Yoga therapy to help cancer pain management
Sue Skelton, Registered Nurse and Yoga Teacher
Pain is generally thought of as either acute or chronic and is a protective mind-body response to threats.
ACUTE PAIN: When the body experiences a threat, which could be a cut, a burn, an inflamed muscle or a tumor pressing on a nerve, the pain response starts. It is an immediate and temporary response to the injury. Generally, the intensity of the pain will match the seriousness of the threat/injury. As the body heals the intensity of the pain should diminish.
CHRONIC PAIN: Chronic pain continues long after the injury is over and can range from mild to severe.
In most cases the pain reflects an over-protective mind-body response. It differs in 3 main ways from Acute Pain:
1. The body becomes more sensitive to a threat or injury. Sending signals to the brain even when the threat is minimal, or even non-existent.
2. The brain may interpret situations as threatening and more painful, out of proportion to any real danger or injury.
3. With repeated pain experiences, the pain response, sensation, suffering and stress become blurred.
Pain in cancer can start out as Acute Pain but then becomes Chronic, it can be caused not only by the tumor pressing on nerves, but it could be due to chemicals produced by the tumor. It could also be caused by the treatment itself (CRUK).
Cancer pain can be classified under different types, they are:
Nerve pain
Bone pain
Soft tissue pain
Phantom pain
Referred pain
Incidental pain
Chronic pain not only makes you more sensitive to physical pain, but it can make you more sensitive to any kind of physical, emotional or social stress (McGonigal K, 2009).
As a Palliative Clinical Nurse Specialist, when assessing one of my patients for pain, I would always recommend drugs for the management of it, which usually means ever increasing doses as time goes on, working up the WHO analgesia ladder.
Being a Yoga Therapist has opened up so many ‘tools’ to help the management of cancer pain, with surprising success.
Yoga Therapy is based on the wisdom and tradition of yoga, it combines yogic philosophy, teachings including a focus on all of the yogic practices as well as appropriate modifications adapted to a client’s needs (Pearson et al, 2020).
As a Yoga Therapist, there are various yogic tools I might use to assess someone’s pain, the one I like to use is the 5 Koshas. The Koshas are energetic layers or sheaths of the body. They are Annamaya Kosha (physical layer), Pranamaya Kosha (energetic or life force layer), Manomaya Kosha (Mental layer), Vijnanamaya Kosha (wisdom layer) and Anandamaya Kosha (bliss layer). If we change the energy in one Kosha, it will affect all of the others.
A Yoga Therapy session will utilize neuroplasticity – the ability of the neural networks to re-wire themselves, by using all of the tools of yoga – asana (movement), pranayama (breathwork), mudra (a symbolic hand gesture used during meditation or pranayama), mantra, mindfulness, relaxation, visualization and chanting can all be useful.
Hsueh et al (2021) having reviewed 26 trials involving 2069 patients concluded that yoga (therapy) can help to reduce pain in cancer patients, also improving their anxiety, depression, stress, fatigue levels, enhancing their quality of life.
References:
Cancer Research UK
https://www.cancerresearchuk.org/about-cancer/coping/physically/cancer-and-pain-control/causes-and-types [Accessed 05/09/2022]
Hsueh, J., Loh E., Lin J. & Tam K (2001) Effects of yoga on improving quality of life in patients with breast cancer: a meta-analysis of randomized controlled trials. https://pubmed.ncbi.nlm.nih.gov/33452652/ [Accessed 05/09/2022]
McGonigal K, (2009) Yoga for pain relief, New Harbinger Publications, USA
Pearson, N., Prosko, S., Sullivan, M., Taylor, M., (2020) International Association of Yoga Therapist, Yoga Therapy and Pain – How Yoga Therapy serves in Comprehensive Integrative Pain Management, and how it can do more.