Ep 49: The Effects of Chronic Pain on the Nervous System Pt. 2

The last few episodes we've been discussing pain, how you experience it, how to deal with it, and the different types of pain. Last week’s episode was part 1 of this conversation on the effects of chronic, long-term pain on your nervous system, I walked you through the stages of the sympathetic nervous system and explained that Central Sensitization and Altered Brain Structure & Function are 2 effects on your nervous system because of Chronic pain. 

This is part 2, and in this episode, I’ll explain the stages of the parasympathetic branch of your nervous system and introduce you to 3 more effects this long-term pain experience has on your overall nervous system. How does it show up? In this episode, I’ll explain it to you… so get your journals and get ready to jot down this info!

I’m covering Impaired Descending Pain Modulation, Hypervigilance and nervous system activation, and Emotional and cognitive effects. 

Understanding these effects will help you consider approaches that support your nervous system regulation and what you consider teaching to help your students. I’m excited! So let’s get to it!

How does it show up? In this episode, I’ll explain it to you… so get your journals and get ready to jot down this info!

Transcript

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We've been talking about pain over the last few episodes, how you experience it, how to deal with it and different types of pain. Last week's episode was part one of this conversation on the effects of chronic long-term pain on your nervous system. And in that episode, I walked you through the stages of the sympathetic nervous system. And explain that central sensitization and altered brain structure and function are two effects on your nervous system because of chronic pain. This is part two. And in this episode, Alex Blaine, the stages of the parasympathetic branch of your nervous system and introduce you to three more effects. This long-term pain experience has. On your overall nervous system. How does it show up? In this episode, Alex explained it to you. So get your journals and get ready to jot down this information. I'm covering impaired descending pain, modulation hypervigilance. And emotional and cognitive effects. Understanding these effects will help you consider approaches that support your nervous system regulation and what you consider teaching to help your students. I'm excited. So let's get to it.

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Welcome to the Essential Conversations for Yoga Teachers podcast with me. I'm Monica Bright, and I've been teaching yoga and running my yoga business for over a decade. This is the podcast for you if you're a yoga teacher, you're looking for support, you love to be in conversation, and you're a lifelong student. In this podcast, I'll share with you My life as a yoga teacher, the lessons I've learned, my process for building my business, and helpful ideas, tools, strategies, and systems I use and you can use so that your business thrives. We'll cover a diverse range of topics that will help you whether you're just starting out or you've got years under your belt and you want to dive deep and set yourself up for success. I'm so glad you're here. Listen, I don't take myself too seriously, so expect to hear some laughs along the way. Now, let's do this together.

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Oh, welcome back to the podcast. I'm Monica and I'm so glad you're here because today we're continuing to explore your nervous system and pain and how the two are connected as well as the long-term effects that pain has on your nervous system. Before we get started, I would just want to remind you to download my latest freebie for you. It's the ebook sequencing for different injuries. The link is in the show notes below. And I promise you, it's going to help. Form a foundation for teaching students with injuries, and it'll be a great resource for you to return to again and again. All right. In my last episode, that's episode number 48. We covered your entire nervous system. So if you want to refresh her, go back and listen to it. It'll help you understand all of the branches of your nervous system. Often we reference the sympathetic and parasympathetic branches of the autonomic nervous system, but there's more, and I would love for you to have a full understanding of it. So check that episode out. So let's just jump straight into this episode. Let's dive into your parasympathetic nervous system. It's known for promoting relaxation, recovery, and energy conservation in your body, and is often referred to as the rest and digest system. It is most well-known for the rest and digest response and helps your body relax after stress by slowing down your heart rate. Promoting digestion and conserving energy. So let's go through each one of the stages. The first stage is the baseline or the resting state. In this state, the parasympathetic nervous system maintains your body's regular balanced functions. When you're not under stress, your heart rate, breathing digestion and blood pressure are kept at baseline levels. And your body is in a state of homeostasis where energy levels are balanced and bodily systems function. Optimally. Then there's the rest and digest state, which we refer to often. And this is the parasympathetic nervous systems, primary active state, where your body conserves energy and focuses on restorative processes. Your heart rate slows your blood pressure decreases and your muscles relax. And this state often follows meals. Quiet relaxation or periods of breasts. Finally in this state, your body focuses on recovery, immune function and maintaining energy stores. The third state is the social engagement state. In this state, your parasympathetic nervous system plays a role in social bonding and communication. Your heart rate and breathing remain calm, which allows you to feel relaxed, open, and socially connected. The state can be activated through positive social interactions, deep breathing and mindfulness practices. And it's sometimes called the ventral vagal state. It supports trust, safety and engagement with others. Next is the freeze state. Do you remember that? I mentioned in the last episode, how the free state is actually part of both branches. Of your. Autonomic nervous system, the sympathetic and the parasympathetic nervous system. Although freeze is often associated with your sympathetic nervous system, a mobilization or freeze responses involve aspects of your parasympathetic nervous system as well. Particularly when triggered by intense fear. This state is a mix of sympathetic activation followed by a strong parasympathetic shutdown. Where your heart rate slows and your body may experience a numbing effect or dissociation. The free state can arise when your ability to escape seems impossible and it leads to a type of protective paralysis. The final state is the deep rest or healing state. And this is where a parasympathetic activity peaks and your body undergoes, extensive healing and repair. This is often reached during deep sleep or deep meditative states. This phase allows your immune system to work efficiently. Tissue repair to occur and your energy stores to replenish. This state is crucial for longterm health, as it allows your body to repair and prepare for future activity. Okay. Those are the five states of the parasympathetic nervous system. A quick recap is the resting state or baseline state. The rest and digest state. The social engagement state. The immobilization or freeze state, and finally the deep breast or healing state. As always my intention is to not overload you with so much information and said, I want these episodes to be as easy to digest as possible. And when it comes to the nervous system and pain, you can't just learn it all in a quick podcast episode. So now that we've covered the parasympathetic nervous system. Let's dive into more ways. That chronic pain affects it. As I've mentioned before, there are five major ways chronic pain affects your nervous system. Through central sensitization altered brain structure and function impaired descending pain, modulation, hypervigilance, and nervous system activation and emotional and cognitive affects. In this episode, I will focus on the last three. And paired descending pain, modulation, hypervigilance, and nervous system activation and emotional and cognitive effects. Just as I did in the last episode, I'll explain each of these and offer an analogy which might help you understand the concepts a little bit better. So if you're not taking notes yet, This is a good time to do so, or remember, please. Come back to this episode to listen as many times as you need. First is impaired descending pain. Modulation. Your body has a natural system for inhibiting pain, but chronic pain can weaken this modulation pathway. Making it harder for your nervous system to. Turn down pain signals. This impaired inhibition means your brain may receive more pain signals. Without the usual dampening effect, leading to a greater experience of pain. Impaired descending pain modulation occurs when your nervous system's natural ability to turn down pain signals is disrupted. Normally your brain and spinal cord work together to regulate pain. Using a system of breaks that help reduce the intensity of pain signals. Before they're fully experienced. When this system malfunctions pain signals become amplified and your body loses its ability to filter out unnecessary or excessive pain sensations. Descending pain. Modulation is a top down process where your brain actively inhibits pain signals from the spinal cord to prevent them from reaching conscious awareness unless they're necessary. Think of this system as a volume control for pain. With the brain deciding how loud the signal should be based on the situation. For example, if you're injured, but in immediate danger, like running from some kind of predator. Your brain might turn down pain signals temporarily, so you can focus on survival. On the other hand. If you're in a safe environment. Your brain might allow pain signals through to encourage rest and recovery. This system involves pathways in the brain stem that release. Uh, pain, dampening chemicals, like serotonin. And endorphins, which act as natural painkillers. They inhibit the transmission of pain signals in the spinal cord, ensuring that only relevant pain is felt. In chronic long-term pain. The descending pain modulation system can become weakened or dysfunctional, which means the brakes on pain signals are no longer effective. So your brain and spinal cord. Bale to suppress pain. As they normally would. Your pain signals that should be dampened or ignored are instead amplified making you more sensitive to pain. And the balance between amplification and inhibition. Shifts towards amplification, creating a cycle where your nervous system becomes stuck. In a heightened state of pain perception. When descending modulation is impaired, your nervous system essentially loses control over pain processing, leading to chronic pain states where pain persists. Even in the absence of injury because your nervous system continues to send amplified pain signals. As well as a heightened sensitivity to stimuli. Non-painful stimuli like light touch or mild pressure can feel painful because your spinal cord becomes overly responsive to incoming signals. And finally emotional stress. Since pain pathways overlap with emotional and stress processing centers in the brain. The inability to regulate pain can lead you to increased anxiety, frustration, and feelings of helplessness. Here's an analogy. Um, imagine the descending pain modulation system as a gatekeeper in a theater deciding who gets to enter. Normally the gatekeeper carefully assesses each person and each person is a pain signal. And only lets in those who are important, severe or relevant pain. When your system is working well, the gatekeeper is from only admitting a few people and keeping things orderly. But with impaired descending modulation, the gatekeeper is either overwhelmed or absent. Suddenly the theater is flooded with people, Many of whom don't need to be there. These people are unnecessary pain signals. The theater, which is your conscious awareness becomes crowded, chaotic, and hard to manage. In this state. Even minor disturbances, like someone coughing. Seemed overwhelming because the gatekeeper is no longer filtering out the noise. So, how does it affect you? The first way is via persistent pain. Without proper modulation pain signals persists long after an injury has healed or they occur without any injury at all. Then there's an increase in your emotional load. The ongoing barrage of pain signals can lead to fatigue, stress, and emotional overwhelm. As your brain struggles to cope with both the sensory and emotional impact of constant pain. Third, there's a fear of movement or kinesiophobia that's when small movements consistently trigger pain and you may avoid activity altogether. Leading to deconditioning and further nervous system dysregulation and my mentorship, yoga for injury management. I explained further the effects of kinesiophobia on the person experiencing pain. And ways to eliminate this fear. All of these lead to a reduced quality of life. Your inability to suppress unnecessary pain signals can interfere with your sleep, your work, your relationships, and your overall wellbeing. To help restore balance. Your goal should be to retrain your nervous system and strengthen the descending pain modulation system. Doing this can include mindfulness and relaxation practices. These help calm the brainstem and reduce over-activation in pain pathways. Gentle movement and yoga. Gradual safe movement encourages the nervous system to relearn how to distinguish between safe and threatening stimuli activities that release endorphins like exercise laughter and social connection, which can boost your body's natural pain, relieving chemicals. And support your descending modulation system. cognitive behavioral therapy has been shown to be effective. Uh, CBT helps address the psychological impact of chronic pain, reducing fear and anxiety that might otherwise reinforce pain pathways. Understanding this concept can be helpful for you when you're teaching. As you guide students in practices that focus on nervous system regulation. Fostering an environment where students feel safe and supported while gently retraining their nervous systems to better manage pain. Okay. The next effect is hypervigilance and nervous system activation. With chronic pain. Your nervous system often becomes hypervigilant. On high alert for pain or perceived threats. This can increase the fight or flight response and lead to tension and anxiety, which can contribute to a heightened pain response. Hypervigilance refers to a heightened state of sensory and emotional alertness where the nervous system is constantly on the lookout for potential danger or threats, even when none are present. It's common in people dealing with chronic pain, trauma, or stress related conditions. Hypervigilance is like your body and brain being stuck in survival mode. Uh, unable to relax fully or feel safe. Okay. Stick with me now. Your nervous system has two key divisions that manage how you respond to the world. The sympathetic nervous system. Which activate. Activates the fight or flight response to perceived threads. And the parasympathetic nervous system, which promotes relaxation and recovery. Through the rest and digest response. In hypervigilant. The sympathetic nervous system is over active, keeping your body and mind in a state of heightened readiness. This state may develop after prolonged exposure to stress trauma or chronic pain where your nervous system begins to prioritize survival above all else. Perceiving, even minor sensations or situations. As potential dangers. Hypervigilance is particularly problematic in chronic pain because your nervous system becomes hyper aware of sensations in the body. Here's the cycle. Your brain interprets normal or harmless body sensations as a threat. Your sympathetic nervous system activates increasing muscle tension, your heart rate, And stress hormones like cortisol. These physiological changes, heightened the sensitivity of your pain receptors, making sensations more intense and painful, then your brain learns to expect pain. Further reinforcing the hypervigilant state. This creates a feedback loop where a heightened sensitivity to pain keeps your nervous system on high alert. And being on high alert, intensifies your perception of pain. How does hypervigilance affect your nervous system? It affects it in a few ways. One is sensory overload. Your brains, sensory processing centers become over WellMed interpreting even normal sensations like light touch or mild heat as painful or threatening. Another effect, diminished parasympathetic function with your sympathetic nervous system. Always on. Your parasympathetic nervous system struggles to activate this imbalance prevents relaxation, recovery, and healing. You might experience a heightened startle reflex where your body reacts strongly to small stimuli, like loud noises or sudden movement. Further perpetuating feelings of danger or vulnerability. And you might have also experienced chronic muscle tension. Persistence sympathetic nervous system activation can cause your muscles to remain tight or engaged. Leading to additional pain. Uh, restricted mobility and often lethargy and fatigue. How does hypervigilance affect you? The person. Emotional strain. Constant alertness leads to anxiety, irritability, and difficulty concentrating. So you may feel on edge all the time, even in calm situations. Exhaustion your body cannot sustain a state of high alert, indefinitely and can lead to physical and emotional burnout. Avoidance behavior. You may start avoiding activities, environments, or movements because you associate them with potential pain and finally hypervigilance often disrupts sleep as your nervous system. Doesn't allow your body to enter restorative states. Here's an analogy for hypervigilant. Imagine you're a security guard. Stationed in a building. Normally you'd only sound the alarm when you see real danger, like a fire or an intruder. But in a hypervigilant state. Your alarm system has become faulty. Now the alarm goes off at every little noise. A Creek in the floor, the wind blowing. Or a harmless shadow. Over time you, the security guard become exhausted from constantly responding to false alarms and your body and mind feel trapped in a constant state of stress. This is what happens to your nervous system in hypervigilance, the security system, your sympathetic nervous system. Becomes so sensitive. That it overreacts to minor or non-existent threats, keeping your entire body in a state of distress. To help regulate hypervigilance. You should focus on calming your nervous system and shifting it out of survival mode. How do you do that? Some strategies can include breathing techniques, slow, deep breathing, activates your parasympathetic nervous system and reduces the intensity of your fight or flight response, mindfulness practices. For example, body scans and meditation. Help retrain your brain to differentiate between real threats and false alarms, gentle movement practices like yoga, semantics, and Tai Chi, encourage safe exploration of the body and help relieve chronic muscle tension and restore a sense of physical safety. Create safety offer yourself a predictable calm environment with supportive guidance to reassure your nervous system and reduce hyper-vigilance. And let's not leave out therapeutic approaches like cognitive behavioral therapy, somatic therapy. Or trauma informed practices, which can address the emotional and psychological aspects of hypervigilance. The third and final effect on this episode that I'll address is the emotional. And cognitive affects chronic pain has on your nervous system. Chronic pain. Interacts with your brains, emotional and cognitive centers and creates negative thought patterns, such as fear of movement and emotional responses like frustration. And despair. This can trigger the limbic system, reinforcing pain-related pathways and further sensitizing, your nervous system to pain. Creating a cycle of pain and emotional distress. Chronic pain. Doesn't just impact your body. It profoundly affects emotions and cognitive functions as well. This happens because pain is not just a physical sensation. It's also processed in the emotional and cognitive centers of your brain. Leading to changes in how you feel, how you think. And how you perceive the world. Chronic pain affects your nervous system, emotionally and cognitively. And here's how. The amygdala is a part of your brain responsible for processing fear and emotional responses. And it becomes overactive in people with chronic pain. This creates heightened, emotional sensitivity, making you more prone to anxiety. Fear and even depression. The amygdala signals danger. Constantly. Even when no actual threat exists, keeping your nervous system on high alert. There's a reduced function in your prefrontal cortex. which helps with focus. Planning decision-making and emotional regulation becomes less active in chronic pain. This reduction can impair your problem solving abilities and make it harder for you to stay emotionally balanced, resulting in feelings of overwhelm. Poor concentration and mental fatigue. Your brains, praying processing areas become more connected to emotional centers. This means that pain becomes more closely tied to feelings of distress, amplifying its emotional impact and making it harder to separate physical pain from emotional suffering. And finally chronic pain alters your levels of key brain chemicals, which regulate mood and cognitive function. Low levels of these chemicals contribute to feelings of sadness, lack of motivation and difficulty experiencing pleasure. Some emotional effects include heightened anxiety and fear. Depression and hopelessness. And emotional reactivity with your amygdala in overdrive emotions like irritability, frustration, or sadness can be triggered more easily. And intensely even by small stressors. cognitive effects show up as brain fog. And poor concentration. Impaired memory. Difficulty making decisions. And negative thought patterns. But how do nervous system changes affect you? The person. The combination of heightened emotional sensitivity and cognitive impairments can lead to isolating yourself socially. Experiencing work and daily life challenges because memory issues, poor focus and decision-making difficulties can interfere with your productivity and your routine activities and the emotional toll of chronic pain or Rhodes resilience, making it harder for you to bounce back from setbacks or manage your stress. Here's an analogy. Imagine your brain is like a busy office, managing many tasks at once. In a healthy state, each department, emotions, memory, focus, and decision making work efficiently together. Chronic pain. However, it is like an emergency alarm that never stops ringing and the noise distracts every department, The emotions team. Becomes frantic thinking the office is under constant threat. The focus team. Struggles to concentrate on projects because the alarm keeps interrupting

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The memory team forgets tasks because they're overwhelmed by the chaos

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and the decision-making team feels paralyzed, unable to decide the best way to respond to the constant. Alarm. Over time, your brain becomes less productive and more stress leaving you feeling. Burned out. To counteract these effects. It's essential to focus on calming your nervous system and restoring balance. You can do this by incorporating mindfulness and meditation, gentle predictable movement. Prioritizing your sleep hygiene. Engaging in pleasurable activities and therapeutic support. Although it may be challenging to help students with nervous system dysregulation, especially in group classes. You can definitely incorporate mindfulness practices, gentle breath, work, and safe gradual movements to help students begin to feel more in control of their emotions and thoughts. This can help them break the cycle of pain, driven distress, and regain a sense of balance. And call them. In this episode and in the last one, we've covered a lot. A breakdown of your entire nervous system, the branches. A more thorough explanation of the states of your sympathetic and parasympathetic nervous systems. And five effects that chronic pain has on your nervous system. A quick recap of the five affects chronic pain has on your nervous system that I've covered our central sensitization. Altered brain structure and function. Impaired descending pain modulation. Hypervigilance and nervous system activation. And emotional and cognitive effects. I know it's a lot of information, which is why I suggest you come back and listen to these episodes as many times as you need. Typically, we need to hear information more than 10, 15, 20 times before we start to get it. So listening again, just means that you're trying to hear it again. And integrate the information. I'll leave you with this reminder. When you understand these potential changes in your brain or your students' brains? It emphasizes the importance of teaching mindfulness, relaxation. And super gentle movement in pain management. Practices that promote neuro-plasticity your brain's ability to rewire itself Gradually helps shift your brain function away from pain dominant patterns. Try incorporating practices that balance relaxation and feel like safe movement. Which can support students in untangling their pain pathways, and nurturing a sense of calm. Control and resilience. And there. Brain. And body. If you can't tell already, I love talking about anatomy, pain and injuries, and I want all teachers of movement to understand how a working knowledge of it affects your teaching. I don't think we talk about the importance of pain enough. And if this conversation feels uncomfortable, don't worry. This is exactly where change happens. I pick up an anatomy book, watch a video series, talk to your students about their bodies. Really watch them move and notice what you see. And find trusted teachers and accounts on social media that will teach you. Just keep taking steps to be more informed. I hope that this episode sparks some deeper thought around why a knowledge of pain understanding its affects and recovery is so important as a movement educator. I've added a link in the show notes for you to send me a quick text message about your thoughts on this episode or any other, I won't know your phone number. It's just a new addition to the platform I use. That allows for this new and super easy way for you to communicate with me. Once you click on it, it will take you to your messages, but don't delete the code. That's how your message is going to get to me. And I would love to know your thoughts on this topic. If you can't tell already, I love diving into these conversation because there are so many important discussions to be had in the teaching world. You know, that my goal is for you to love the yoga teaching life and allow it to be fulfilling and rewarding. The ability to take care of yourself while you care for so many of your students is important as well. If you love this episode, let me know, subscribe to the podcast. So you're always in the know when a new episode drops and share it with another yoga teacher who you think would love to be in on these conversations. Thank you so much for helping to spread the word about this podcast. And if you've been taking notes in your journal, as you listened to these episodes, I'm so glad you are. And I would love to hear about it. Don't forget to download the ebook sequencing for different injuries. The link is in the show notes below. I promise you it's going to help you form a foundation for teaching students with injuries. And it'll be a great resource for you to return to again and again. When you download the ebook, you'll be joining my newsletter. That's just for yoga teachers. I've got more exciting teachings coming soon. So I want to tell you all about them. The link is in the show notes below, and I would love for you to join it so we can always stay connected. All right. That's it for now. Bye.

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Mhm.