One year ago I was diagnosed with fibromyalgia, a disorder that affects the way my brain/nervous system processes pain. It all started in 2020, while I was finishing my Intermediate Integral Yoga Teacher Training online. Over the course of several months, the pain that began in my knees had spread to other parts of my body. I was also experiencing debilitating fatigue, headaches that caused me to miss work, and for the first time in my life, disability. Stairs and distances I had walked regularly were now challenging or impossible. Activities I enjoyed became painful. Even sitting for meditation became an act of torture.
“Try sitting in a chair,” well-meaning people said.
“Try using props.”
“Try lying down.”
There truly was no “steady, comfortable posture” to be found. I was without health insurance, and could not afford to go to the doctor out of pocket. The only person responsible for my healing journey was me. I had stopped practicing Hatha Yoga (physical Yoga) due to the pain. At some point I recognized that lack of movement was only making me feel worse, both physically and mentally. The less I moved, the less I was able to move. And the more depressed I became.
About six months before I finally had health insurance, my incessant googling had led me to the conclusion that I had fibromyalgia. A rheumatologist and neurologist later confirmed this for me. Fibromyalgia is the result of a dysregulated nervous system. The way my brain/nervous system processed sensory input had changed. Even clothing made of certain fabrics had become painful to wear. The smallest tasks tired me out. Being comfortable felt impossible on the most basic of levels.
At some point I decided that pain or not, I might as well do the things I loved. So I inched back into my Hatha Yoga practice. I had lost a great deal of physical ability, but it helped me take care of my sore/spasming muscles, and soothed my nervous system in the process. Slowly reintegrating movement helped me to retrain my brain’s pain pathways. I didn’t know it at the time, but the technique I was using was a common psychological intervention called gradual exposure. Gradual exposure introduces the patient to their feared/painful stimulus in tiny amounts over time, until their brain can gradually process more and more of that stimulus.
It worked. Not only did I reduce my pain, I reduced my fear of the pain. This makes sense; gradual exposure is a common psychological technique often used to treat phobias. Slowly but surely I was able to practice poses I once loved. While I still experience pain sometimes during my hatha practice, it is no longer associated with particular poses or movements.
So I decided that I’d sit for meditation, and allow my pain to sit beside me. Eventually it wasn’t always there. I also dove into chronic pain research and learned everything I could about the science of pain. This was when something very interesting began to happen: my pain lessened. First to about half. And from there, a quarter.
Recovery is not a straight line, but on average, my pain has been reduced by about 75%. I can now identify several reasons why this happened. In addition to Hatha Yoga, there are a number of other practices and core beliefs in Yoga that are helpful for chronic pain recovery. Here are five of the major ones.
1) Ishvara Pranidhana – Surrender (to God). For those who believe in a higher power, this is the ultimate practice. But even if you’d rather leave the idea of God out of it, learning to surrender and let go of resistance has neuroscience-backed benefits for chronic pain and overall health.
Pain Science 101: All pain, whether from a physical injury/illness or not, is produced by the brain. From a survival standpoint, pain is the brain’s way of indicating to you that you are in danger (i.e. “Ouch! Get your hand off that hot stove!”).
In fibromyalgia and many cases of chronic pain, the brain’s ability to assess what is or is not dangerous is not always accurate. This is why for a person with fibromyalgia, even receiving a hug or a light touch from a friend can be painful.
Surrender is the direct opposite of fear. Over time, surrender allows the nervous system to accept pain/discomfort as a part of life, rather than a threat. When the nervous system no longer perceives pain as a threat, it stops heightening those sensations.
Just as my brain gradually became wired to create, sustain, and amplify my fibromyalgia symptoms, it became rewired to lessen them. Does this mean I’m cured forever? Not necessarily. Neural pathways in the brain are tricky. And life is full of things that can dys-regulate one’s nervous system. But 75% improvement is a change I never could have imagined.
2) “I am not the body” – This is a huge one. In Yoga we are taught that our bodies are temporary shells through which we experience the world, and that our true Self is the unchanging peace at the core of our being.
When we falsely identify with our bodies we believe that we ARE our bodies. If you’re living in a body with chronic pain, this is a horrifying belief. Yoga can help us to reframe our relationship with our bodies. We learn that pain, like our thoughts, is a temporary experience that comes and goes. The less important we make it, the less our brain focuses on it, and the less heightened the nervous system becomes. Is this easier said than done? Yes. Pain is designed to get your attention. But we have to try, otherwise we feed the mechanism that keeps us in chronic pain.
3) “I am not the mind” – Similar to the point above. When we falsely identify with our minds, we believe all the thoughts they produce. Understanding that we are not our minds is powerful for chronic pain recovery, because many difficult thoughts will come up (e.g. “My life is over. It’s never going to get better. I’ll never be able to do x ever again.” etc.).
From a neuroscience perspective, it is important that we don’t identify with these thoughts. Just as our brains can become wired over time to produce/sustain pain, they can also become wired to produce negative thoughts. Understanding that these thoughts are not “you” is key in chronic pain recovery, because negative thoughts have the power to heighten the nervous system, thus creating more pain.
4) Pratipaksha Bhavana – “When disturbed by negative thoughts, the opposite (positive) ones should be thought of” –Yoga Sutras of Patanjali 2:33
This is a helpful follow-up to the previous point. Disclaimer: I am not suggesting that positive thinking is the antidote to all suffering. Nuance is needed here.
That being said, when we practice countering negative thoughts with positive ones, we rewire our brains to focus on more adaptive thoughts, rather than those which heighten our nervous systems. This is a key technique in chronic pain management, and it can even help us to lessen the pain response over time. Here’s an important quote from a neuropsychologist Donald Hebb that speaks to this idea.
“Neurons that fire together wire together.”
5) Pratyahara – Sense withdrawal, the 5th Limb of Ashtanga Yoga.
In Yoga we are taught to monitor and limit what we take in through the senses. Withdrawing from sensory input is highly beneficial for a heightened nervous system. Some ways to practice pratyahara include observing silence, avoiding excess screen time/consumption of media, and being mindful of physical environments which can be overstimulating (e.g. crowded gatherings, places with bright light and/or loud sounds, etc.). This is not to say that we should avoid all stressful situations and coddle our nervous systems. Pratyahara is a compassionate practice that recognizes and honors our sensory limits. It encourages us to consider the input we allow ourselves to receive in a way that best supports our physical, emotional, and spiritual health.
To summarize my thoughts on this topic: Yoga has a unique ability to support the brain/nervous system in chronic pain management and recovery. I truly would not be here if not for this profound practice, which not only helped me to cope, but helped me to heal. I look forward to serving others, by continuing to share these ancient ideas/techniques, which have been so meaningful in my own healing journey. If I were given the chance to go back in time and erase my chronic pain experience, I would not take it.
“Accepting pain as help for purification, study, and surrender to the the Supreme Being constitute Yoga in practice” –Yoga Sutras of Patanjali, 2:1
About the Author:
Leila ‘Lavanya’ Hegazy, RYT 500 has been practicing Yoga for over 20 years. She found her home with Integral Yoga in 2015, and has trained in Basic and Intermediate Hatha Yoga, Raja Yoga, Accessible Yoga, and Yoga For Teens. Leila’s mission is to make Yoga equitable and accessible to all, regardless of ability, age, race, gender identity, or socioeconomic status. Leila’s current focus is Yoga For Fibromyalgia and chronic pain, an issue that has become deeply personal for her since her own fibromyalgia journey began in 2020. Her training and experience has given her the opportunity to serve students from all walks of life, including seniors, children, and people living with chronic conditions. A singer and musician, Leila brings creative flow to her classes and encourages her students to tune in to their inner experience.