For people living with chronic pain, nervous system dysregulation is not a side effect — it is central to the experience. Here are six evidence-based practices with the science behind each one, and the honest reality of how I use them myself.
If you live with chronic pain, your nervous system is working overtime.
Not because you are anxious by nature or failing to cope — but because central sensitisation, the underlying mechanism of most chronic pain conditions, keeps the nervous system in a state of persistent low-level activation. It is scanning for threats. Producing pain as a protective response. Keeping you in physiological high alert even when there is no immediate danger and even when you are consciously trying to rest.
This is exhausting. And it is self-perpetuating — a dysregulated nervous system is more sensitive to pain, and more pain creates more activation. The loop continues.
Calming the nervous system is therefore not a wellness extra or a nice addition to pain management. It is one of the most direct, evidence-based interventions available. And it is something you can begin today.
Here are six practices I use — as a BABCP accredited psychotherapist and as a woman living with hEDS and chronic pain myself. For each one I will give you the mechanism, because when you understand why something works, you trust it more — and that trust genuinely enhances the effect.
1. Diaphragmatic breathing —
your fastest available tool
This is the one I reach for first, every time. Not because it is the most impressive thing on this list, but because it is available in any moment, costs nothing, and produces measurable change within minutes.
How to practise: Sit or lie comfortably. Place one hand on your belly. Breathe in through your nose for four counts, feeling your belly rise — not your chest. Hold for four. Breathe out through your mouth for six counts. Hold for two. Repeat for five to ten minutes. The extended exhale is what does the work — do not rush it.
I use this before client sessions, during pain flares when the panic around the pain is making everything worse, and last thing at night. It does not remove the pain — but it removes the physiological terror around it. That distinction is genuinely significant.
2. Progressive muscle relaxation —
for pain and sleep
PMR is one of the oldest evidence-based techniques in psychology, and one of the most underused. It is particularly valuable for people with chronic pain who carry persistent muscular tension throughout the body without necessarily being aware of it.
How to practise: Lie somewhere comfortable. Tense each muscle group for five seconds, then release completely and notice the difference. Move upward through calves, thighs, abdomen, chest, hands, arms, shoulders, face. Take 15–20 minutes. I do this most evenings, often with lavender diffusing. The combination is particularly effective for sleep.
3. Cold water exposure —
the norepinephrine effect
This is the one that surprises people most — especially coming from a psychotherapist. But the evidence is robust, and my own experience of it is why I swim in the Peak District at 6am several mornings a week.
You do not need a reservoir or a river. Ending your shower with 30–60 seconds of cold water provides genuine benefit through the same mechanisms. Start with a few seconds and build gradually. Breathe slowly throughout — the breath is what regulates the experience.
4. Grounding —
interrupting the pain-anxiety loop
Grounding techniques are deceptively simple and, in my clinical experience, one of the most immediately effective tools available during a pain spike or moment of overwhelm — because they work in seconds and need no equipment.
The 5-4-3-2-1 technique: name five things you can see — really look at them. Four things you can physically feel. Three things you can hear, however quiet. Two things you can smell — this is where an essential oil works beautifully as a grounding anchor. One thing you can taste. Move through each slowly. This is not a distraction technique — it is a neurological intervention.
5. Nature exposure —
the cortisol research
"Go outside" is not what most people expect from a psychotherapist. But the research on nature exposure is specific, robust, and directly relevant to the chronic pain population.
You do not need the Peak District — though if you have access to it I wholeheartedly recommend it. A local park, a garden, or sitting near an open window with natural light provides real benefit. Brief, regular exposures are meaningfully therapeutic. This is not optional nature time. It is medicine with a mechanism.
6. Essential oils —
the limbic pathway
I include this because it is the practice most people in clinical circles would expect me to leave out — and because the science behind it is more robust than many people realise.
Used consistently as part of a daily ritual — diffused, inhaled from the palms, or applied diluted to pulse points — essential oils provide genuine nervous system support. The ritual itself also matters: the deliberate act of choosing something that says "I am caring for my nervous system right now" carries therapeutic value alongside the chemistry. Science meets soul.
QUICK REFERENCE → →Diaphragmatic breathing — 5–10 mins daily, extended exhale is the key
→ Progressive muscle relaxation — 15–20 mins, most effective before sleep
→ Cold water exposure — end showers cold, 30 seconds, build gradually
→ Grounding — 5-4-3-2-1 during pain spikes or overwhelm
→ Nature exposure — 20 minutes outdoors measurably reduces cortisol
→ Essential oils — lavender, frankincense, bergamot as daily support
Putting it together —
building a sustainable rhythm
None of these practices work as well in isolation as they do used together, consistently, over time. The goal is not a perfect daily routine — it is a rhythm that is genuinely sustainable for your life and your body on the days you actually have.
A simple starting point: one breathing practice in the morning — five minutes, that is all. One grounding technique available for acute moments of pain or overwhelm. One evening practice that signals to your nervous system that the day is over — PMR, an oil ritual, a slow walk outside, or all three if you have the capacity.
Start with what feels most accessible. Add gradually. Notice what shifts — not necessarily in the pain level, but in your relationship with it. That shift, however small, is the beginning of everything.
Want a free guide to take this further?
Download my free Holistic Tools for Emotional Balance and Nervous System Regulation — eight practices in full, with the science and the soul behind each one. Or get in touch to talk about one-to-one support
