The Vagus Nerve Explained: What Women with Persistent Pain Actually Need to Know

Mandy: If you have spent even five minutes on social media lately, you've probably had a 15 second video served to you promising you that your chronic pain and your fatigue and your burnout, your constipation, and your brain fog can all be wiped out in moments. All you have to do Is reset your vagus nerve And you'll see all sorts of techniques like dunking your face in ice water, humming, tapping your collarbone, or probably buying a $300 neck buzzer. And supposedly your nervous system reboots like a frozen Wi-Fi router. As somebody who's spent 15 years in evidence-informed pain care, I understand why that promise is so alluring. When you're living with persistent pain and central sensitization, you are exhausted. So the promise of an instant reboot sounds incredible. Look, I get questions all the time from my clients about the vagus nerve because all of that social media stuff is confusing. It feels like another quick fix that will fail, but the premise of it is pretty compelling. But here is why women navigating chronic pain like you. Need to actually be informed about the real science behind this. Women carry a disproportionate burden of conditions characterized by central sensitization from fibromyalgia and chronic migraine to endometriosis and autoimmune pain. Yet in traditional healthcare, women are still routinely told their symptoms are just stress or in their head. And you're more likely to walk out of the doctor's office with an antidepressant than a diagnosis. And then when you turn to social media for answers, the algorithms target you with pseudoscientific quick fixes that trivialize your pain all over again. So being informed about your neurobiology isn't just an academic exercise that is, by the way, super fun and interesting in my opinion. It's actually self-care. When you understand how your nervous system actually communicates, you take your power back, you protect your emotional energy, and you stop wasting money on these predatory wellness gimmicks. and maybe most importantly, you stop blaming yourself for failing at these impossible cures. So here's the truth cranial nerve 10, the vagus nerve, is very real and its neurobiology is genuinely fascinating. Today we're cutting through all the noise on social media. I'm gonna talk to you about the real anatomy. I'll unpack why the TikTok in real culture gets it wrong, and I'll help you to distinguish temporary relief from sustained healing and how to focus on actually building long term nervous system capacity. Welcome to the Somatic Strength Collective. I'm your host, Mandy Ryle, certified strength and conditioning specialist, pain care coach, and nervous system educator. This is a dedicated, compassionate space for midlife women who can hold up the sky but feel like their bodies are falling apart. Together, we bridge clinical pain neuroscience, somatic movement education, and bone-building strength. Chronic pain is not your destiny. Let's build a robust, reliable body and replace pain with peace. Let's begin. Before we dissect the anatomy, I would like to take a moment to thank our presenting community sponsor for this season of the Somatic Strength Collective podcast. The content that you're enjoying today is made possible through an extraordinary gift from a dedicated member of our listening community, Lori Brook. Producing episodes that are deeply researched and grounded in 15 years of experience in evidence-informed pain care takes a lot of time, I'm gonna admit. And resources. So generosity like Lori's is the reason that we can keep this platform completely independent and why I can bring you honest, uncompromised science without having to sell unproven wellness gadgets and fads. So Lori, from the bottom of my heart, thank you for investing in this work and believing in this community and making today's deep dive possible. To understand why viral clips that you see on TikTok fall short, we have to look at the actual anatomy for the vagus nerve. So the word vagus comes from the Latin word for wanderer, which is, by the way, the same root as vagabond, and it really earns that name because it's the longest cranial nerve in your body. It originates in your brainstem and travels down through your neck, inside the cartoid sheath. It branches deep into your chest, heart, lungs, and even your gut. And it is the primary highway for something you've been hearing about a lot on the podcast: the parasympathetic nervous system. So, what we clinically think of as your rest, digest, and repair network. In persistent pain, building the capacity to shift into that restorative state, that parasympathetic state, is super, super important. Now, anatomically, the vagus operates across four major territories in the body. So the first zone that I want to talk about is the throat and the voice box, the larynx and pharynx. So the vagus nerve controls the muscles you use to swallow, speak. And regulate vocal cord tension. And this is really important because so many of the women in midlife that I work with have a a major complaint, back pain, knee pain, shoulder pain, for example, but they also have this persistent throat tightness. And so understanding that it's more than just these muscles, but probably more related to your nervous system can really be a key to healing. So this is also important because we know that sustained exhalations during humming and singing, like you may have seen on social media, engage these laryngeal motor branches and stimulate the the cartoid barro receptors, which signal your heart to release acetylcholine and slow down. So there is a link here between all of those reels that you see of people doing all these humming exercises and the actual tension and even pain that you might be feeling in your throat. So in zone two, that's the chest, the heart, the lungs. The vagus connects directly to your heart's natural pacemakers, which serve as a continuous biological break on resting heart rate and also to regulate bronchial airway tone. Now, zone three, the gut highway, the stomach and intestines, is particularly interesting to me. As someone who has suffered from What has been diagnosed as IBS since my twenties. So the vagus nerve can coordinates gut motility, stomach acid, and digestive enzyme release. That's crazy, right? So when your nervous system senses danger, it actually shuts down or really slows down digestion, which is why visceral hypersensitivity, IBS, and chronic pain run hand in hand so often. So if you've been dealing with issues. gut issues like bloating and constipation, you've probably thought about your diet, but maybe it's time to have a look at your nervous system. Because so often all of those dietary interventions really yield very disappointing or no results at all. So maybe this is the missing piece that you've been needing. Now let's talk about zone four. This is the immune and inflammatory pathways. So through downstream signaling to the spleen, vagal activity communicates with immune cells to help calibrate systemic inflammation. This is a word you've heard before, I'm sure. It does that by suppressing pro-inflammatory cytokines like TNF alpha and intraleukin 6. Managing chronic inflammation is essential to moving beyond pain. And it's more than just diet and exercise. Many of you are already doing that, right? You're trying to eat less sugar or less processed meat, and maybe you're trying to get out for a walk every day to reduce. Inflammation, but you're still really struggling. So this may be the piece that's missing. Please keep listening. I have some really good stuff in here for you. So here's a crucial fact that social media almost never mentions that is really essential to your understanding so that you can cut through all of that hype that you're seeing. Roughly 80% of vagus nerve fibers are sensory. We call that afferent, which means that they carry information upward from your organs to your brain, not Downward. So even though social media makes it sound like it, it's not a megaphone that your brain uses to shout at orders at your body to just calm down. It's more of an upward surveillance cable. so many of you are struggling with this chronic bracing. Maybe it's your hip, maybe it's your back. Maybe it's your pelvic floor. You're struggling with shallow breath, or like many of my clients will say, I'm not even breathing most of the time. Or maybe your gut is inflamed. So when that's happening, your vagus is delivering steady second by second alarm reports straight into your brain's pain processing networks. And that is what matters, not just those Instagram hacks that you're seeing. That the body is sending these alarm messages into the brain about the state of the body. So if we want to change vagal activity, we can't just tell the brain to relax and do a quick eye exercise, right? That will at best provide temporary relief. We have to change the physical sensory feedback traveling upward from the body. And I'm going to tell you how to do that today. Now that we know that the Vegas is an upward reporting sensory cable, let's talk about the real elephant in the room, these 15, 30-second reels. So, guys, look, I've been a creator now since Instagram became a thing. I can't say I'm super successful at it. But partially, that's because, like most creators with integrity, I'd really rather teach you something. Then just get your attention for 15 seconds, right? Which is why I'm doing the podcast. So social media algorithms are built to reward whatever sounds fast, revolutionary. maybe it contradicts a belief that you already had, and of course it has to be effortless, right? But chronic pain is complex, it is adaptive neurobiology. So when you force complex human physiology into a quick 15, 30 second soundbite, nuance dies. And the creator who made the video may get rewarded by the algo, but this content provides little to no real value to you in actually moving forward with healing your chronic pain. So here's what happens on your feed. Someone tells you to hum a little or do one of these eye stretch things or splash cold water in your face. And they label it and they label it as a nervous system reset. Now, let's be completely fair. With the exception of direct-to-consumer wearables, which I'm gonna talk about in a second, many of these hacks that you're seeing actually do have genuine capacity to shift your nervous system. Yes, I said it. It's true. Some of these are actually effective. Briefly. And as part of my research for this episode, I really spent a lot of time at looking at all these different reels. And I have to admit, some of them should work, but only temporarily. So a lot of the things that you're seeing on social media, like taking a prolonged resisted exhale while you're humming, you are actually engage engaging your baroreflex, which stimulates the vagus nerve. When you splash cold water or you take a slow physiological sigh, you are stimulating vagal motor output and you're prompting your heart to tap the biological break. That transient drop in heart rate, that momentary easing in your shoulders, that is real physiology. Can feel a little bit jarring. So we're not trying to jerk you back and forth And by the way, I actually see this shift all the time with my midlife female clients. So many of us are living in this chronic fight or flight. And so when they get in front of me and they're doing somatic work or breathing, it's not uncommon for me to actually watch them shift from this wired state into this like very abrupt down regulation into. Parasympathetic, or we might even call it something like dorsal vagal if you're familiar with polyvagal theory. And for the women experiencing this, it's not altogether pleasant because it is so different and abrupt. And what does it look like? Yawning, like can't stop yawning, eyes watering, feeling suddenly very sleepy or cold. And while it's nice for me as the coach to know that my client can shift out of sympathetic activation, it's not the end goal. That's not the thing that we're aiming for. We're not trying to jerk you back and forth between sympathetic and parasympathetic activation. We're not even trying to keep you in parasympathetic activation permanently. What we're trying to do, what we should be trying to do. Is remove the obstacles to autonomic flexibility, the ability to move effortlessly and situationally between states as needed. So again, it's not that these practices that you're seeing on social media do nothing. The issue is that social media confuses the temporary moment of relief or that big shift, which can be very compelling with sustained structural healing. So it's like tapping that biological brake pedal for 30 seconds at a stoplight, right? It's gonna give the engine a little pause, which is nice, but it doesn't rebuild the transmission and it doesn't undo the three, five, or ten years of entrenched central sensitization that you've been living with. And the sole exception to this that I want to bring up now. Is the direct to consumer gadget market. So remember I said that a lot of these quick hacks actually do have some physiological truth to them. Those $300 neck buzzers and ear clips, though, marketed across Instagram, TikTok, all that, are almost entirely low-powered TENS units wrapped in some, you know, nice packaging. And the promises they cure pain and brain brain fog in 15 minutes. But the truth is. But they lack the precise wave frequency and current parameters needed for clinical depolarization of a nerve, okay? That is distraction at best. It is not physiological relief and it is predatory marketing targeted at people who are exhausted and who think they're out of options. I'm gonna provide options here though for you, okay? For everything else, the breath work, the vocalizing, the gentle somatic cues, those two tools are helpful, if not sort of abrupt and maybe a little bit jarring for your nervous system. But there is deeper and more rewarding work that we can do. So after pulling back the curtain on social media, here is the big question that I hear from my clients Is the vagus nerve actually something that I need to pay attention to as a woman living with chronic pain? Or is it just another wellness distraction that I can safely ignore? And here's my answer as a painkare coach with 15 years of experience. Yes, you should care, but you should care about the real biology. I know that your time and energy are limited, so let's help you use it wisely and efficiently. And here's why it matters specifically for women navigating persistent pain. First, the autonomic nervous system and persistent pain Share the exact same neural circuitry. When you live with chronic pain, fibromyalgia, endometriosis, or migraine, we know that your system is operating under persistent threat. Over time, that sympathetic alarm system gets pinned in the on position, and your cardiac vagal break is chronically slipping. And what that means is higher resting inflammation, shallow breathing, heightened muscle tension, a brain that amplifies every incoming sensory signal, and a weird feeling inside of you all the time that you're missing something, something's chasing you. And then second, there's a profound connection between vagal tone, hormonal fluctuations, and inflammation. estrogen and progesterone actively interact with autonomic receptors and immune cells. whether that's across the menstrual cycle that we go through every thirty days as women for most of our lives, postpartum or paramenopause and menopause. A blunted vagal break makes women significantly more vulnerable to inflammatory flares, visceral sensitivity, and autonomic dysregulation. Third, women in pain are routinely subjected to medical gaslighting and told that their symptoms are just stress or in their head. And when the wellness industry responds by telling you that humming for 30 seconds will fix your nervous system, it feels just as dismissive and it minimizes the complexity of what your body is living through. Understanding your vagus nerve matters because it proves your pain is a whole person neurobiological reality. And by the way, this doesn't mean that your nervous system failed or that your vagus nerve is lazy. It adapted. It's working hard to protect you based on years of threat. And pain. You don't need a gadget to care for it, but learning how to genuinely support that upward surveillance pathway is one of the most powerful agency restoring tools you have in long-term pain care. So, how do we move from chasing those 30-second hacks to creating genuine, sustained autonomic healing? In polyvagal and autonomic science, the goal is building ventral vagal capacity, giving the nervous system repeated, undeniable proof over weeks and months that it is safe enough to disarm. Imagine that getting a lot of attention from the algorithm. It's not gonna happen. So because the vagus nerve reports upward, we have to change the sensory cues coming from the tissues. And remember, success with the practices and the techniques that I teach you on this podcast is not whether your pain drops to zero in five minutes. Success is consistently giving your system. A reliable moment of deceleration, letting those safe signals accumulate until your baseline begins to shift. What I like to say is sending good news consistently to your nervous systems. So here are four evidence-supported strategies. We're going to start with breathing. Remember, I mentioned something called the barro reflex. So that's why the vagus nerve responds to. Slow exhales and you don't need an app, you don't need complicated ratios. The reason this works is because when you inhale, your heart naturally speeds up a little bit, and when you exhale, your vagus nerve releases acetylcholine to slow it down. So basically, all you have to do is extend the length of your exhale. Ideally, you'll make it one and a half to two times longer than your inhale. So one way to do this is simply by breathing smoothly in through your nose for four counts and then exhaling through your nose for six to eight counts. Or try another scientifically validated practice called the physiological sigh So that's two inhales through the nose followed by one long, slow exhale. And doing this for just three to five minutes sends direct mechanical feedback. Through those arterial barro receptors, that the system is safe right now. It is absolutely a biological hack for your nervous system. But we don't just want to do it once, we need to actually do it several times a day. Okay, what is another validated tool for improving vagal tone? When you deal with persistent pain, as you know, your brain views movement as dangerous. And so It locks down muscles and is constantly bracing for impact due to this subconscious prediction that your body is very vulnerable. So pushing through intense workouts or forcing yourself into these deep stretches that you're seeing on the internet often backfires. So here's what you should do instead: small micro movements. Slow exploratory joint circles in pain-free ranges, gentle pandiculation, which is basically contracting and then relaxing a muscle or muscle group, or supported restorative stretches, like you'll find in the older episodes of this podcast. So I wanted to give you simple stuff that you can do right here, right now, even if you're sitting in your car. But of course. This podcast has hundreds of resources. My YouTube channel has hundreds of resources. And you will also find in this Somatic Strength Collective app just about anything you could ever need. So when you move gently without setting off the danger alarm, you send clear sensory feedback via the vagus nerve upstairs. This movement is safe. And over time, this will cause baseline vigilance to drop. It's guaranteed, it's inevitable. It's only a matter of time. Let's talk about one that you probably didn't see coming, that is co-regulation and vocal prosody. So the ventrovagal network connects directly with cranial nerves seven and nine, which control facial expression, the middle ear muscles, and vocal tone. So there's a reason why you find some voices very soothing, and that is because they have a quality. Known as prosody, which is lots of fluctuations in pitch. And this is why human nervous systems are social. Instruments. It's part of our evolution. Humans did not evolve to be the fastest or strongest. We don't have armor on our bodies. What we do have is the ability to cooperate and collaborate with each other. And so when we do that, when we have an unhurried, genuine conversation with a trusted friend, or we spend time with a pet, we listen to a calming voice like you are right now. Or we just spend time with a warm person, that triggers evolutionary safety cues. Remember, pain is a whole self-experience. An authentic connection is pain care. And the flip side of the coin is that the chronic absence of a safe connection is deeply pain-enhancing. When I start working with a new client, one of the questions that I like to ask is. What do they do for fun? And what do they do when they spend time with friends? And unfortunately, many of my clients tell me that they don't spend a lot of time with friends and they don't have a really warm network of supportive people in their lives. And that is absolutely contributing to this nervous system sensitivity. Okay, one more resource for you that is so, so powerful. I teach this to every client in some capacity. So chronic pain often forces people into an all or nothing trap. So you're either hyperfixated on your symptoms Or you're trying everything you can just to numb out completely, even for five minutes. This practice is designed to help you sit right in the middle of that, which is a much healthier and more productive place. So I want you to try something called pendulation. Basically, you're gonna spend 30 seconds noticing a neutral or pleasant physical sensation. And then you're gonna pendulate to that area which you are so often hyperfixated on. And here's how I like to do it. I sit in my comfy armchair in my living room, either with a nice warm cup of coffee or tea in my hands, or perhaps a nice fluffy purring cat in my lap. And I meditate fully on that experience of holding the cup or feeling and hearing the vibration of the cat purring. And then gently you'll pendulate your attention to the area of discomfort without trying to fix it. you'll spend maybe 10, 20 seconds there, and then you'll pendulate back to that neutral anchor. This is very powerful because it gradually teaches the brain that bodily sensation does not equal automatic catastrophe, that you can be aware of something without getting sucked into it. So those are four really, really simple things that you can do today to begin to find more autonomic flexibility, which is the key to caring for your pain condition long term, not just the quick fix like we were talking about. So before we wrap up, another question I get a lot from clients is What about these vagus nerve stimulating devices? So, as I mentioned before, the stuff that you're gonna get on the internet is probably not valid. It's probably just gonna be a waste of your time. FDA cleared invasive and transcutaneous VNS devices do exist. So these are things like surgically implanted stimulators, And they've actually been used for decades in treatment-resistant epilepsy and clinical depression. And then there's also prescription, non-invasive devices which target the outer ear or the neck. And these prescription devices actually have clinical data for treating chronic migraines, cluster headaches, and pediatric abdominal pain. So here's the difference between real medicine and the viral marketing that so many of my clients have been subject to. The exact physics. So clinical neurostimulation requires specific frequencies, often 20 to 30 hertz, calibrated. Pulse widths and precise milliamps of electrical current, which depolarize nerve axons without burning your skin. Hopefully you can see how incredibly complex this is and how calibrated this is. and here's what these devices really do inside of you. So when stimulated with clinical precision, vagal fibers signal the spleen to curb excess pro-inflammatory cytokines like TNF alpha. And also via central pain gating, upward signaling directly modulates the The nucleus tractus solitarius and brain stim centers to dial down central pain sensitivity. So if you're navigating severe refractory migraines or cluster headaches, prescription medical VNS is a legitimate clinical option to discuss with your neurologist, but a generic buzzer butt off social media is not clinical medicine. my friend, you do not need to reboot or reset your nervous system in 30 seconds. Your nervous system isn't broken. Your vagus nerve is not a flabby muscle that you neglected. It's not glitching. it is an adaptive Biological organ doing its absolute best to protect you based on years of threat signals that it has received. Your biology already houses the mechanisms of the vagal break in your respiratory anatomy, your vocal cords, and your barrow reflex. You don't need a $300 gadget to access them. You don't need to buy into the pseudoscience to benefit from them. All you need to do is start sending small, reliable signals of biological safety. Through how you breathe, how you move, how you connect with others, and the respect that you give your body, especially on the hard days. Okay, so remember, if you take anything away from this episode, the idea is to send good news consistently to your nervous system, to your brain via your body. If you're ready to take that next step and you want structured evidence informed guidance, I invite you to explore the Somatic Strength Collective app. We offer a seven day free trial with hundreds of movement, mindfulness, and breath practices specifically designed to send good news to a sensitized nervous system from pain education to restorative mobility, progressive strength. You'll find the link to join in the show notes. And if today's Conversation give you clarity. Supporting the show is as simple as taking 30 seconds to leave a rating and review. When you share what you've learned, you help cut through the social media noise and you make sure other women living with chronic pain can find reliable, hype-free health information right when they need it most. So until next time, stay curious, send good news, and I'll see you next week.