Flight, fright, or freeze. You may have heard that phrase to describe what happens when our nervous system perceives a threat.
That makes sense when it’s something that can do you harm: a car that doesn’t see you in the crosswalk or a rattlesnake on the trail.
But did you know that when we experience pain our nervous system responds in the same way? Our body thinks we are in harm’s way and sends the signal to fight, take flight, or freeze.
The good news is once you know the basic anatomy of the nervous system, you can use this knowledge as strategy for relieving pelvic pain.
Branches of the nervous system
Our bodies have two main nervous systems branches called the central nervous system and the peripheral nervous system:
- The central nervous system is made up of the brain and spinal cord.
- The peripheral nervous system branches out into the body.
The peripheral nervous system is further divided into the somatic nervous system and the autonomic system.
The somatic nervous system sends sensory information to the brain and spinal cord (central nervous system) and motor nerve fibers to skeletal muscles.
The autonomic system is divided into the sympathetic, parasympathetic, and enteric systems:
- The sympathetic nervous system ramps up the body (fight, flight, freeze).
- The parasympathetic nervous system calms down the body (an oversimplification but you get the idea).
- The enteric nervous system supplies the gastrointestinal system and other organs with nerve communication.
Parasympathetic nervous system and pain
How does this apply to people with persistent pelvic pain?
Think of the sympathetic nervous system and the parasympathetic nervous system as the gas and the brake of a car.
When you are in danger or perceived danger, your body needs to be ready to fight, run away, or freeze. This primitive evolutionary reaction remains after from years of running away from a saber-toothed tiger or other danger.
Our body physically responds:
- Pupils dilate so we can see better.
- Blood is shunted from our organs to our muscles so we have extra power to run.
- Our heart rate, blood pressure, and respiratory rate increase.
The challenge with having an overactive sympathetic nervous system due to persistent pain or trauma is that your body might tend to default to this activated state. You may experience:
- global muscle tension
- orthopedic issues like jaw pain and headaches
- poor digestion
The pain loop might have a harder time being broken because of this hamster wheel-like effect. Here is the scientific explanation behind the stress response:
- The amgydala (part of the limbic system where emotion lives) trips the alarm.
- The thalamus (a sensory relay system) instructs brain stem to release norepinephrine (increases blood flow to “large” muscles).
- The sympathetic nervous system preps organs and muscles for “fight or flight.”
The stress hormone cortisol further stimulates amygdala via the brain stem.
The brain stem is the communication port between the body and the brain and controls our basic functions, like eating, sleeping, heart rate, and blood pressure.
This stimulation activates the sympathetic nervous system/hypothalamic pituitary adrenal (sympathetic nervous system/HPA) axis, further increasing cortisol release. This additional increase in cortisol quiets the hippocampus (part of the limbic system regulating emotions) which creates more cortisol release.
The hypothalamus tells the pituitary gland to give the green light for the adrenal glands to release epinephrine (increases heart rate & dilates pupils) and cortisol (suppresses immune function).
Long-term sympathetic nervous system/HPAA activation increases the amygdala’s response to apparent danger, thereby increasing amygdala sensitivity. The amygdala colors implicit (unconscious) memories with fear, which increases trait anxiety (generalized anxiety).
Long term sympathetic nervous system/HPAA activation diminishes function in the hippocampus which distorts the formation of new memories and can encourage low grade anxiety.
Throw on top of that chemical reaction additional fear and anxiety around a medical condition that isn’t going away fast enough, and it’s a recipe for emotional distress. (Thus a hamster wheel!)
So far we’ve mostly focus on heightened sympathetic nervous system response, but you don’t want to always be living in an parasympathetic nervous system state either because we would be in a state of torpor. I think of the relationship between the sympathetic nervous system and parasympathetic nervous system like Lady Justice’s old-fashioned scales. We want balance.
A persistent sympathetic nervous system state creates anxiety, but we can choose to activate the parasympathetic nervous system when we feel our bodies shift into sympathetic nervous system overactivity and restore more balance.
Restoring balance in the nervous system
What strategies can we use to restore this balance?
One of my favorite, portable, and free strategies is conscious breathwork (pranayama). Pranayama decreases heart rate, respiratory rate, and blood pressure.
Because pain is an output of the nervous system, working to retrain the brain is possible. The use of pranayama is particularly helpful. Working with your breath asks your nervous system to shift the balance of fight or flight (sympathetic nervous system) to rest and digest (parasympathetic nervous system).
Remember the analogy about the gas and the brake? If we are in a lot of pain, our sympathetic nervous system, acting as the gas, adds more cortisol into our bloodstream.
When we apply the brake by stimulating the parasympathetic nervous system, we decrease the global stress response. This is one reason why pranayama can be a useful strategy for people experiencing persistent pain.
Read more about different types of pranayama, like Dirgha and Nadi Shodhana. Letting Go Breath is also another lovely breath to reset the nervous system.
Meditation is another strategy we can use to rebalance the nervous system. Studies demonstrate positive cardiovascular findings associated with meditation practice, even for those who have no prior experience with meditation!
Try this short Mountain Meditation:
How else could you activate the parasympathetic nervous system? What activities make you feel calm and grounded in your body?
- Restorative yoga?
- Taking a walk in the woods?
- Cuddling with your pet?
Here are 10 ideas on how to decrease the sympathetic nervous system response.
I’m interested to read your comments below about your favorite ways to access your rest and digest nervous system response!