Simple Step Exercise: Breathing to Control Pain

Simple Step Exercise: Breathing to Control Pain

Pause for a minute and pay attention to your breathing. What is going on right now? This is such a routine body activity that we rarely think about the quality of our breathing.  Breathing allows for oxygen to go in and carbon dioxide waste to be eliminated from the body.  This is a necessary function. Without breathing, we would quickly die.  Fortunately, the body is very good at doing this on a basic level most of the time.  This does not mean, however, that our breathing is always optimal for our health.  For example, people in pain are not good breathers. Their breathing is often shallow, fast, and involves a lot of upper body movement.  
What if there was something you could do that would improve your pain levels, blood pressure, heart rate, immune system, sleep,and energy levels as well as improve your body's reaction to stress? How much would you pay for something like this?  
Well, breathing a specific way is a simple method to get all of these benefits.   Did I mention it also happens to be FREE and you can do it anywhere?  How is that for a drug-free treatment for pain?
Go back to paying attention to your breathing while just sitting around at rest. (It is normal for your breathing to be faster with more movement when you are more active, such as climbing up stairs.)  You may notice some or all of the following signs of poor breathing habits that are especially common in people with pain:

• shallow, fast, or uneven inhalation or exhalation
• more than 12 breaths per minute
• forced breathing
• upper chest movement
• little to no movement of chest or belly

To tap in to the relaxation response you want your breathing to have these qualities:

• deep, slow, even inhalation and exhalation
• less than 12 breaths per minute, even better at around 4 breaths per minute
• relaxed breathing
• relaxed lower rib cage and belly movement with little upper chest and no shoulder movement

To watch an example of one of the best breathers on the planet, check out a sleeping baby.  They breathe effortlessly and with their little bellies rising up and down- almost like they were born to it.  In fact, we are all born to breathe this way but somehow we tend to lose this ability along the way to being a grown-up.  Well, now is the time to start practicing the relaxed breathing that is your birthright. Along the way you just may have less pain, sleep better, and feel more relaxed.

HOW RELAXED BREATHING WORKS

The diaphragm is a dome shaped muscle that sits at the bottom of the rib cage.  Check out this video of the diaphragm in action.  It is the main muscle involved in breathing.  All breathing involves the use of the diaphragm,  but there are also "helper" muscles in the rib cage and the upper shoulders that help us when we need to breathe faster or more forcefully.  When these "helper" muscles are used, the brain tends to think the body is under some type of stress and gears up the other systems including the heart, blood circulation to be able to react to the stress.  This is a totally appropriate "fight or flight" reaction if you have to run really fast to get out of the way of traffic or a hungry tiger.  This is not the way you should be breathing at rest.  When you learn to return to a slower, deeper type of breathing, the brain gets the signal that "everything is ok, nothing to worry about here".  You activate the body's relaxation response and get all the benefits of doing so (improved blood pressure, heart rate, pain, etc..).

HOW TO BREATHE FOR RELAXATION AND PAIN CONTROL  

Here is a basic way to learn to perform relaxed diaphragmatic breathing or belly breathing:

• start at first in a quiet area away from distractions
• lie down on your back in a comfortable position
• place one hand gently on your belly and the other on your upper chest
• start to pay attention to your breathing
• try to slow your breathing down gradually to a goal of around 4 seconds in and 4 seconds out
• Monitor your hands.  You should have little to no movement at the upper chest hand and a lot of movement at the belly hand
• breathe slowly and deeply but DO NOT force
• the belly should gently expand like a balloon filling with air and then deflate without force
• continue to breathe this way as long as you can
• once you get the hang of breathing this way lying down, try it sitting or standing

The most common errors I see when people are learning to breathe this way are:

• Trying to breathe deeply and slowly by FORCING the air in and out.  Diaphragmatic breathing should be very relaxed and quiet.  If you sound like a blowhard, you are probably trying too much.  
• Using the upper chest to assist in deep breathing.  Again, this is trying too hard and it activates the "fight or flight" system instead of the relaxation response.  Gently pay attention to your upper and lower hands.  Bring you attention to allowing the lower belly hand move in and out.  Relax the upper chest to the point you get little movement at the top hand.  
• Using the abdominal muscles to force the belly movement.  Do not use your abdominal muscles to squeeeeeeeeze the air out of your belly, just relax and let your belly deflate gently without effort
• Trying to force the timing of the inhalation and exhalation.  The 4 second in-out tempo is just a guide.  Let your breathing slow down as you pay attention to your hand movement.  It will naturally reach a slower pace. 

Diaphragmatic breathing is easy to learn with a little practice.  Be patient with yourself.  Remember, most of the errors happen when you try too hard and force the breathing.  Just relax,  you will get better with time.  It is easy to incorporate diaphragmatic breathing into your day.  Once you get the hang of it, do little mini breathing breaks throughout the day.  It is especially useful if you are feeling increased pain or stress.  Take a few minutes to practice your breathing and it should help.
Do not let the "simplicity" of this exercise fool you. I often have patients question how something as simple as breathing can help.  Like most of the important things in life, diaphragmatic breathing is very effective and makes profound changes to your body via the relaxation response. Patients are very surprised to find that this little exercise has a big impact on their lives.  They find that they are able to control their pain levels and headaches when using this technique during the day. It is also good to get into the habit of doing it before bed.  Most everyone who tries this reports they sleep more deeply and wake up more refreshed with less pain.  The hardest part of this little breathing exercise is REMEMBERING to do it.  Sometimes it helps to set an alarm on your phone or computer to remind yourself to take breathing breaks.
Start practicing diaphragmatic breathing today.  It is simple, free, and you just might find yourself feeling better!

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