Effect of Deep Slow Breathing on Pain-Related Variables in Osteoarthritis

Abstract

This study evaluated the effect of a six-week deep slow breathing (DSB) program on pain, physical function, and heart rate variability (HRV) in subjects with lower extremity joint pain. Twenty subjects were assigned into training (n = 10) and control (n = 10) groups. The training group participated in a six-week DSB program consisting of weekly training sessions and at-home breathing exercises. DSB exercises focused on prolonging the exhalation and the pause following exhalation. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess pain and physical function, and HRV data were obtained before and after intervention. Results revealed no significant interactions between group and time for any of the variables. There was no significant main effect for group, but there was a significant main effect (p<0.025) and a large effect size for time on both pain (ηp2 = 0.454) and physical function (ηp2 = 0.506). There were no significant main effects (p>0.017) for group and time on LF power (group ηp2 = 0.039, time ηp2 = 0.061), HF power (group ηp2 = 0.039, time ηp2 = 0.039), and LF/HF ratio (group ηp2 = 0.036, time ηp2 = 0.169). Results indicated that the six-week DSB program was not sufficient to alleviate pain or improve physical function in subjects with lower extremity joint pain. Although the pain was not alleviated, other beneficial effects such as better coping with the pain were reported in the majority of training subjects. As this is the first study to examine the use of DSB for lower extremity joint pain and dysfunction, further research is needed to investigate the efficacy and applicability of DSB.

Gender differences on pain threshold, body temperature and reaction time among elderly population after alternate nostril breathing exercises-A comparative study

“…19 The present study results differ from previous study results showing no change or decreased pain sensitivity after deep breathing exercises. [11][12][13] Body temperature decreased significantly (p value <0.001) immediately after 30 minutes of ANB (Table 2). Generally there is decrease in body temperature with advancing age along with loss of diurnal variation in body temperature due to derangement of the temperature regulating mechanisms.…”

“…An increase in pain threshold was observed after 6 weeks of slow alternate breathing practice in a study, whereas other studies reported no change in pain threshold immediately after slow breathing as well as after 6 weeks of training. [11][12][13] Body temperature is normally kept within control by adjustments in the autonomic nervous system. 14 As Hypothalamic temperature regulatory mechanisms decompensate in old age, the body temperature of older individuals is less than the normal value of 36.5 degree celcius.…”

Keeping the Breath in Mind: Respiration, Neural Oscillations, and the Free Energy Principle

“…Processing of sensory signals can also be dramatically influenced by the breath ( Brown and Gerbarg, 2005 ; Arch and Craske, 2006 ; Ma et al, 2017 ). Perhaps the most striking example has to do with pain perception, where numerous studies have shown that respiration modulates the ways in which noxious stimuli are felt or appraised ( Iwabe et al, 2014 ; Larsen et al, 2019 ; Jafari et al, 2020 ; Wells et al, 2020 ). The attenuation of pain associated with slow deep breathing, especially with a low inspiration-expiration ratio, occurs independently from cardiovascular changes ( Jafari et al, 2020 ).…”

Keeping the Breath in Mind: Respiration, Neural Oscillations and the Free Energy Principle

“…Processing of sensory signals can also be dramatically influenced by the breath (Arch & Craske, 2006;Brown & Gerbarg, 2005;Ma et al, 2017). Perhaps the most striking example has to do with pain perception, where numerous studies have shown that respiration modulates the ways in which noxious stimuli are felt or appraised (Iwabe et al, 2014;Jafari et al, 2020;Larsen et al, 2019;Wells et al, 2020). The attenuation of pain associated with slow deep breathing, especially with a low inspiration-expiration ratio, occurs independently from cardiovascular changes (Jafari et al, 2020).…”