Dance Therapy For Chronic Pain

  • Maria WeissenbruchPhD, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
  • Regina LopesSenior Nursing Assistant, Health and Social Care, The Open University

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Introduction

Treatments for long-term pain do not always come in the form of medication. Therapies, such as talking therapy, exercise, or music therapy have been shown to be helpful in long-term pain and other health conditions. 

In this article, we will discuss the use of movement through dance as a therapy for individuals experiencing long-term, or ‘chronic’, pain. We will explore possible benefits and how you can get started with dance therapy. 

Understanding chronic pain

In this section we will explain what chronic pain is, the different types, and how it is usually treated. 

Definition and types of chronic pain

Long-term, or ‘chronic’, pain describes pain that does not go away or keeps coming back, for longer than three months.1 Different types of chronic pain can be separated into pain that is not due to another condition, or pain that can be explained by another condition. 

Pain that lasts longer than three months and is not due to another condition is known as chronic primary pain.1 Normally the cause of this pain is not known.1 Often individuals with this type of pain experience stress and anxiety or interruptions to their daily life.2 Examples of conditions that may experience this type of chronic pain include fibromyalgia and irritable bowel syndrome.1 

Pain that lasts longer than three months and can be explained by another condition is known as chronic secondary pain.2 The cause of this pain is known and well-understood.2 Examples of conditions that cause this type of pain include muscle damage and surgery but may be due to a number of other conditions.1

Factors contributing to chronic pain

Many factors contribute to developing or worsening chronic pain.3 Some of these factors cannot be changed, including: 

  • Being female
  • Being over the age of 45
  • Having a family history of chronic pain

However, some factors are related to lifestyle choices which may be managed with help from health care professionals.3 These include: 

  • Smoking
  • Drinking alcohol
  • Being overweight
  • Lack of exercise
  • Other long-term conditions
  • Mental health 
  • Poor sleep
  • Poor nutrition
  • Employment status 

Common treatment approaches for chronic pain

Medicines can be used to manage chronic pain. In chronic secondary pain, where the cause is known, these may include painkillers, such as paracetamol or ibuprofen.4 In chronic primary pain, where the cause is unknown, other drugs like antidepressants may be used.4 

However, research has shown that a wider approach to treatment is beneficial for chronic pain.5 These approaches may include cognitive behavioural therapy, exercise, and massage therapy.5 

Introduction to dance therapy

This section will introduce dance therapy and explain how it works. 

Definition of dance therapy

Dance therapy, otherwise known as dance movement therapy or dance movement psychotherapy, involves the use of movement by dance to promote the connection of the body and the mind. The therapy encourages you to dance, be creative, and explore movement to music. 

How does it work? 

Dance therapy was introduced to Western countries in the 1940s, and spread to the rest of the world by the 1990s.6 The therapy is implemented by a certified dance movement therapist, who may work privately, in hospitals, or in schools.6 The therapist works with you to create movement through dance to music which may be one-to-one or in a social setting. They will encourage you to experiment, enjoy, and express yourself through the movement. 

It works through five main principles:6 

  1. Creating pleasure and play 
  2. Connecting the body and mind
  3. Engaging in non-verbal communication and emotional expression
  4. Participating in an activity
  5. Being creative and productive 

Each individual engaging with dance therapy will have a personalised programme built, depending on physical ability and pain severity. Generally, sessions will last between 30 minutes to an hour and a half.7 Different types of dance can be included in dance therapy and it may be structured or unstructured.6 Discussion with your health professional will also decide if you will continue receiving your usual care, any other activities or therapies, or medications.7

Dance therapy offers various health benefits in many different contexts. For example, it has been shown to decrease depression and anxiety and improve quality of life and cognitive skills in individuals with various physical or psychological conditions.6 The next section will discuss how dance therapy can be beneficial for people with chronic pain. 

The benefits of dance for chronic pain

Controlled exercise is known to be an effective therapy for individuals with chronic pain.8 Similarly, dance movement therapy offers various benefits for individuals with chronic pain which can be broken down into physical, psychological, and social benefits. 

Physical benefits

Increased mobility and flexibility

Dance movement therapy encourages you to move to music, which naturally will improve your mobility and flexibility. Individuals with fibromyalgia who engaged in Zumba dancing showed an improvement in their mobility.9 

Pain modulation through movement

Dance movement therapy has been reported to improve the capacity of coping with, and accepting the presence of, chronic pain.7 Some individuals say they “don’t feel the pain so much” or that “dancing helps to release pain” when taking part in dance therapy sessions.7 

Improved posture and body awareness

The therapy has also been shown to help individuals with chronic pain to improve their body understanding and awareness.7 It may also help improve body posture, as engaging in dance programmes increases balance and stability.10

Psychological benefits

Stress reduction and relaxation

Many individuals participating in dance therapy say they are less afraid of pain recurring in the future.7 This is likely through an improved self-awareness and understanding of their pain. Dance therapy may therefore help to reduce stress and to relax more.

Enhanced mood and emotional well-being

Many individuals with chronic pain say they feel “calmer” and “happier” after taking part in dance therapy.11 For many, dance therapy helps to increase positivity and thoughts about life in general.7 

Increased self-esteem and empowerment

Individuals with persistent pain taking part in dance therapy reported that the therapy helped them to feel empowered, to improve physical confidence, and to break unhealthy patterns they had developed.11 

Social benefits

Sense of belonging and community

Dance therapy also helps individuals feel a sense of belonging and helps them connect with others in similar positions.12 

Opportunities for social interaction and support

The therapy enables those suffering from chronic pain to find and connect with others with similar conditions.7 This importantly may help you to create a strong support network. 

Reduction of social isolation

Dancing in a group for therapy will improve socialisation, whether that is before or after class, or even during dance through eye contact and movement.7 

Getting started with dance therapy

Finding a qualified dance therapist or instructor

To find a qualified dance therapist or instructor, speak to your healthcare professional. The Association for Dance Movement Psychotherapy (ADMP, UK) and The American Dance Therapy Association (ADTA, US), also have lists of registered professionals based in the UK, and US, respectively. 

Your therapist will help you to build personalised goals and expectations from your sessions. They may also provide you with some simple exercises you can do at home. 

FAQs

What do you do when your chronic pain is unbearable? 

The UK National Health Service provides a list of ten things which may help reduce pain. The first is to do some gentle exercises, including dancing. The rest include:

  • concentrating on breathing
  • reading more information on pain
  • talking therapies
  • distraction
  • improving your sleep routine
  • taking a self-management course
  • contacting family and friends
  • relaxing
  • and sharing your story of pain with others

Why is my chronic pain getting worse? 

The mind and body are interconnected when it comes to processing pain. Therefore, having anxiety, depression or feeling stressed may make your chronic pain worse. However, other underlying reasons may be making your chronic pain worse, so speak to your healthcare professional if this is constant or you are worried. 

Why is chronic pain so exhausting? 

Having chronic pain can make it hard to rest completely. This may lead to fatigue or stress which can feel exhausting. Speak to your healthcare professional if this is worsening or if you are worried. 

Summary

Chronic pain describes pain that does not go away or keeps coming back, for longer than 3 months. The cause of chronic pain can be known or unknown. Dance therapy involves movement by dance to connect the body and mind. Dance therapy for chronic pain can be a highly effective method to improve physical, psychological and social outcomes. This may be through an improved capacity to cope with pain, enhanced mood and well-being, and social interaction. To get started with dance therapy, or decide if it is right for you, speak to your healthcare professional. 

References

  1. Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. A classification of chronic pain for ICD-11. Pain [Internet]. 2015 [cited 2024 Feb 10]; 156(6):1003–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450869/.
  2. Carville S, Constanti M, Kosky N, Stannard C, Wilkinson C. Chronic pain (primary and secondary) in over 16s: summary of NICE guidance. BMJ [Internet]. 2021 [cited 2024 Feb 10]; 373:n895. Available from: https://www.bmj.com/content/373/bmj.n895.
  3. Hecke O van, Torrance N, Smith BH. Chronic pain epidemiology – where do lifestyle factors fit in? Br J Pain [Internet]. 2013 [cited 2024 Feb 10]; 7(4):209–17. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590163/.
  4. Swedish Council on Health Technology Assessment. Methods of Treating Chronic Pain: A Systematic Review [Internet]. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2006 [cited 2024 Feb 10]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK447986/
  5. Shi Y, Wu W. Multimodal non-invasive non-pharmacological therapies for chronic pain: mechanisms and progress. BMC Medicine [Internet]. 2023 [cited 2024 Feb 10]; 21(1):372. Available from: https://doi.org/10.1186/s12916-023-03076-2.
  6. Koch SC, Riege RFF, Tisborn K, Biondo J, Martin L, Beelmann A. Effects of Dance Movement Therapy and Dance on Health-Related Psychological Outcomes. A Meta-Analysis Update. Front Psychol [Internet]. 2019 [cited 2024 Feb 10]; 10:1806. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710484/.
  7. Hickman B, Pourkazemi F, Pebdani RN, Hiller CE, Fong Yan A. Dance for Chronic Pain Conditions: A Systematic Review. Pain Med [Internet]. 2022 [cited 2024 Feb 10]; 23(12):2022–41. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714531/.
  8. Ambrose KR, Golightly YM. Physical exercise as non-pharmacological treatment of chronic pain: Why and when. Best Pract Res Clin Rheumatol. 2015; 29(1):120–30. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534717/ 
  9. Assunção Júnior JC, Almeida Silva HJ de, Silva JFC da, Silva Cruz R da, Almeida Lins CA de, Souza MC de. Zumba dancing can improve the pain and functional capacity in women with fibromyalgia. J Bodyw Mov Ther. 2018; 22(2):455–9. Available from: https://www.bodyworkmovementtherapies.com/article/S1360-8592(17)30246-2/abstract 
  10. Kostić R, Uzunović S, Purenović-Ivanović T, Miletić Đ, Katsora G, Pantelić S, et al. The effects of dance training program on the postural stability of middle aged women. Cent Eur J Public Health. 2015; 23 Suppl:S67-73. Available from: https://pubmed.ncbi.nlm.nih.gov/26849547/ 
  11. Nordström K, Ekhammar A, Larsson ME. Physiotherapist-guided Free Movement Dance for patients with persistent pain is empowering in everyday living. A qualitative study. European Journal of Physiotherapy [Internet]. 2020 [cited 2024 Feb 10]; 22(1):2–13. Available from: https://www.tandfonline.com/doi/full/10.1080/21679169.2018.1536893.
  12. Shim M, Johnson RB, Gasson S, Goodill S, Jermyn R, Bradt J. A model of dance/movement therapy for resilience-building in people living with chronic pain. European Journal of Integrative Medicine [Internet]. 2017 [cited 2024 Feb 10]; 9:27–40. Available from: https://www.sciencedirect.com/science/article/pii/S1876382017300112.

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Taylor Fulton Ward

BMedSc Clinical Sciences, First Class Honours, 2021

Taylor is a final year Cancer Research UK PhD Student at the University of Birmingham, UK. She has several years of experience within academic writing and has published on a range of topics, including medical education, cancer genomics and immunology. Her academic interests lie within immunology, oncology and haematology and her PhD has interrogated the hypoxia-mediated dysfunction of CD8+ T cells in Multiple Myeloma. She is now embarking on her career in medical writing.

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