Slow Breathing for Pain Relief

Can slow breathing really relieve pain?

But is this really true? Is it medically proven that slow breathing can relieve pain?

Well, one study that’s got a lot of press was conducted at the University of Arizona in the US. The researchers gave “thermal pain stimuli” to women aged 45 – 65. (The pain stimuli were hot pulses administered to the palms of the hands.) Half of the time the women were breathing normally. The other half of the time they were breathing at about half their normal breathing rate. They were then asked to rate how painful the stimuli were, how unpleasant they were, and how they were feeling emotionally.

Overall, women reported less pain and less feelings of unpleasantness when they were receiving the heat stimuli during slow breathing, compared to during normal breathing.

Slow breathing for pain relief – how does it work?

There are several ways in which slow breathing can affect pain. It can affect the source of the pain itself. Slow breathing can also affect one’s perception of pain, rather than the source of it. And make no mistake – this effect is no less profound.

Muscular relaxation

First of all, the most obvious way in which slow breathing relieves pain is through muscular relaxation. A period of focused slow breathing can help evoke a body-wide ‘relaxation response’, in which the heart rate is slowed, blood pressure is reduced, and muscles are relaxed. As such, slow breathing can directly relieve pain which is due to muscle tension. It can also at least partially alleviate pain which is exacerbated by muscular tension, muscular spasms etc.

Mental relaxation and stress reduction

Slow breathing can also help with mental relaxation. It’s well-known now that frequent feelings of mental tension and strain can have subtle but serious effects on our body. In fact, being prone to stress is linked to greater sensitivity to pain. As such, techniques which can relieve stress can also reduce pain.

For example, at the University of Utah, researchers compared pain responses in different groups of people: healthy yoga practitioners (yoga is well known for its stress-reducing effects), sufferers of fibromyalgia (a chronic condition characterised by chronic pain and heightened pain sensitivity), and healthy folk who didn’t do yoga or have fibromyalgia.

The researchers squeezed the thumbnails of the participants, to cause them pain. As well as asking the participants to report when they felt pain, they also monitored their brain activity. They found that yoga practitioners had the highest pain tolerance, and fibromyalgia sufferers the lowest. In other words, the yoga practitioners didn’t feel pain till the thumbnail pressure was greater. They also found that this corresponded to activation of pain perception areas of the brain, the yogics having less activation of these areas during the experiment than fibromyalgia sufferers.

They concluded that techniques, such as yoga, which help manage stress can also help manage pain.

How slow breathing reduces stress

Now, it’s well established that slow breathing is a highly effective way to reduce stress. This is because quick, shallow breathing activates the sympathetic nervous system, the part of the nervous system which controls our responses to threats and danger. In other words, the part that raises our adrenalin and stress levels so we can take action.

In contrast, slow, deep breathing activates the parasympathetic nervous system, the part of the nervous system which calms us down and enables relaxation. The main nerve activated here is the vagus nerve, and research is increasingly finding that stimulating the vagus nerve has multiple positive implications for the body.

One doctor uses the analogy of driving a car, with slow breathing being the brake:

“Think of a car throttling down the highway at 120 miles an hour. That’s the stress response, and the Vagus nerve is the brake. When you are stressed, you have your foot on the gas, pedal to the floor. When you take slow, deep breaths, that is what is engaging the brake.”

Esther Sternberg, researcher at the US National Institute of Mental Health.

To get even more specific, researchers at Stanford University, in the US, have recently (March 2017) discovered specific neurons which transmit signals from the parts of the brain involved in controlling breathing to the parts of the brain which deal with arousal, in other words, with your state of mind

What about stress which is due too pain?

So, when you’re less stressed, you’re likely to feel less pain. So far so good. But what about the opposite effect – the way that being in pain can cause you to feel tense and anxious?
Well, practices like slow breathing, yoga and meditation can help here too, as they can help counteract the anxiety and nervous tension which often arise when you feel pain.

As Dr. Bloom explains (quoted on prevention.com),

“The ways in which pain affects your brain are just beginning to be explored. When you have acute pain, you actually develop neurocircuits in the brain that create that pain perception. People report that meditation doesn’t necessarily take away pain, but it changes their perception of it, so it bothers them less. They lose a lot of that fear and stress that makes pain worse. They might still have the pain—but it seems much less painful.”

Emotional management

Just as stress can affect your perception and experience of pain, so can other mental and emotional states.

For example, the Arizona university study mentioned at the start of this article found that women’s emotional state influenced their perception of pain. Half the women taking part in the study had fibromyalgia, a chronic pain condition. And they didn’t experience the positive effects of slow breathing on pain perception as much as the healthy women.

Those who had fibromyalgia reported less pain and less unpleasantness during the slow breathing sessions only if they were feeling quite positive overall. Those fibromyalgia sufferers who generally were feeling depressed, or otherwise down, did not experience the pain-relieving effects of slow breathing so much.

Fibromyalgia can be associated with depression, in some people. And of course, chronic pain and depression can be a vicious circle. If you’re in constant pain, it’s going to get you down. Which in turn can exacerbate or entrench the perception of pain. Which comes first in any particular case may be a chicken-and-egg argument, but breaking the cycle is key. And slow breathing can help, if it’s practiced regularly.

Pain is also often associated with anxiety which again can be helped by slow breathing. You can read more about this in our article here: slow breathing exercises for anxiety.

Slow breathing for depression and anxiety

A study at the University of Pennsylvania, published in 2016, found that a breathing-based meditation practice alleviated depression and anxiety in people with major depressive disorder.

The people involved were already taking anti-depressants, but those who regularly did the controlled breathing meditation became less depressed and anxious than those who didn’t do the breathing but were also taking the same anti-depressants.

The controlled breathing meditation used a specific yoga technique called Sudarshan Kriya, which involves alternating periods of slow breaths with periods of fast breaths, so it wasn’t slow breathing as such. However, it is a powerful demonstration of how changing one’s breathing patterns – even for a short period each day – can significantly affect one’s state of mind.

How to do slow breathing for pain relief

The most effective way to use slow breathing for pain relief is to do it every day for at least fifteen minutes. This way you’ll learn to gradually relax your body and mind more deeply. The more often you do it, the more slowly you’ll be able to breathe. And the more you get used to breathing slowly at will, the better able you’ll be able to do it whenever needed.

A regular practice of slow breathing than therefore can help with chronic pain relief and also with sudden episodes of pain.

Now, obviously, if you need to do slow breathing repeatedly throughout the day you should do so! But having a regular practice as a baseline is very useful.

The hardest thing perhaps is just making sure to set aside some time each day for this. It might be easiest to do it at the same time of day. Whenever you think you’ll most benefit. First thing in the morning if you need to loosen up after a tense night. Or before bed as it can help you relax and get a good night’s sleep too.

Getting started with slow breathing for pain relief

Just find a place where ideally you can be undisturbed. It’s easier to breathe slowly when sitting upright or standing for most people, but if you find it easier to lie down, then do so. Whatever is most comfortable and enables your upper body to be open and unrestricted.

Once you’re settled, bring your attention to your breathing and just gradually slow down your breaths. Focus on extending your out-breath / exhalation. If you experience pain doing this, just try to stay relaxed and keep breathing. Resist the temptation to contract and tense up.

Of course, if you’re experiencing unusual pain or anything that makes you concerned then check with your doctor before continuing with slow breathing. In fact, if you have any concerns at all about any aspect of this, consult a health practitioner before trying it.

And that’s it. Just keep focusing on your breathing, on relaxing, on slowing down. Most of us take around 10 – 12 breaths a minute normally (‘one’ breath here being an inhale and an exhale). Around five or six breaths per minute is a good speed to aim for eventually, for maximum relaxation. But don’t rush it. Don’t force yourself to breathe slower than is comfortable for you. Just take it easy. And keep doing it.

If you need more support – aids to slow breathing

So as you can see, slow breathing for pain relief is really very simple. Having said that, the simplest things can be the trickest! And you might find it can be very difficult just to stay focused on your breathing.

If you do find this, then you can try listening to guided slow breathing audio recordings. These give you breathing prompts at a certain rate which you can just breathe along in time with. This makes it easier to keep a steady and consistent slow breathing rate.

It just so happens that we have such audio tracks on this website.

If you like them, you can buy a full set of guided slow breathing tracks as digital downloads, which means you can start using them right away. (Physical CDs are now also available.)

Click here to listen to some samples and/or to buy them:

Breathe Slow guided slow breathing audio tracks

However you do it, we wish you all the best with using slow breathing for pain relief.

Post by Alison, updated 26th June 2021

Slow Breathing for Pain Relief

Can slow breathing really relieve pain?

Slow breathing for pain relief – how does it work?

Muscular relaxation

Mental relaxation and stress reduction

How slow breathing reduces stress

What about stress which is due too pain?

Emotional management

Slow breathing for depression and anxiety

How to do slow breathing for pain relief

Getting started with slow breathing for pain relief

If you need more support – aids to slow breathing

Further reading and references:

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