I suggest breathing a lot as a way to start to get a handle on your pain. I am often looked at like I have lost my mind, or that there is no way breathing can help. If you have been reading my blog for very long, you know I am a firm believer that pain is more than just tissue and it affects our whole being, especially when it persists. 

So yup, breathing as a way to help yourself when the increase in pain comes, in the moments where you feel like you might lose control when you just “can’t” anymore. It’s always with you, it’s free and it’s not “just” breathing, It’s a mini magic wand to calm your nervous system. 

The basic principle is this:

Holding your breath, shortness of breath, constrained and tense breath, and rapid breath are part of survival, fight/flight/freeze, and activation of the nervous system, or a stress response. Basically, ramped up the nervous system and ramped up the pain experience, 

Natural, full, diaphragmatic breaths = opening up to life beyond survival, opening up to calmness, regulation of the nervous system, bringing about physical relaxation, improving health, being able to think. More oxygen to the brain, a switch from survival to rest and digest. Which is where calm lives. 

For calming pain, conscious breathing acts as a nervous system interrupter. The survival brain gets stuck in this pattern: stimulus in the environment (trigger) leads to an automatic response of the autonomic nervous system (shallow breathing). Taking control of the breathing interrupts this circuitry and breaks the cycle, pretty cool magic wand huh?

Breath is a function of the autonomic nervous system that we can consciously change. By changing our breathing, we can change the state of our bodies. That’s powerful stuff when you think about it. You can’t change the way your heart beats, or if you perspire or digest your food, but you can change how you breathe and directly affect your nervous system. 

If these techniques are good enough for elite athletes, escape artists, and Navy Seals then maybe we should give them a shot. What do you think?

8 Breathing Exercises you can try

1. Four In, Four Out Slow Belly Breathing

Also Called: Relaxed Breathing, 4 Count Breathing, 4-1-4-1 Breathing

The following is from the Psychology Tools download.

“When we are anxious or threatened our breathing speeds up in order to get our body ready for danger. Relaxed breathing (sometimes called abdominal or diaphragmatic breathing) signals the body that it is safe to relax. Relaxed breathing is slower and deeper than normal breathing, and it happens lower in the body (the belly rather than the chest).

Instructions:

1. Make sure you are sitting or lying comfortably.
2. Close your eyes if you are comfortable doing so.
3. Breathe through your nose rather than your mouth if that is comfortable for you.
4. Deliberately slow your breathing down.
5. Breathe in to a count of 4
6. Pause for a moment
7. Breathe out to a count of 4
8. Pause
9. Repeat
10. Make sure that your breaths are smooth, steady, and continuous – not jerky; pay particular attention to your out-breath – make sure it is smooth and steady

Am I doing it right? What should I be paying attention to? 

Relaxed breathing should be low down in the abdomen (belly), and not high in the chest. You can check this by putting one hand on your stomach and one on your chest Try to keep the top hand still, your breathing should only move the bottom hand Focus your attention on your breath – some people find it helpful to count in their head, to begin with (”In … two … three … four … pause … Out … two … three … four … pause …”)

How long and how often?

Try breathing in a relaxed way for at least a few minutes at a time – it might take a few minutes for you to notice an effect. If you are comfortable, aim for 5-10 minutes Try to practice regularly – perhaps three times a day

Variations and troubleshooting

Find a slow-breathing rhythm that is comfortable for you. Counting to 4 isn’t an absolute rule. Feel free to try 3 or 5, this should be relaxing, not stress-inducing.. The important thing is that the breathing is slow and steady Some people find the sensation of relaxing to be unusual or uncomfortable at first but this normally passes with practice. Keep practicing, it gets easier and then almost natural.

2. Whole Body Muscle Tensing and Relaxing

This exercise switches on the parasympathetic nervous system (“relaxing” nervous system) more quickly than the others. It’s also more impactful than the others because it engages all the muscles of the entire body. This powerful practice can help you make a rapid change, even in tough situations.

This exercise is a relative of Progressive Muscle Relaxation, which is one of my favorite forms of relaxation. I have used it to help me sleep for years. I even used it for pain control during the birth of both my kids. I learned this technique as a swimmer and came to find out many of my former teammates also still use it to manage stress and pain. Check out my post on it here. In Progressive Muscle Relaxation, you relax and tense each muscle group progressively and reach deeper and deeper states of relaxation as you go. That takes time though. This one is more of an emergency measure. I’m calling it “Whole Body Muscle Tensing and Relaxing” because you do it with your whole body system at once rather than progressively. Because you tense and relax your whole body it’s much faster. If you are facing anything that is anxiety-provoking, like a flare-up, for example, this one can be done quickly. If you have more time, you can do it over again several times, or instead do Progressive Muscle Relaxation.

Instructions:

1. Take a very deep breath in with your mouth open; fill your lungs up.
2. Hold your breath.
3. While holding your breath, tense muscles all over your body as tense as you can – face, fingers, toes, shoulders, stomach, butt, legs, etc. – without injuring yourself (if you have a known issue go easy on that part of your body)
4. Count 5-10 seconds while holding your breath and keeping all muscles tense.
5. Then relax everything, let go of all the tension in your muscles and
6. Slowly let your breath out.

3. 4-4-4-4 Breathing

This exercise is from Lieutenant Colonel Dave Grossman. Grossman has trained thousands of law enforcement personnel on how to teach this exercise to trauma survivors. He has found that having a trauma survivor do this exercise immediately after the traumatic event helps their nervous system regulate around the experience and may stop the extreme cycles of PTSD from getting started in their body. Chronic Pain can often have many trauma responses associated with it. So don’t discount the use of this breathing technique when you need to go into a procedure, visit a new doctor, or clean the house. 

Instructions:

1. Breathe in while counting to 4. Make it a deep, belly breath.
2. Hold your Breath while counting to 4.
3. Breathe out while counting to 4.
4. Hold your Breath while counting to 4.
5. Do this sequence 2 more times.

Why it works:

When there is a perception of an overwhelming threat and the system goes into a freeze/flight/fight response. The autonomic nervous system is telling the breathing to become shallow and fast in order to respond to the threat.

Then you step in and by using your voluntary muscles to open and close the breathing deliberately, slowly, fully and deeply, you are using the somatic nervous system (voluntary moving muscles) to influence something that, when in a trauma response, is under the control of the autonomic nervous system. Breathing acts as the bridge between the two systems.

Eventually, by putting this bridge into action, you break the connection between the threat and the breathing.

Although Grossman explains this sequence of physiological events really well in his article in relation to 4-4-4-4- Breathing, which he calls Autogenic Breathing, by the way, this applies to all breathing exercises with the same characteristics.

For example, slow breathing in general seems to allow people to slow their entire system (mind, emotions, body) down enough to integrate pieces of what happened to them that came too quickly for their system to process during the event.

Additionally, deep breathing in general seems to allow emotional release and processing of the energy stuck in the body from the trauma (people may, after a while of breathing, begin crying, tingling, feeling hot or cold, releasing energies from the trauma).

All of the natural responses to trauma – the fight/flight response to stimulus, the arrested and unmoving state of not processing anything, and repression of the energies and emotions from the trauma – are normally held static inside the body indefinitely to wreak havoc. Breathing is able to get a whole slew of things unstuck and moving.

In the case of using any deep, slow breathing exercise when you are triggered, you can actually think about what you fear – the trigger – as you slow your breath. The idea is to try to disconnect the thought of the trigger from the automatic response of fight and flight in the nervous system. 

4. 4-6-4-6 Breathing 

Instructions:

1. Breath in for a count of 4
2. Hold for a count of 6
3. Breathe out for a count of 4
4. Hold for a count of 6

“The 4-6-4-6 breath trains the mind to be peaceful.” – Sonia

5. The Sigh

This one is a very soothing and healing exercise that is like a balm for the nervous system.

Instructions:

1. Breath in.
2. When you breathe out, open your mouth and exhale the air with the sound of the air releasing, a soft sigh sound.
3. Relax your shoulders, neck, and other muscles, and let everything go.
4. Do 3 or 4 times, or however many times feel right.

“It’s like being wrapped in a warm blanket; it calms the nerve endings, it quiets the brain, it grounds the body, it expands the lungs…” -Sonia

6. For Deep Relaxation – Buteyko Small Breath Holds

This one is so relaxing. I think this is one of the best exercises I’ve done so far for entering deep relaxation. I really felt the switch she describes into the “relaxing nervous system,” the parasympathetic nervous system.

Instructions:

1. With your mouth closed, take a small, but calm and relaxed, breath in.
2. Take a small breath out.
3. Block your nose.
4. Hold for a count of 5
5. Release
6. Gentle, soft breathing in-between sets
7. Tongue rests at the roof of the mouth; Teeth slightly apart; jaw relaxed; Drop shoulders; relax chest and belly; Relax facial muscles.

7. Alternate Nostril Breathing (a kind of Pranayama/Yoga Breathing)

Any breathing exercise that includes very slow breathing helps pull us into our center and helps the body to integrate with the mind.

Instructions:

1. Sit down on a chair
2. Close the right nostril with your right thumb. Then inhale slowly through your left nostril.
3. Then close the left nostril with your right index finger and open the right nostril by removing the right thumb. Exhale very slowly through the right nostril.
4. Then draw the air through the right nostril as long as you can do it with comfort and exhale through the left nostril by removing the right index finger
5. This is one round. Do 12 rounds.
6. Note that for this, breathing in and out should be as slow, soft, steady and long as possible. But don’t force.
   The alternate nostril breathing harmonizes the whole nervous system and balances the activity of both hemispheres of the brain.

8. 4-7-8- Breathing (a kind of Pranayama/Yoga Breathing)

For any breathing exercise, when the exhale is longer than the inhale this slows the heart rate and lowers blood pressure. When you pause after inhaling it slows the heart rate. Divers, like Navy Seals, do breathing exercises to control their heart rate.

Also, for any breathing exercise that involves counting, the counting itself can be calming as well because of focusing your mind on something simple and rhythmic, something other than what is causing the pain or stress.

Instructions:

These instructions are quoted directly from the blog Madly In Love With Life: ( which is no longer available 12/22)

“You can do this exercise standing, lying down, or sitting in a chair (keeping your back straight and both feet on the floor). You may keep your eyes open or closed. Count at a comfortable pace for yourself and don’t force anything.

1. Begin by exhaling all the air out through your mouth.
2. Curl the tip of your tongue up to touch the hard ridge behind your upper front teeth and hold it there for the duration of the exercise.
3. Close your mouth and inhale through your nose for a count of 4. Don’t force it, but take a good breath as this has to last for the next 15 counts.
4. Hold your breath for a count of 7.
5. Open your mouth and exhale through your mouth (still pressing the tip of your tongue to the hard ridge behind your upper front teeth) for a count of 8. You will make a sound as the air moves around your tongue. You may want to purse your lips if this helps you to direct the flow of your exhalation.
6. Repeat 4 times.

At the end of the last cycle, relax and notice how you feel. I always like to finish with an inner and outer smile. Yes, a smile. Pause after your breathing exercise, check in with your body and take that calm with you as long as you can. This feeling is only a breath away.