How Yoga Is Changing the Way We Perceive Pain
- A Physiotherapist’s Perspective
(Originally published in Yoga Australia in 2016, this article feels just as meaningful now as it did then. Certain reflections not be 100% recent but I thought it would be still relevant for some.)
Yoga — a word that holds within it so many meanings: connection, interaction, union. It’s an ancient practice that began in India about 5,000 years ago, alongside many rich philosophical traditions.
While the physical postures we recognise today developed more recently (around the 1800s), yoga has become part of the modern conversation on wellbeing — and for good reason. Its benefits are wide-ranging and deeply documented.
As a physiotherapist working in the field of pelvic, women’s, and men’s health, I’ve found yoga to be one of the most powerful tools for managing pain — not only because of what it does for the body, but also for how it helps us understand ourselves.
So, what is Pain?
Pain is a highly complex protective mechanism. It relies on the brain’s evaluation of a massive amount of information — such as perceived danger — and is shaped by each individual’s cognitive processing. This includes expectations, anticipation, cultural and social beliefs, and information received from other sensory systems (such as vision).
So, in a way, yes — pain is a product of the brain (your mind), but perhaps not in the way you might think! Depending on how the brain interprets these signals, it can “turn on” or amplify the feelings of pain whenever it perceives sufficient evidence that the body is in danger and needs protection.
To put it simply: pain is real, and it is always in the mind — because it depends on the brain to be processed and ultimately felt. Pain is not necessarily a warning that something is damaged, but rather an unpleasant experience that reflects the individual’s perception of threat. To address pain effectively, we must be mindful of this complexity.
Stress functions in a similar way. It is a reaction of the brain to perceived harm and depends on how danger is evaluated. When the brain feels threatened, a cascade of chemical reactions is triggered to prevent injury — the well-known “fight or flight” or stress response. The long-term effects of stress are well-documented, and many studies highlight stress as a crucial variable in pain management.
So, why Yoga?
Yoga is a mind–body practice that integrates postures (asanas), deep breathing (pranayama), and meditation. Modern yoga, depending on the school or instructor, often encourages sustained postures, reinforces positive self-awareness and mindfulness, and accommodates individual physical abilities through modifications.
In recent years, yoga’s popularity has grown tremendously, becoming the seventh most commonly used complementary alternative medicine for various musculoskeletal conditions — particularly those related to pain.
Your body and physical benefits
On a physical level, asanas can be, for some, a gentle form of exercise designed to promote steadiness, health, and lightness in the body. Pain experiences, due to the body’s protective mechanisms, can lead to stiffness, fatigue, and muscle imbalance.
Studies have shown that yoga practice can decrease cortisol and cholinesterase levels and stimulate the release of endogenous opioids during sustained muscle stretching — reflecting a soothing or quieting of the stress response.
Physically, yoga practice is linked to improvements in joint mobility (flexibility), balance, and reductions in pain, stiffness, and swelling — especially in individuals with lower back pain, PMS and chronic pelvic pain, fibromyalgia, osteoarthritis, or rheumatoid arthritis.
Breathing and the Nervous System
Pranayama — the art of controlled breathing — aims to restore and expand vital energy. Pain is known to alter breathing patterns, and in chronic pain, respiration often becomes shallow, strained, and thoracic-dominant — similar to the breathing seen in prolonged stress states associated with high cortisol levels.
Pranayama stimulates the parasympathetic nervous system and quiets the central nervous system, leading to calmness, relaxation, and improved physiological regulation.
Mindfulness and Meditation
The benefits of mindfulness and meditation are widely documented. Deep meditation induces measurable physiological changes — such as reduced muscle activity (EMG), improved circulation, lower blood pressure, and reduced cortisol levels. Meditation produces a hypometabolic state associated with relaxation and improved physical function.
Low cortisol levels and meditative states are strongly supported in the literature as effective tools for pain management.
The role of Yoga in Pain and Stress
The practice of yoga has been shown to reduce both pain and stress on physical and metabolic levels. Yoga is also associated with a decrease in the use of opioid-based pain medication. In short, yoga has effects opposite to those of stress on the brain and can help relieve chronic pain.
Because of its gentle and (particulaly when its practice has an) adaptable nature, yoga can be practiced safely by people of all ages — from children to frail older adults. By emphasizing self-exploration, mindful movement, and breathing, yoga becomes a valuable tool for addressing the psychological and social dimensions of chronic pain.
A Physiotherapist’s Perspective
While not every yoga style is suitable for chronic pain, my goal as a physiotherapist is to promote optimal movement and function, and to empower my patients through education about health maintenance and injury prevention.
Pain can have a profound impact on quality of life, often leading to isolation and depression. From an early stage, it’s crucial to find a form of movement that allows the body to enjoy moving again.
The gentle practice of yoga — through adapted asanas, pranayama, and meditation — can play a crucial role in managing both pain and stress. From personal and professional experience, I strongly recommend incorporating yoga as part of a holistic approach to pain management.
2016, Yoga Australia