What’s unusual about yoga is that it is a physical discipline and also a mind-body discipline if it’s done correctly. You are positioning your body, which makes you conscious of your body. You’re also stretching the body which is often very helpful, even just doing the sun salutation every morning. Yoga also involves controlling your breath, breathing through the stretching and strengthening postures in a conscious way, so it’s a combination of a physical and a mind-body therapy at the same time. Is it the only one? No. Tai chi can certainly be that as well. Using the breath, you can bring that kind of consciousness into anything that you do. There are a lot of professional athletes who tell you that they practice yoga and that consciousness and the use of the breath actually help them to excel at a sport.

But what is particularly good about yoga is that it makes you stop. You have to stop watching television, stop fighting with your wife and stop eating coffee fudge ice cream, because right now you’re doing yoga. So it makes your life stop for a second, which is a challenge for lots of people, whether in pain or not in pain. You’re getting multiple things going on at once. There are other ways, but I like getting people into yoga because it stretches and strengthens your frame while also getting you out of your head and out of the refrigerator.

You wrote in The Chronic Pain Solution that you recommend meditation for everyone with chronic pain? How does that help?

I don’t think everyone has to wear saffron robes and drink wheat grass juice. But think about it: what do we teach every woman, in all of the industrialized countries, to do when she’s delivering a baby? Breath control.

Lamaze breathing.

Yes, which is something that looks a lot like the “breath of fire” in yoga. I think they stole a lot of the yoga breathing methods for the Lamaze courses. Every woman, even in the big industrialized hospitals, is taught to do breathwork to help her push the baby out. Does it take all the pain away? No. Does it help? Absolutely, or it wouldn’t be taught by every nurse midwife and OB-GYN in the world.

So my premise is that you can at least use something as simple as controlled breathwork for painful conditions, and even for anxiety and depression. It is the most fundamental technique and I teach every single patient how to do a simple breathwork technique. That alone can often take the edge off their pain flares, take the edge off their anxiety, take the edge off their insomnia, take the edge off many things. And if they do it twice a day, just sit and do some breathwork—they don’t have to do anything fancy, they don’t have to chant, don’t have to visualize the Buddha—just sit and stop your life for a second and do some breathing and let everything flow past you.

Now, if you want to do Jon Kabat-Zinn’s 8-week or 12-week program in mindfulness-based stress reduction, beautiful. If you want to do Transcendental Meditation, or any of a number of other practices, that’s beautiful, too. It’s a kind of mental hygiene. People who don’t brush their teeth have bad hygiene, right? I propose that you also brush your mind twice a day, because it gets cluttered. Brush your mind twice a day, take 5 or 10 or 15 minutes, five at a minimum, and don’t do anything else during that time. Just breathe, like you’re the rock in the river and the river is flowing past you and through you and around you. And you’re seeing it, observing it all. This is mindfulness. Let it flow through and return your focus to the breath. That’s brushing your mind. It’s really simple.

What role do diet and nutritional supplements play in integrative pain management? And what dietary approaches do you find best for overall health?

Let’s say you have chronic pain, a neuropathy, a nerve-based pain condition or any one of a number of painful conditions. If you’re getting your meals handed to you through a window and then you’re driving off, or lunch is a bag that you pop open and it goes “crinkle, crinkle, pop,” your pain is going to stay ramped up. If you’re eating a highly inflammatory diet, your nerves will stay sensitive, your c-reactive protein will be higher than it needs to be, you’ll be inflamed, with inflammatory cytokines floating around in your system.