By Philip Peng, MBBS, FRCPC

The Wasser Pain Management Centre (WPMC), one of the leading interdisciplinary pain clinics in North America, is collaborating with the Rehab and Wellbeing Centre at Mount Sinai Hospital to offer medical Tai Chi classes for individuals with chronic pain.

The idea originated late last year when the New England Journal of Medicine published a randomized controlled trial suggesting impressive health benefits in patients with fibromyalgia. In that article, the improvement in pain and functional outcomes was three to four times superior to that achieved by some FDA-approved medications. As the Director of Research of the WPMC, I further researched the existing literature and found additional support for the use of Tai Chi in various chronic pain or related conditions, such as osteoarthritis and mood disorder.

Tai Chi is an ancient martial and health art. It involves gentle, flowing, circular movement of the upper limbs, constant weight shifting of the lower limbs, meditation, breathing, moving of qi (the internal energy in Chinese belief) and various techniques to train mid-body control. In the United States, approximately 2.5 million people practise Tai Chi for its health benefits.

According to the literature, Tai Chi is a mild to moderate aerobic exercise. Because the movement is slow and gentle, individuals with chronic illness and pain can pace themselves according to their abilities and their physical fitness. The constant shifting of body weight helps to improve balance, minimize the risk of falls, and even maintain bone mineral density in post-menopausal women. In a review after examining this form of exercise in patients with cardiovascular disease, a group of investigators from Harvard Medical School suggested that Tai Chi could reduce blood pressure and improve exercise capacity in this type of patient.

Tai Chi helps individuals focus and improve their body-mind control. The role of higher centres in pain modulation is well supported by an abundance of literature. The central belief of Tai Chi – that “the mind moves the qi and the qi moves the body” – helps people optimize their coping mechanism. Meditation, breathing and visual imagery are essential components of Tai Chi and help control mood. A systematic review recently published by Dr. Chenchen Wang, a well-known Tai Chi researcher in Boston, suggested that Tai Chi is associated with improvements in psychological well-being, including reduced stress, anxiety, depression and mood disturbance, as well as increased self-esteem.

In addition to fibromyalgia, Tai Chi has been examined in some other chronic pain models. This prompted me, as a pain specialist, and three Wellness Centre acupuncturists with special interest in pain to organize Tai Chi classes for patients. Altogether, we have more than 100 years of experience in practising Tai Chi!

What is so special about these Tai Chi classes?

1. The instructors are experienced practitioners in both Tai Chi and pain management.

2. A few “practice movements” have been adapted from the classic Yang-style Tai Chi to help patients understand breathing, weight shifting and body-mind interaction. This helps prepare patients to practise at home – similar to practising scales in addition to actual songs when learning piano.

3. The “song” is the Tai Chi, which includes 103 to 108 movements. The classes do not modify the movements but break them down into five-movement fragments. Depending on their health and learning potential, patients learn as many fragments as they can acquire.

Currently, the Tai Chi class is offered to patients, staff and the public as a one-hour class every Thursday. Anyone interested should call the Rehab and Wellbeing Centre at (416) 619-5546.

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Dr. Philip Peng is a pain specialist and anesthesiologist in the Wasser Pain Management Clinic, Mount Sinai Hospital, and an Associate Professor at the University of Toronto. He is currently chair of the Education Special Interest Group (SIG) in the Canadian Pain Society and executive of the Education SIG in the International Association for the Study of Pain. He learned Yang-style Tai Chi from his father when he was a child.