Is anyone else singing Sheryl Crow’s 1994 banger yet? No? Just me?
You’re welcome.
Okay, so now that we’re all here, let’s gather round to chat about the vagus nerve. If you’re in the bodywork/movement/yoga world, you know that the vagus is special. People (myself included) have somewhat of a vagus clinical fetish because it’s just so damn helpful when it’s regulated, and sooooo problematic when it’s not.
Sometimes, when I talk about nervous system regulation, I make a point to say that “Hey, this isn’t woo. I’m talking about the up or down-regulation of a physical set of nerves in your body.” The vagus is one of the epicenters of this phenomenon — a physical entity that can make pelvic pain better or worse depending on its regulation.
Let’s get into it.
Here’s the tl;dr:
The vagus nerve is one of twelve cranial nerves, which means that it comes directly off your brain (instead of the spinal cord). The term vagus means wanderer in Latin, because this bad boy goes [almost] everywhere throughout the body.
The vagus nerve is a key part of the parasympathetic nervous system. When it’s regulated, it promotes good digestion, calm mood, and less pain sensation. When it’s dysregulated, well, the opposite happens.
Vagus nerve stimulation is a super hot concept in the medical field at large for a slew of maladies, but there are lots of no- to low-cost strategies to stimulate the vagus nerve at home!
The deep dive:
Let’s get started with some anatomy. Here’s a hella simplified diagram showing the beginnings of the vagus journey:
But! It doesn’t end there. The vagus nerve is the primary parasympathetic nerve to the pelvic floor. WTF does this mean? The parasympathetic nervous system is the part of the system that is active during a resting state. To dramatically oversimplify, it’s what allows your urethral and anal sphincters to open while you pee and poop, and the system that allows your pelvic floor to chill when it’s at rest. In contrast, the pelvic floor also has sympathetic nervous system innervation, which allows you to hold in pee and poop when that’s on the agenda, and contract the pelvic floor when, for example, you have a big sneeze and want to keep pee on the inside.
Further, it’s also the primary parasympathetic nerve to the digestive system. If you’ve had tummy troubles of any stripe in the past, you know that the interplay between your digestion (or lack thereof) can seriously screw with your pelvic health. (For one common example, see my many posts on constipation.)
And last but certainly not least on the pelvic floor front, the vagus nerve is one of three primary nerves that take sensory information of sexual activity from the organs to the brain. So, yeah. It’s a big fucking deal.
All told, the vagus nerve holds 75% of the parasympathetic nerve fibers in the body. That’s a lot of responsibility for one physical entity!
So if the vagus nerve is out of whack, we have a problem.
When I googled “Why does the vagus nerve get messed up” (true story) the basic response was “stress”. The evidence-based response was more interesting. Remember how the vagus nerve innervates a huge part of the digestive system? The bi-directional communication of the gut and brain, aka the gut-brain axis, is one reason why emotional stress can be manifested physically. And since the vagus nerve hangs out hard in the gut, it can be dysregulated by stress.
And! Let’s recall that it’s bi-directional; a two way street! This is why vagus nerve stimulation has been shown to be helpful for conditions like depression and PTSD. Because the vagus nerve is all over the damn place, you can also access it through other places on the body. One study used gentle electrical stimulation of the vagus nerve on the ear and found that it significantly reduced pain in folks with chronic pelvic pain due to endometriosis.
Here’s the take-home:
If you’re sitting here thinking, “That’s super, but I lack access to a fancy nerve stimulator,” I got you.
The vagus nerve can be stimulated through a number of ways. Try a few out and see what you like!
deep breathing. Yeah, I said it. And yeah, it’s true. And yes, breath work is the answer to most things. The vagus nerve goes through the diaphragm, of course! Where doesn’t it go!?
humming/chanting/singing. Yup, it goes through the throat, too. This study found that humming improves heart rate variability (HRT) and overall parasympathetic activity. Because vagus.
cold exposure. Specifically on your face. A minute or two a day can significantly improve HRT and recovery from stressful stimuli.
facial massage. I couldn’t find research for this one, but I was too into my own N of 1 results not to share. I really like this tutorial video!
As with all things, I encourage you to gently explore what is accessible and available to you.
There is soooo much more to treating pelvic pain (and for that matter, gut and mental health challenges) than humming and facial massage. And at the same time, having sustainable, easy practices to down-regulate the parts of our brain that sense pain seems like a pretty great plan to me.
And if you’re in this spot, remember that you are a rock star. I am rooting for you, always.
Thank you for your writing. This one in particular is sooo good.
Sheryl Crow AND Vegas imagery AND nervous system regulation!? I loveeeeeee this one.