Discovering a role the vagus nerve plays in chronic pain management
When lupus pain overwhelms me, humming and moaning are a defense
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Pain management is difficult and complicated for people living with lupus. In my experience, nonsteroidal anti-inflammatory drugs and over-the-counter medications are weak, and opioid analgesics tend to fail. Even combined with home remedies, herbal teas, essential oils, heating pads, ice packs, and tinctures, lupus pain is often unmanageable.
During a flare, I must decipher if the pain is temporary and will respond to medication or homeopathic treatment, or whether it is the start of an emergency and will be uncontrollable without hospitalization. When that happens, we patients must give in and allow our caregivers, spouses, children, or parents to call an ambulance for emergency care.
Those pain experiences are vivid and brutal. Just the thought of how high the level of pain can get on a pain scale can trigger terror and anxiety.
A body defending itself
Along the way, we figure out self-soothing mechanisms. For me, that generally involves a slow shaking, deep moaning, and shallow breathing. I gently rock and moan, hoping the pain will ease just a little and allow me to sleep. When it doesn’t, my rocking quickens and the moaning deepens. If possible, tears will fall. And if they can’t fall, the moaning becomes the crying, in an attempt to allow my body to soothe itself. Deep moaning vibrates my vocal cords, and I can feel it across my chest. The soothing sound also vibrates my ears.
I recently realized that there might be more to the fact that moaning seems automatic when my body reaches a threshold of pain that my mind can’t comprehend. That reason, I believe, has to do with the vagus nerve, the longest cranial nerve in the body, which is involved in pain processing. In 2019, I began questioning both my rheumatologist and a remarkable friend about what the vagus nerve is, and whether it affects my body’s response to lupus pain. We didn’t know it at the time, but the short answer is yes.
Researchers have found that stimulating the vagus nerve can help improve pain management for some patients. Humming — the simple act of producing continuous sounds with the mouth closed — is one way of stimulating the vagus nerve.
According to Psychology Today, “Humming does more than create sound; it produces vibrations that ripple through the body, stimulating the vagus nerve. The stimulation activates the parasympathetic nervous system — the system responsible for calming you down and reversing the fight-or-flight response. When activated, the body shifts into rest-and-digest mode, which decreases stress and promotes relaxation.”
Once I learned that, I began paying attention to when I hear humming. Elders hum. Young children hum.
But I didn’t hum. The sounds I made had no rhythm or pitch. I moaned.Â
That’s what I presumed until a recent flare locked my hands and wrists while I was trying to drive home. While in intense pain, I returned to my soothing technique of quietly moaning while rubbing my hands.
And it clicked. What I had defined as moaning was actually humming. My vocal cord vibrated the same. All this time, my body’s reflex to moan was its attempt to heal. My body had been automatically working for my good to keep me alive. Like an overactive immune system fighting what it deems to be a threat, the vibration of sound was pushing back to soothe and calm.
I’m still working through having locked hands, yet I celebrate because I’m thankful for a body that defends me.
Note: Lupus News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Lupus News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to lupus.
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