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Yoga as a Tool for Pelvic Pain: Why it Matters

Why yoga? Maybe you’re asking yourself, how could downward facing dog, some yoga tights, and breathing actually change and reduce a person’s level of pain? Despite the westernized evolution of yoga, this very ancient practice was not initially developed to reduce pain. Instead, its main purpose was to improve a person’s ability to sit and meditate for long periods of time. Now, however, yoga is being both scientifically studied and used clinically as a way to treat and heal certain aspects of pain. It’s pretty remarkable.


Chronic pain is much more than just the physical, instead it is significantly influenced by physical, psychological, and social factors throughout a person’s complex life. This model is known as the biopsychosocial approach to pain. When yoga is used therapeutically, it helps people not only engage physically with the body, but also helps to improve introspection, social connection, and autonomic nervous system regulation. When all or some of these ingredients are lost, a person can be left with very real pain.


Specifically, for this post, I will talk about two common causes of pelvic & abdominal pain. Both IBS and Endometriosis are complex but can be treated through a more hands-on approach like physical therapy and even yoga.


IBS

First, IBS can manifest as both abdominal and pelvic pain. This condition commonly presents as cramping in the abdomen or pelvic floor, changes in bowel habits (alternating between diarrhea and constipation) and bloating. An awesome book that discusses the relationship between yoga and pain is called Yoga and Science in Pain Care. In the book, there’s a chapter written by Steffany Moonaz who discusses the effects of yoga on IBS. She found multiple research studies that emphasize practicing yoga for just twice a week for six weeks to help improve “worse pain” (aka really bad uncomfortable pain). But how does this happen? If you go online and research IBS, you will find that many well acclaimed sources don’t actually know the cause of IBS. It’s believed to be both a physical as well as a psychological condition that is even occasionally treated with antidepressants. What we know about yoga is that it has profound abilities to both improve the mind-body connection through introspection (like meditation or a body scan) and down-regulate the autonomic nervous system through deep breathing like pranayama (check out my previous blog post “Pranayama – The Portal to our Nervous System” to learn more).


Here are some recommended yoga postures for IBS related pain:


1. Sphinx pose: Hold for about 30 seconds to 1 minute. It’s a lovely posture to stretch the abdominal wall as well as soften the internal abdominal muscles and organs. Remember to breathe long, slow, and deep as you hold the pose.

2. Anjaneyasana: This is a great posture to help lengthen and soften both the psoas muscle and the large intestine. When practicing with the left leg back, the descending colon is both lengthened and decompressed. When practiced with the right leg back instead, the ascending colon is lengthened and decompressed. Both sides should be practiced for 30 seconds to 1 minute. Try putting a blanket under your back knee to support the knee joint.


Endometriosis

Another very common, but not often discussed, condition that causes abdominal and pelvic pain is Endometriosis. Endometriosis is caused when tissues similar to the lining of the uterus begin to grow in abnormal places, like the ovaries, cervix, or fallopian tubes. An article from The Journal of Alternative and Complementary Medicine found that practicing yoga for 90 minutes twice a week for 8 weeks significantly reduced the degree of daily pain in women living with endometriosis. While I was researching online, I found about 6-7 additional articles that showed similar effects and results. From my own experience, patients with endometriosis seem to respond the best to slower forms of yoga like Restorative Yoga. Similar to IBS, the exact known cause of endometriosis is unknown, but the pain is definitely real and very present. Specifically, for endometriosis, the book Yoga and Science in Pain Care mentions that when women shared their pain stories with other women living with endometriosis, the social support and connection helped to reduce perceived pain. The simple feeling of community and connection can truly help.


Recommended yoga postures for Endometriosis related pain:

1. Restorative balasana (child's pose): Bring the big toes to touch, separate the knees, and place either a bolster or pillow in between your thighs. Lay comfortably on the bolster and turn one head to the side. This pose should be held for 3-5 minutes. Check in with your breath, see if you can slow down and breathe in for 3 seconds and out for 3 seconds.


2. Supported prone twist with a bolster: For this one you will start with your knees pointed to the right with the left hip touching the short end of the bolster. From here, rotate the spine so that you are facing the bolster, then slowly lower the body so that you are laying comfortably on the bolster. You can either turn your head to face your knees or turn away from your knees depending on the flexibility of your cervical spine (neck). Like supported child’s pose, hold each side for 3-5 minutes with long, slow, deep breaths.



This short and sweet list of yoga poses is just a taste of therapeutic yoga postures used for pelvic pain. If you have more questions, want to learn more modalities of care, or are struggling with either IBS or Endometriosis feel free to reach out. I listed below both the research article and book from this blog. Both are excellent resources.


Thanks for reading everyone! I hope yoga helps your body heal as it has done for me time and time again.


Dana


Resources:

Andrea Vasconcelos Gonçalves, Nelson Filice Barros, and Luis Bahamondes

The Journal of Alternative and Complementary Medicine 2017 23:1, 45-52


Yoga and Science in Pain Care: Treating the Person in Pain

Forwarded by Timothy McCall, MD

Here’s a link to the website of one of the authors with an explanation of the book.


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