Increase Parasympathetic Activity for Pain Relief: from the Bottom Line

Kristen Sparrow • October 19, 2016

Increasing patients’ parasympathetic activity is what I do in the clinic every day!!!

“Chronic pain patients tend to live in the sympathetic nervous system’s “fight or flight” mode, which intensifies pain by secreting inflammation-promoting hormones. That’s why it’s crucial to fire up the parasympathetic system, which tells the body to secrete acetylcholine instead, a neurotransmitter that counteracts inflammation.”

Commonly used drugs are actually making your pain worse

If you’re among the estimated 25% of adults in the US who live with moderate-to-severe chronic pain, from conditions such as arthritis, headaches and fibromyalgia, you may be so desperate for relief that you decide to try a powerful opioid—and take your chances with side effects.

It’s widely known that people can become dependent on (or addicted to) these drugs—including older standbys such as morphine and codeine…as well as newer heavy hitters such as hydrocodone (Vicodin, Norco) and oxycodone (OxyContin, Percocet). Yet many doctors are still too quick to prescribe them.

Sadly, these drugs don’t stop the root cause of the pain—they simply block the intensity of pain signals that a patient feels. While opioids can be appropriate for acute conditions (including broken bones and postsurgical pain), they rarely are the best choice for chronic pain.

What’s more, a recent study published in JAMA: The Journal of the American Medical Association found that long-acting opioids, such as OxyContin or fentanyl (Duragesic), increase one’s risk for death by 65%—due to heart attack and other cardiovascular events.

So what’s the best solution for chronic pain? Bottom Line Health spoke with Heather Tick, MD, an expert in pain medicine, for answers…


It’s an unfortunate paradox that pain medicine can actually worsen pain. In fact, researchers are now finding that patients who are weaned off opioids, using such nondrug therapies as physical therapy and relaxation exercises instead, actually can experience less pain than they did while on opioids, and they have a greater sense of well-being and function better.

Here’s what happens: It’s relatively easy to develop a tolerance to an opioid, which requires increasingly higher doses for the drug to work. Even when properly prescribed, chronic high doses of these medications can trigger a condition called hyperalgesia, which results in new pain sensitivity either in the primary area of pain or in a new area. For example, a patient who takes an opioid for low-back pain may begin to develop neck pain and headaches.

The good news: Nonopioid therapies that stimulate the parasympathetic nervous system—the branch of the nervous system that helps us feel calm and relaxed—can be highly effective for pain relief.

Chronic pain patients tend to live in the sympathetic nervous system’s “fight or flight” mode, which intensifies pain by secreting inflammation-promoting hormones. That’s why it’s crucial to fire up the parasympathetic system, which tells the body to secrete acetylcholine instead, a neurotransmitter that counteracts inflammation.

There’s strong evidence supporting the effectiveness of meditation for fighting pain. It induces the relaxation response—literally altering your body’s chemistry. Meditation also lowers stress hormone levels, decreases muscle tension and builds pain tolerance. Other ways to trigger the parasympathetic system’s pain-fighting mechanism…* 

Autogenic training. Autogenic training (AT) is a relaxation technique based on a set of affirmations (self-directed statements) that are designed to reverse the physical effects of stress. You can buy AT recordings online, in which a person with a soothing voice says the affirmations…or you can repeat them to yourself or make your own recording, using a script like the one below.

What to do: Sit or lie in a comfortable, quiet room. Repeat each of the following statements three times, then dwell on each statement for about 30 seconds afterward. Try to truly feel each sensation in the script. Do this daily.

  • I am completely calm.
  • My arms feel heavy and warm.
  • My legs feel heavy and warm.
  • My heartbeat is calm and regular.
  • My abdomen is warm and comfortable.
  • My forehead is pleasantly cool.
  • My shoulders are heavy and warm. 

Ujjayi breathing. Stress causes us to breathe shallowly from the chest instead of deeply from the belly. This leaves stale air trapped in the bottom of the lungs and hinders delivery of healing oxygen to muscles. Any deep-breathing technique can stimulate the parasympathetic system, but Ujjayi (pronounced oo-ja-EE) breathing is particularly effective.

What to do: To get the hang of this technique, inhale deeply through your nose and exhale through your open mouth, gently constricting the muscles at the back of your throat and making a HAAAH sound, as if you were trying to fog up a mirror. Then try to make the same sound on the inhale.

Once you’ve achieved the correct sound, close your mouth and breathe in and out through your nose, making the HAAAH sound on both the inhale and exhale. Spend equal time (at a pace that’s comfortable for you) inhaling and exhaling several times a day. When you first start this technique, try to do it for six  minutes at a time. You can work up to 15 to 20 minutes at a time.

Important: If you have a favorite deep-breathing technique of your own, feel free to use that—just be sure that you keep the flow of air constant, and you don’t hold your breath for longer than a beat. Otherwise, you will stimulate the sympathetic nervous system, triggering the pain response.


In addition to the approaches described above, the following supplement can help ease pain by reducing inflammation

Turmeric. This mildly bitter spice is a powerful analgesic with impressive anti-inflammatory powers. A 2014 study suggested it may be as effective as ibuprofen in reducing the pain of knee osteoarthritis.

Capsules are one option to try. But if you like the taste, try making “Golden Milk.” What to do: Combine one-quarter cup of turmeric with one-half cup of water in a pot, and blend to create a thick paste. Heat gently, adding a pinch of ground black pepper and drizzling in water as needed to maintain a thick but stirrable consistency.

Refrigerate the mixture in a glass container, and add one heaping teaspoon to an eight-ounce glass of warm water mixed with a little almond milk every day. You can add some honey to cut the bitterness. Or use warm broth instead of water and a dash of ginger and/or garlic for a tasty soup.