Do you have chronic pain in your back or your knees? Are you suffering from chronic arthritic
pain, or maybe generalized pain from fibromyalgia or some other autoimmune condition? Are you
taking things like ibuprofen or even prescription painkillers on a daily basis, trying to figure out
some way to have a natural self-care routine? If so, this video is for you. Hey, my name is Lucas.
I'm a yoga teacher, I'm a breathing instructor. In this video I'd like to share with you some of the
published literature around breathing exercises and pain management and then I'll show you a
very simple "4x8 I feel great" breathing practice that you can do at home, to see if it helps you
with your pain situation. A quick disclaimer here: this video is for educational purposes only.
Please do not discontinue any kind of medication without checking with your doctor first. If you'd
like to jump straight ahead to the exercises there's a PDF link down below. Before we talk
about breathing exercises and pain, let's talk about pain more generally. I think it's helpful to
break pain up into two different buckets. We often think of pain as just a terrible thing, but it's
not. Most pain is adaptive pain. It doesn't feel good, but it's there to keep us safe. It is called
nociception, this ability for us to sense and react to negative stimuli in our environment. But
then there's maladaptive pain, or runaway pain, where it's suddenly disconnected from any kind
of physical situation. Let's talk about a real life example so we can think about this adaptive
versus maladaptive pain. Let's imagine you're in the kitchen and you're cooking something and
you space out, you forget what's happening and you start a little fire. You run over and you grab the
pan with your bare hand and the nociceptors, the pain receptors in your hands, signal your brain to
pull back your hand. You shake, shake, shake, and it hurts. That doesn't feel good but that's
an adaptive response, that's your body doing what it should. That's your brain talking to your body,
that's adaptive pain. Now if that pain were to linger for months after that initial minor burn
that would suddenly be maladaptive. This rarely happens with something like an epidermal burn, but
it happens very often with things like joint pain, happens very often with autoimmune conditions,
and it can happen for a number of other reasons too, where suddenly
it's almost like there's a fire alarm going off in your body but there's no longer a fire. For these
types of situations we might categorize as chronic pain breathing exercises have shown to be really,
really effective. When you look at the published literature there are literally thousands of
studies connecting breathing exercises to pain management and the outlook is really,
really positive. So I guess the question is why haven't you heard about it before? I think there's
a few different reasons for this, but one of the biggest reasons is patient compliance. There are
lots of things that are very helpful for you, like regular exercise, like improving your diet,
and this goes for anything from a chronic illness, to headaches, to mental health. And doctors don't
often recommend this because the compliance is so low. It's hard enough to get somebody to take
a pill every day, it's very, very hard, to get somebody to do breathing exercises every day.
The second reason I think that this literature is often ignored is because the mechanisms of action
are not really that clear. What I mean by that is even though the overwhelming body of evidence is
very positive in terms of pain management it's not that clear exactly what's happening. Is it because
we're increasing our heart rate variability? Maybe. Is it because we're stimulating our
vagus nerve through deep diaphragmatic breathing? Maybe. Is it because we are reducing our resting
heart rate or lowering our cortisol levels? Maybe. Could it be all these things combined? Also maybe.
I think most importantly then why it's working is to look at the fact that it is working and
look at the situations where it is working. When we look at the published literature,
and I'll send some links down below if you'd like to take a look at it, there are pretty extensive
studies around joint pain like back and knee pain, extensive studies around things like fibromyalgia,
and even just pain tolerance tests, and when you look at the literature here's what we find
in things like emergency medicine acute pain, like you crash your bike into a tree, breathing
exercise is probably not going to be so helpful. It might be helpful for managing your mood,
but in an acute injury emergency room, you've just got hurt, probably not the best. That would again
fall under that adaptive pain. But for chronic pain, especially that maladaptive pain where like
a fire alarm that just won't stop, the pain is disconnected from a reality, breathing exercises
are very positive, overwhelming - back pain, knee pain, fibromyalgia, and other body aches.
And when I say breathing exercises the literature is really mixed but generally
researchers are using slow breathing, reducing your breathing rate, slow deep breathing,
reducing your breathing rate and breathing deeper, or slow deep breathing with an extended exhale.
One or more or a combination of these are generally what people are using. This is breathing
that tends to emphasize diaphragmatic engagement, tends to emphasize a slower respiration rate,
so that's what we'll focus on here. We'll focus on slow, deep breathing with an extended exhale,
assuming that we can replicate the results that have been demonstrated in thousands of different
exercises. When you're doing breathing exercises really the only contraindication for this style
of breathing is it can make you sleepy. You shouldn't do this while you're driving,
you shouldn't do this while you're operating machinery, but you could do this really
anytime as long as you're sitting down, you're all alone, and you're safe. A couple of things before
we start. The first thing is we'll use a practice called ocean breath and it makes a "ah ha" sound
in the back of your throat. You do this by closing off your glottis at the back of your throat. So
sound, but you breathe through your nose. So
you should have an audible whisper both on the inhale and then on the exhale. Second thing to
remember is we'll do this in a seated position, but we'll inhale to the count of four and then
we'll exhale to the count of eight. That means that you need to regulate that exhale so that it
comes out half speed, so you don't run out of air. Slow breathing, deep breathing, extended exhale,
to hopefully create that pain relieving response. I called this "4x8 I feel great" breathing, let's
give it a try. If you're sitting in a chair like me scoot away from the back of the chair. If you
can plant your feet on the floor, rest your hands on your knees, relax your shoulders with your chin
parallel, close your eyes. We'll inhale through both nostrils one, two, three, four. Exhale
slowly eight, seven, six, five, four, three, two, one. Inhale both nostrils one, two, three, four.
Exhale eight, seven, six, five, four, three, two, one. Inhale one, two, three, four.
Exhale eight, seven, six, five, four, three, two, one.
Inhale one, two, three, four. Exhale eight, seven, six, five, four, three, two, one.
Inhale one, two, three, four. Exhale slowly eight, seven, six, five, four, three, two, one.
Inhale one, two, three, four. Exhale eight, seven, six, five, four, three, two, one.
Last one. Inhale one, two, three, four. Exhale eight, seven, six, five, four,
three, two, one. Eyes remain closed, shoulders relaxed, breath is normal.
And slowly open your eyes. I hope that practice is helpful for you. As a reminder,
we use that ocean sound both on the inhale and on the exhale. That helps to promote our vagus
nerve stimulation. Remember, your exhale is twice as long as the inhale, so slow down the breath on
the way out to stay in control. I'd encourage you to practice this right before bed every evening
and if you find it helpful you might include it multiple times throughout the day. Again,
the biggest contraindication is it can make you pretty sleepy. Breathing exercises are
not a panacea. They're probably not going to be a strong as opioid drugs. But over time,
with regularity, it's very, very possible that you can mitigate or at least down regulate some
of your pain response, especially for that chronic pain. Hope you found this video helpful. If you'd
like more science-based yoga breathing and yoga videos please hit subscribe down below. I try
to answer all my questions and comments in the comments section down below. And if you'd like to
join one of my breathing challenges or breathing courses you can find info at yogabody.com