There’s a pH in Pain
During my Wim Hof Method instructor training we had a session from Professor Pierre Capel, an Emeritus Professor of Experimental Immunology from The Netherlands. In it he talked about the link between breathing + pH + pain, something which blew me away at the time (and still does).
I’m going to attempt to unpack it here and share with you the relationship between how you breathe and pain, and how this offers a way to help manage it, especially for those with chronic pain.
This year, more than 3.3M Australians will live with chronic pain, with the total financial cost estimated to be $144B. By 2050 that figure is expected to rise to 5.2M.
Pain doesn’t just take a physical or financial toll, with doctors often looking for signs of depression when diagnosing chronic pain (nearly 45% of those with chronic pain also live with depression and anxiety).
(While these are Australian statistics, I don’t doubt it’s a similar picture worldwide).
What is pain?
Contrary to the popular quote, pain is not weakness leaving the body!
Pain is defined as ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage.’ While it is a response to sensory input, it’s influenced by a range of factors including our current psychological & emotional state, memories of previous experiences, our beliefs and values, our age & gender and the society & culture we live in. It’s highly subjective and very complex.
This is why two people can experience a similar painful condition but have vastly different responses. It’s also why if you’re storming around the kitchen in a huff and you stub your toe, it hurts way more than if you’re more relaxed and you accidentally do it (I’ve done both in the past week #MyPoorToe).
How do we sense pain?
We process harmful stimuli through a process called nociception (cool word, I still can’t pronounce it properly). This is done through sensory neurons known as nociceptors, which detect changes in temperature, pressure and injury-related chemicals. These neurons send the pain signal via our central nervous system (CNS) to our brain, where the brain tries to make sense of it. It recalls past memories of similar stimuli, attaches emotion and triggers a response, often by activating our ‘fight or flight’ stress response (our sympathetic nervous system).
However, the pain pathway is not a one- or even a two-way street. It’s more like a multi-lane, multi-directional highway with on and off ramps and stop lights.
Firstly, according to the gate control theory, the pain signal sent via the CNS can be amplified, turned down or even blocked out before it reaches the brain. If the brain is busy doing other things it may shut the receiving gate until it is ready to pay attention. You can see this in action in several ways:
Soldiers in battle accomplishing heroic things, even while heavily injured
MMA athletes continuing to fight despite broken limbs
Getting a child to rub their knee when they fall over, or
Rubbing your toe when you stub it (I have first hand experience here)
Secondly, once the signal reaches the brain, the brain is able to influence our perception of that pain (it’s actually only once the signal reaches our brain that we become aware of the pain). This is demonstrated in three ways:
The sensation of pain eventually goes away
If you consciously distract yourself, the pain bothers you less
Placebos have been shown to reduce or cease the feelings of pain
What about chronic pain?
The feeling of pain activates parts of our brain that respond to stress, firing up our sympathetic nervous system, putting our body on high alert. When the pain goes away, the signal turns off.
With chronic pain, pain that lasts beyond the expected healing time (usually 3 months), that signal doesn’t turn off. Your nervous system remains on high alert because the brain is attempting to process every pain signal it receives. This eventually wears both the body and mind down, disrupting sleep, making you feel exhausted and lowering your mood. Being overworked in this way is one of the causes of depression. Unfortunately, this becomes a vicious cycle. You feel in pain, which leads to feelings of depression, which increases your feelings of pain and so on.
One of the keys to breaking this cycle is to find ways to deal with the pain (and associated stress) in order to create space to deal with the depression.
Your breathing & pain
Pain, and pain management are huge topics, especially when you start to bring the brain, perception, emotion, conditioning etc. into the equation. Instead, I want to focus on the physical aspects. We’re going to get granular, but stay with me.
Highly acidic environments have been identified as potential causes of inflammatory problems and autoimmune diseases. These environments also increase our pain sensitivity as the low pH stimulates the nerve roots, the nociceptors, that sense pain. Within these nerves are proteins called Acid Sensing Ion Channels (ASICs), which play an important role in nociception. As the name suggests, they’re also acid sensitive. ASICs are monomeric (single) units, but in the right pH environment (a low pH environment) they form a trimeric unit (group of 3). In this form they help facilitate the electrical conductivity for nerve communication.
Professor Capel’s message was that in a more acidic environment pain signals are transmitted more effectively and in a more alkaline environment the pain signals are less effective.
This is where influencing how you breathe comes in.
Carbon dioxide is an acid (low pH), so when CO2 levels increase, pH decreases and when CO2 levels decrease, pH increases.
So, if we breathe in such a way as to lower our carbon dioxide levels, we have the potential to influence our body’s perception of pain.
Using the Wim Hof Method to manage pain
The superventilation (deep breathing) part of the Wim Hof Method breathing technique lowers the concentration of CO2 in the blood, creating a state of respiratory alkalosis, which based on the above, helps to increase our pain threshold.
This has a twofold benefit:
It helps us during cold exposure and is one of the reason why we recommend doing the breathing before you have a cold shower or an ice bath (however, not immediately before, give it a few minutes - safety first)
It can help those suffering from chronic pain to find some daily relief
This global survey conducted by RMIT University, highlights the impact that practicing the Wim Hof Method can have for those with chronic pain (and other health conditions).
While I mentioned ‘daily relief’, this is based on information from Professor Capel’s lecture (who does know a lot more than I do!). As yet, there’s no consensus on how long the ASICs remain monomaic following respiratory alkalosis. Depending on the intensity and duration of alkalosis, the body rebalances the blood pH within hours, which may or may not extend to the ASICs.
Additionally, as I continually mention, everybody’s body is different. The best way to assess the efficacy of the Wim Hof Method (and any other health/wellness/fitness/life practice), is to try it for yourself, for your condition, for your situation.