Effect of slow, deep breathing on visceral pain perception and its underlying psychophysiological mechanisms

Abstract

Background Studies using somatic pain models have shown the hypoalgesic effects of slow, deep breathing. We evaluated the effect of slow, deep breathing on visceral pain and explored putative mediating mechanisms including autonomic and emotional responses. Methods Fifty‐seven healthy volunteers (36 females, mean age = 22.0 years) performed controlled, deep breathing at a slow frequency (6 breaths per minute), controlled breathing at a normal frequency (14 breaths per minute; active control), and uncontrolled breathing (no‐treatment control) in randomized order. Moderate painful stimuli were given during each condition by delivering electrical stimulation in the distal esophagus. Participants rated pain intensity after each stimulation. Heart rate variability and self‐reported arousal were measured during each condition. Key Results Compared to uncontrolled breathing, pain intensity was lower during slow, deep breathing (Cohen’s d = 0.40) and normal controlled breathing (d = 0.47), but not different between slow, deep breathing and normal controlled breathing. Arousal was lower (d = 0.53, 0.55) and heart rate variability was higher (d = 0.70, 0.86) during slow, deep breathing compared to the two control conditions. The effect of slow, deep breathing on pain was not mediated by alterations in heart rate variability or arousal but was moderated by pain catastrophizing. Conclusions and Inferences Slow, deep breathing can reduce visceral pain intensity. However, the effect is not specific to the slow breathing frequency and is not mediated by autonomic or emotional responses, suggesting other underlying mechanisms (notably distraction). Whether a long‐term practice of slow, deep breathing can influence (clinical) visceral pain warrants to be investigated.

Heart rate variability and slow-paced breathing:when coherence meets resonance

“…Gholamrezaei and collaborators estimated that SPB had no effect on pain through vagal activation, but rather suggested that other mechanisms, such as attentional modulation (distraction) may underlie this effect (Gholamrezaei et al, 2021b(Gholamrezaei et al, , 2021a.…”

Slow, deep breathing intervention improved symptoms and altered rectal sensitivity in patients with constipation-predominant irritable bowel syndrome

“…A recent study by Gholamrezaei et al (2022) also observed that SDB could decrease visceral pain intensity. Botha et al (2015) reported that the development of acidinduced esophageal hypersensitivity could be prevented by deep breathing.…”

“…Practice logs were recorded to ensure that the experimental group met the practice requirements. Participants in both groups were instructed to maintain 10.3389/fnins.2022.1034547 their regular diet and exercise regimens (Lee et al, 2021;Gholamrezaei et al, 2022).…”

Impact of yoga asanas on flexion and relaxation phenomenon in women with chronic low back pain: Prophet model prospective study

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