breaths like hyperventilating cause it to go up. Both can impact inflammation and pain levels.

* automatic nervous system: As previously discussed the autonomic nervous system has two main branches the sympathetic- fight or flight pathway – and the parasympathetic-rest and restoration. Research has shown that ten minutes of diaphragmatic breathing a day can reduce pain by calming the body and increasing oxygen stores.

Diaphragmatic breathing occurs on an unconscious level. Imagine how well we’d survive if we had to think about every breath we took. Instead, we inhale, expand our thorax, gently massage our lower organs, then exhale. We then relax, and pause briefly before starting all over again. It’s spontaneous and effortless. We switch to a more conscious level of breathing when life demands it, like when jogging, stressed, or singing. Humans are unique in this ability to switch between conscious and unconscious breathing. 

Breathing more fully not only improves our lung and oxygen capacity but also massages the heart, lungs, gastrointestinal tract and reproductive organs, improving digestion and waste disposal. A tight, muscular or stressed abdomen acts like a corset, severely restricting air supply which then mimics a perpetual state of anxiety and stress. This forces our muscles to work harder to breathe. We can break this cycle by consciously breathing more deeply, which then releases tension, calms our minds and stops the release of stress hormones.

In one study, patients who’d had a total knee replaced were taught diaphragmatic breathing exercises to help cope with the stress, anxiety, pain and fears that can impact the outcome and post operative recovery period. Learning to contract the diaphragm and expand the abdomen to deepen inhalation improved oxygen levels, decreased breathing rates and reduced the need for opiates. Deep breathing plays a pivotal role in regulating our ph levels, anti-inflammatory processes and activating autonomic centers that can decrease perceived pain levels.

From Tai Chi to yoga to meditation…  Learning how to deep breath can significantly improve all aspects of our health and lessen pain. It can also help to reverse the long term impacts poor posture and shallow breathing have had over the years on our contracted, stressed and perpetually misaligned muscles and spine. 

Breathing is as natural as walking and talking. But too often we learn poor behaviors that impact our health in ways we never imagined. Research has shown deep breathing decisively influences how we process and modulate pain through the sympathetic nervous system. Something as easy as breathing deeper and more efficiently can restore balance and calm which then lessens pain. Next weeks post will offer some easy techniques to achieve these goals.

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