Dear Pain Matters blog readers,
As part of any pain management strategy, it is important to be able to relax (de-stress) and induce the Relaxation Response at least 2-3 times daily.
Regular activation of the Relaxation Response may result in many benefits including:
– Reduced pain levels;
– Decreased dosages of, and more effective, pain medication;
– Improved function and mobility; and
– Healing (partial or complete).
There are many different techniques to induce the Relaxation Response including:
– Deep breathing;
– (Self) Hypnotherapy;
– Music therapy;
– Acupuncture, and
– Qi Gong.
(More on these later.)
As pain levels decrease,
(1) due to the regular (daily) practice of relaxation techniques to engage the parasympathetic nervous system (vagus nerve); and also
(2) due to effective interventions including pain medications, nerve blocks, and/or surgery,
the pain patient will (more likely) embrace physiotherapy and physical exercise to recover function and mobility.
Many chronic pain patients find yoga beneficial, while others find that meditation and visualization helps. To reduce pain, for example, they may visualize a beautiful beach with waves lapping onto the shore. Other pain patients may prefer to visualize actual immune cells producing less pro-inflammatories and more anti-inflammatories (and other physiological functions). Whatever works to reduce pain is great!
Relaxation techniques result in increased parasympathetic nervous system (vagal) activity, and hence a more balanced autonomic nervous system (including increased heart rate variability and reduced adrenaline/noradrenaline/cortisol blood levels). This should result in reduced pain levels.
In addition to above, there are other ways to induce the Relaxation Response including Autogenic Training.
What is that?
Autogenic Training is a relaxation technique that induces the Relaxation Response. It was first developed in the 1920’s by German psychiatrist and independent psychotherapist, Johannes Heinrich Schultz (and simplified recently).
A review paper explores Autogenic Training as a relaxation technique that may reduce pain during childbirth, headaches and migraines, back pain, cancer pain, and cardiology-related pain. Regular Autogenic Training sessions may result in decreased pain medication (Kanji, 2000).
Autogenic Training is a form of self-hypnosis, and has (at least) 4 visualization-related components to induce the Relaxation Response:
(1) Deep breathing;
(2) Focus on relaxation;
(3) Aim to make skeletal muscles ‘heavy’ (to promote relaxation of the limbs’ voluntary muscles and reverse stress-induced tension); and
(4) Focus on ‘warming’, to increase blood flow back to the arms and legs, and away from the centre of the body (to reverse the effects of the sympathetic nervous system).
Like yoga and other relaxation techniques, once Autogenic Training is properly learned from a qualified practitioner, Autogenic Training sessions can be done by yourself anywhere that is very comfortable (at home, at work during lunch, etc). One can do an Autogenic Training session while lying down, sitting upright in a chair, or in any other accepted position. It is best to choose a quiet place where you won’t be disturbed. These sessions can be done several times daily (in the morning, at lunch, and in the evening, just before you go to sleep). Each session may last around 15 minutes, although they may also be as short as 2 or 3 minutes.
The key is to do Autogenic Training regularly (daily), 3 times a day.
Note: Please see your physician before doing Autogenic Training.
More studies are warranted to assess whether regular Autogenic Training sessions can lead to reduced pain levels in some pain patients.
Hope this helps….
(1) Kanji; Management of pain through autogenic training; Complement Ther Nurs Midwifery (Aug 2000); 6(3):143-8.
(2) British Autogenic Society
For German readers:
(3) This excellent book first introduced me to Autogenic Training –
Autogenes Training (2005; 128 pages)
Authors: Dietrich Langen, Karl Mann Prof. Dr. Med. Dietrich Langen