In Ayurveda we are constantly going on about customization, personalized medicine, uniqueness and individuality. In the west were we are so self obsessed you would think that Ayurveda would be on every other episode of the Dr. Oz show by now. Unfortunately Ayurveda has not yet matured in the west, but is has a lot of helpful strategies for self awareness and understanding that we can employ in the meantime. One of these is understanding different types of pain patterns.
In order to understand pain profiles through an Ayurvedic lens there must be a simple understanding of the two concepts of dosha and vayu. Dosha’s are bioenergetic principles that underlie our physiological functions through the qualities they contain.
What? Basically dosha’s are a way to categorize separate parts and functions of the body based on their similarities. All of the Doshas are everywhere in the body but certain tissues or systems may have a relative excess of one or more of the dosha’s. For example the nervous system is characterized by movement of nerve impulses and relates to Vata dosha. The digestive system is characterized by heat and it relates to the Pitta dosha. The lubricants of the body like mucus, synovial fluid and cerebral spinal fluid are moist and they relate to the Kapha dosha.
The second concept to understand is vayu which relates to five types of movement
It is the vayu that determines how long the pain stays and where it moves. So now that we have addressed some of the foundational concepts let’s jump in. Each pain pattern will be identified by the dosha or dosha’s that predominate to create the qualities that are experienced by the individual. Through knowledge of this information medicated oils, essential oils and dietary strategies can be employed to minimize this particular type of pain.
Keywords: migrating, sharp, superficial pain.
The vayu that predominates in a Vata pain pattern is Apana. This vayu primarily governs elimination and its seat is in sacrum. When they are not able to eliminate mental, emotional or physical trauma they become extremely sensitive as the stresses of the past are still effecting them. Because of this it is likely that they will request deep work. It is a rare case that they will benefit from deep tissue massage because it can further destabilize them. Their intention is correct however that they must improve the patterns of elimination in order to remove past stressors. In some instances deep tissue work can accomplish this, but more often the depth of pressure creates space that is not filled by positive inputs and the trauma returns.
Vata type pain is often concurrent with nervousness, overwhelm, worry and tension. The client may be very talkative at first yet they eventually relax deeply. Their pain profile is that of migrating pain in the joints where the muscle becomes the tendon to attach to bone. Their skin is sensitive as the pain is primarily superficial. The affected and surrounding areas will be cold and stiff and they may have poor circulation. The circulation of energy in their life is also poor and they may feel ungrounded or be prone to emotional swings.
Keywords: intense, migrating focalized pain
The Vayu that predominates in a vata/pitta pain pattern is apana and samana, Apana deals with elimination and downward movement and grounding. Samana deals with digestion, assimilation and moves from the periphery to the center. The vata profile that we looked at earlier is still prevalent with stress and trauma not being eliminated and decreasing the threshold of present moment stress the person can adapt to. With the introduction of the pitta dosha the person will often not be able to shut off their ravenous appetite for stimulation. Because of this they have desensitized themselves to stimulation and will require deeper pressure than the vata individual in order to break up the stagnation in the muscles and tendons. .
Their pain is characterized by an intense, migrating quality usually found in the center of the muscle or muscle belly. People with this pain profile will often be slightly volatile. If you are using deep tissue work make sure that the lines of communication are open as the intensity in the muscle may rise into the mind and create anger, frustration and irritability towards their massage therapist. One way to antidote this is to use cooling oils like coconut and place cooling essential oils like peppermint on the soles of their feet. As they are very goal oriented they want deep work to ensure that they are getting the most out of their experience. You may have to do some re-education with them to help them understand that reducing their stress through medium pressure work will be just as beneficial as the deep work without the unwanted emotional side effects. The individuals who have a tendency towards this type of pain are usually in their heads trying to sort out stressful situations that come from high levels of responsibility. Any additional resources you can provide to help them reformat so that responsibility means the ability to respond instead of carrying the weight of the world on their shoulders will provide them serious benefit.
Keywords: dull, migrating and diffuse pain
This pain pattern incorporates the vayus of apana and vyana to create the unique way it presents. Apana deals with elimination and can lead to stagnation within the tissues. Vyana deals with circulation and moves from the center to the periphery. Because of the involvement of vyana vayu this pain pattern migrates more than the previous ones we have looked into. Part of this migration is going into the more intrinsic structures of the body. Because of this, deep tissue massage may be necessary in order to bring the stagnation to the surface where it can be eliminated. Due to the stagnant circulation the pain in this type of imbalance can also be dull and throbbing. So the overall pain patter in a dull migrating pain usually found in the deep tissues. Usually the Vata/Kapha pain pattern will occur in the denser tissue of people who have a larger frame. The stereotypical sluggishness and slowness that goes along with a large frame is not found in these individuals and they will have quick speech and minds. In addition to this they may have nervous movements that makes them appear tense. Because of their large frames they tend to internalize their stress and it will accumulate over time leading to their unique pain pattern. Although they require deeper pressure they are still very sensitive to touch so one must go slowly and methodically.
Keywords: intense, heat and redness in the muscle belly
The Vayu that predominates in the Pitta pain profile is Samana vayu. We looked at it earlier with the Pitta/Vata individual. It is considered the balancing air of digestion and it moves from the periphery of the body to the center. Samana is like a volcano, the strong mountain holds the molten lava in place, but when samana becomes imbalanced the volcano erupts and leads to intense pain that can be found in the middle layer of the tendons and muscles. The body’s first response to any type of injury is inflammation and this natural healing process is usually accompanied by a strong sensation of pain. That is why heat and inflammation are characteristic of this pain pattern. In addition to the intensity of the pain in the muscles you may find that people with this pain pattern have the most intense emotions and may be angry and irritable. The deep pressure of massage can release these pent up emotions and it is important to prepare them for this possibility if you are providing deep tissue work. They may get overheated during the session so you will want to make sure that you monitor their temperature during the session and utilize rose essential oil or less blankets if they seem too warm.
Keywords: intense, migrating focalized pain
This pain pattern is basically the same as the Vata/Pitta one with a slight variation. The similarities are that it is migrating and intense. The primary differences are that it can have a burning quality that will increase with stress. This type is extremely responsive to the addition of extra stress which can be exacerbated by any worry, overwhelm or nervousness. This pattern is usually brought on by overwork and can result in intense muscle spasms or inflammation which if not remedied can have a deleterious effect on the muscle tissue. Medium to deep work is the best for these types
Keywords: deep, intense and constant pain
The primary Vayu that predominates in this pain pattern is vyana and samana. Vyana moves from the center to the periphery and governs circulation while samana moves from the periphery to the center and governs digestion. Both samana and vyana are intimately related to body temperature and metabolic activity. Because of this they tend to have large powerful muscles that respond well to deeper work. They may also be slightly cool and clammy to the touch as it is the deep circulation that is strongest. The predominant qualities of their pain pattern are deep, intense and constant nature of their pain. You may want to warn them or prepare them as you bring the stress and trauma from the deeper tissues into more immediate awareness as it can create anger and frustration in the short term. It is also important to be aware of inflammation as this is a common contributor to this type of pain. Reducing mental stress and inflammatory foods may have to be introduced in order to assist in the reduction of this pain pattern.
Keywords: dull, deep and localized pain
The Vayu that is primary in this type of pain pattern is vyana vayu by itself. It is more common for this type of pain pattern to arise in large and strong individuals. This will include overweight individuals. The expanding effects of vyana vayu moving from the center to the periphery will either increase or decrease circulation. When circulation is decreased individuals with this type of pain pattern will be very deliberate in their movements and thoughts. It is as if the decreased circulation slows them down and creates an increase sense of being insulated. Treatments will be the most effective if a deep sense of rapport and trust is established with the person with this pain pattern. Naturally this is important with every individual you are wanting to treat but this level of connection is the key to keeping patients with this pain pattern motivated because the circulation is slower to respond then the nervous system (Vata) and metabolic system (Pitta). This is also the reason that they enjoy and respond well to deep work in order to break up the stagnation causing dull, deep and localized pain. People with this pain pattern tend to identify strongly with their bodies and like to feel there muscle being kneaded and the deposits being broken up. As this happens they may have a sentimental or emotional release and will need to be adequately supported.
Keywords: dull, migrating and diffuse pain
This pain pattern is similar to the Vata/Kapha type of pain that is enlivened by apana and vyana vayus. Because of this both the nervous system and circulatory system have been strongly compromised in order to allow this pain pattern to arise. The nervous system does not just refer to damage to the nerves it also indicates that mental stress and tension can get caught in the tissues. The mental and emotional causes or effects of this pain pattern must be addressed for a quick resolution. Providing or creating support for emotional and mental stresses to be dislodged through bodywork is especially important for these types. As our physical body has a profound effect on our mind and vice versa any treatment of the body will affect the mind. Consider educating the patient to help them understand that that emotional and mental traumas can be held in the physical tissues and encourage them to release them in a way that feels right to them. Unlike the Vata/Kapha type of pain the dull, migrating pain tends to move from the surface to the middle of the muscle or joint. But just like the Vata/Kapha type stress will affect their body and relaxation or other stress management techniques will improve therapeutic outcomes.
Keywords: deep, intense, constant pain
Similar to the Pitta/Kapha pain pattern that is a dysfunction of the vyana and samana vayus is this type. Vyana deals with circulation and samana vayu deals with metabolic function. It is common for individuals who have this pain pattern to arise without any known trauma. Usually this will appear is large people with thick muscles. It is important to ask questions and see if the pain fluctuates with stress and strain of work or emotionally challenging situations because these individuals have extremely strong bodies that are rarely injured unless subjected to extreme physical trauma. That is why they respond best to deep pressure. Regardless of whether their pain is brought on by mental strain or physical strain it can be very intense locally and deep within the body.
Ayurvedic Musculo-skeletal Symptoms
A recap of some of the common types of pain associated with the three primary pain profiles.