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Tuesday, June 9, 2015

Yoga, Pain Management, and Sound Therapy

by Ram

Ann Dyer, Yoga Teacher and Musician, by Melina Meza
Yoga stress management practices, including meditation, focused relaxation, and relaxing asanas, help manage stress, which can have a feedback effect on improving pain. In my post How and Why Yoga Helps with Pain, I highlighted the benefits of yoga in curbing pain. Yoga (asanas, meditation, and pranayama) helps in the following ways: 
  • Triggers increased flow of oxygen to the brain and muscle tissues that improves energy levels and sense of wellbeing.
  • Helps to release muscle tension and stretch the muscles thereby reducing the intensity of the pain
  • Creates more mental clarity thereby decreasing the level of perceived suffering
  • Helps manage stress that can have a feedback effect on improving pain.
  • In animal models and in humans, studies show that the practice of yoga reduces pain perception. 
In today’s article, I present yet another evidence-based study that describes the benefit of another Yoga relaxation technique, the effect of sound therapy in reducing the pain response. In several yoga studios, the practice of asans is accompanied by soft sounds of music. The sounds could be from an audio setting or it could be a live music. Several Bay Area yoga studios also feature soft music/kirtans/mantra recordings/or live chanting while the asana class is in progress. In some cases, teachers start and end their practice with the chanting of Aum, an invocation to Patanjali or Ganesh, a Peace (shanti) mantra, etc. For a moment, keep aside your religious affiliation and recall just what those sounds did to your body, mind, and intellect. If you are unable to recall, the next time you are in a class where the asana practice is accompanied by some sound, be more attentive and notice what it does to you before and after the class. 

In my own home practice, I always like to play some soft music as I go through my Yoga routine. When I hear the mantras or sounds of Aum or some musical sounds of nature, a sense of calmness prevails, the chattering in my mind stops, and I feel more attentive and motivated. This state of the body and mind helps as I go through my asana practice. Did you know that since time immemorial, sound was used as a healing tool in almost all of the spiritual traditions? Be it the soft temple bells, chants of Aum, notes from various musical instruments, resonance from the tuning forks, crystal bowls, or Tibetan bowls, among others, sounds have been an integral part of the healing power of not just Hindu or shamanic culture but other traditions as well. My grandfather and his colleagues practiced Sandhya-vandhana (salutations at dawn and dusk that included asanas, mudras, meditation, and pranayama), either at the temple courtyard, in the farm, or by the riverside so they could tune in to the gentle sounds. 

The basic principle of sound/music therapy is that the tune, articulation, pitch, and the arrangement of the musical notes have a major impact on a person’s body, mind, and intellect. Pleasant and relaxing sounds shift the predominant beta brain waves (which keeps us aroused, alert, but also stressed) to alpha waves that puts the individual in the state of “Zone/Flow,” characterized by a state of improved focus, concentration and performance (see Positive Psychology vs. Yoga Philosophy). This is also the state characterized by the release of feel-good brain chemicals, such as endorphins, noradrenaline, and dopamine. Sounds alter the energy patterns in the body and mind, facilitate the connection between mind-body-intellect, and transform the individual into a high state of consciousness. This is why sound therapy is highly recommended for panic attacks and anxiety. Sound therapy serves as a tonic to the brain and is used frequently in the treatment of depression and pain as well.

In a recent study entitled “Complimentary effect of yogic sound resonance relaxation technique in patients with common neck pain," a group of scientists decided to investigate the role of a yogic relaxation technique called mind sound resonance technique (MSRT) as a form of non-surgical management for chronic neck pain. MSRT involves paying attention to the vibrations and resonance from chanting the syllables A, U, M, (Aum/Om) and the Mahamrityunjaya mantra sounds, with the eyes closed. It can be practiced in a supine or sitting posture. The chants are an alternate combination of loud chants and mental sounds repeated three times.

The sample size consisted of 60 literate patients in the age group of 20–70 years with no previous exposure to yoga. All of them suffered from chronic neck pain due to spasm (myalgia), strain of the neck muscles, ligament strain, or cervical spondylosis. Patients were randomized into two groups of 30 each using a computer-generated algorithm. The group included 28 females and 32 males. Both groups received conventional physiotherapy for 10 minutes and ultrasound massage for 10 minutes. Following these procedures, the control group had a non-guided supine rest for 20 minutes. The Yoga group received the mind sound resonance technique (MSRT) through a prerecorded audio tape played with head phones for a period of 20 minutes. The chants alternated from loud notes (Ahata) to unheard sounds (Anahata-mental notes). Instructions were provided to relax, focus, and concentrate on the sounds. The sessions lasted for 10 days. 

Data was collected before the onset of the study and on the final day. Several parameters for pain were measured. Improvements in neck muscle tenderness, neck disability, and movements of the neck were observed in both groups. The MSRT-yoga group showed significant reduction in pain (by 95.5%), tenderness (by 92.82%), and neck disability (91.32%). The cervical spinal flexibility, movements of the neck, (flexion, extension, lateral flexion—to right and left—and lateral rotation—right and left) all improved significantly in the MSRT group compared to the control group. 

This study reminded me of Jon Kabat-Zinn’s impressive articles on mindfulness and pain management all of which point out to the fact that mindfulness strategies including but not limited to relaxing and meditative sounds serve as an appropriate adjunctive treatment for chronic pain by lowering stress, reducing pain response, improving mental emotions, and physical flexibility. So if you wish to see health benefits from your yoga practice, you could complement your practice by  listening to or chanting  soothing/relaxing sounds.

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