can slow deep breathing reduce pain? an experimental study exploring mechanisms

Authors: H. Jafar, A.Gholamrezaeri, M. Franssen, L. Van Oudenhove, Q. Aziz, O. Van Den Bergh, J.W.S. Vlaeyen, & I. Van Diest

Background: Focused breathing is an easy-to-use strategy that has been shown to reduce pain. There are several different approaches that can be used, some of which slow down the pace of breathing and alter the volume of inhaled/exhaled air. It isn’t clear exactly how focused breathing reduces pain, although several different mechanisms have been proposed, including physiological changes to the cardiovascular system.

Objective: To study the effects of different breathing patterns on pain and to determine whether cardiovascular changes mediated these effects.

Who Was It? This study included 48 healthy men and women between the ages of 18 and 30. Subjects were not currently experiencing pain and avoided alcohol and coffee before participating in the activities.

What Was Done? Each subject performed four breathing patterns, including normal breathing, paced breathing, and two patterns of slow deep breathing. During each breathing pattern subjects were exposed to a heat stimulus on the left wrist which they rated in intensity. Subjects did not know the specific objectives and hypotheses of the study. Respiration, heart rate and blood pressure were measured during the pain exposure.

What Happened? Subjects reported less pain with each of the three breathing interventions, and slow deep breathing with a low inspiration/expiration ratio was more effective than both paced breathing and slow deep breathing with a high inspiration/expiration ratio. Breathing patterns did affect cardiovascular function, including baroreflex sensitivity and intervals between heartbeats, although these did not appear to mediate the effects of breathing on pain.

Fringe Commentary: Breathing, or breathwork, is a pain management tool that is continuously at our disposal. Using breathing to reduce pain does not need to be complicated – simple patterns, such as using spontaneously pacing breathing or slowing breaths to around 6 breaths per minute, are effective. Breathwork can be easily learnt and integrates well with other pain reducing interventions.

Citation: The Journal of Pain (2020); 21(9-10):1018-1030


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