Three Hidden Roots of Unexplained Pain

My clinical research and practice over the course of thirty years has been a constant pursuit to understand the causes of chronic pain and to develop treatment strategies.

My focus, to a large extent, has been on postural distortion as the root cause of chronic pain. Namely, how imbalances in muscles and fascia and compensation patterns can result in an array of bewildering symptoms. 

But in recent years it has become impossible to avoid the influence and activity of two additional forces exerting a profound effect on the body, on our posture, and therefore  the incidence of pain.

These two forces are breathing and the mind.

breathing and postural balance

The action of breathing is something we take for granted but  increasingly I've brought it under closer and closer scrutiny.

Since we breathe in excess of 20,000 times each day it's natural to consider the potential for problems if how we're breathing is dysfunctional in some way.

As I've considered this force and its impact while continuing to work with individuals suffering from chronic pain, I've arrived at the following conclusions:

  1. Many of us breathe in a paradoxical fashion much of the time. That is, we chest-breathe, rather than breathing diaphragmatically.
  2. Paradoxical breathing has the power to distort our posture and, when it does, it must be addressed if we hope to achieve lasting success in relieving chronic pain.


I've been a mindfulness meditation practitioner almost as long as I've been a manual therapy practitioner, but it had always remained something I just did privately.

In 2017 my father passed away. His passing had a profound effect on me and I found myself taking stock of my life in a  new way. How did I really want to spend the precious remaining time I had left on the planet, however long that might be? What was most important to focus on? 

The answer that arose was that I wanted to begin teaching mindfulness meditation. It has benefitted my life in countless ways and I felt a strong urge to share that with others.

I now teach a mindfulness meditation course through the OSHER Institute at Dartmouth College every spring and fall.

What does this have to do with posture and pain?

One outgrowth of teaching mindfulness has been that it has bled over into my clinic work with clients and chronic pain. As ever, I'm continually learning.

It has become increasingly clear how profoundly the mind impacts not only breathing and its effect on posture, but also the nervous system itself.

So now, in addition to my focus on postural distortion and how it causes pain in the body, I now focus equally on how both breathing and the mind can set up and instigate pain in the body.

A framework for understanding unexplained pain

In my quest to comprehend the roots of chronic pain, coupled with my hope to share what I've learned over many years of practice and clinical research, I have devised a framework I call, The Three Hidden Roots of Unexplained Pain.

By unexplained pain I mean pain for which standard allopathic testing --  MRIs, X-rays, CAT scans, blood work, etc -- is either inconclusive or the tests come back normal.

Perhaps you've had the experience of consulting your doctor about your chronic pain, your tests coming back normal and the doctor implying (or even insisting) that there's nothing wrong with you. The doctor, in this instance, is operating in the territory of what can be explained by such tests.

What I am talking about here is what cannot be explained by such tests. And this brings me to an important point:

The territory of my work does not seek understand or explain ALL pain. The body suffers pain for innumerable reasons including pathological disease processes, injury and trauma, and many other causes.

The terrain of my work, on the other hand, is focused on the subset of pain for which no medical explanation is provided. This is what I refer to as unexplained pain.

Within this context, then, there are three primary forces responsible for a huge volume of mysterious symptoms and hard to diagnose problems.

These three forces are:    Gravity  |  Breathing  |   Mind

three forces and their dysfunctional expressions

To be precise, it is not the force in its raw or pure form that is responsible for unexplained pain, but rather the dysfunctional expression of the force.

With GRAVITY, the dysfunctional expression is postural distortion.

  • When the body loses equipoise, its upright position in gravity, a struggle ensues between our musculature and the force of gravity.

With BREATHING, the dysfunctional expression is chest breathing or what is known as paradoxical breathing.

  • The potential impact of paradoxical breathing on posture, to say nothing of its impact on the nervous system, can be profound.

With the MIND, the dysfunctional expression is the clinging or grasping mind, and what I call, Second Arrow Mind.

  • There can be no activity in the mind without a corresponding reaction in the body. Habituated and dysfunctional breathing and postural patterns are just two possible results.

As we progress through this overview I will go into significant detail about what various unfamiliar terms mean. (Such as equipoise, paradoxical breathing, and Second Arrow Mind, as well as many other terms.)

But first I want to show this framework graphically.

Three Hidden Roots of Unexplained Pain


GRAVITY is the primary external force acting on us at all times.

BREATHING is the primary internal force acting on us at all times.

MIND is the primary governing force acting on us at all times.




when this force becomes Dysfunctional the expression is...

The dysfunctional expression of gravity is the loss of equipoise caused by postural distortion.

The dysfunctional expressions of breathing are paradoxical and attenuated breathing.

The dysfunctional expression of mind is the clinging or grasping mind, and what I call, Second Arrow Mind.




impact of each dysfunctional expression

impact of postural distortion

Creation of two postural distortion patterns: pelvic torsion and hyperflexion (forward-head posture). Also reinforcement of paradoxical breathing and Second Arrow Mind.

impact of paradoxical breathing

Creation and reinforcement of postural distortion patterns and Second Arrow Mind, and the arousal of the fight, flight, freeze response of the autonomic nervous system. 

impact of SEcond arrrow mind

Creation and reinforcement of habituated postural patterns and paradoxical breathing, and arousal of the fight, flight, freeze response of the autonomic nervous system.




a Solution for each root problem


We need to identify postural distortion patterns and correct them with stretching and toning protocols in order to re-establish equipoise in a lasting and sustainable way.


We need to cultivate awareness and continuity of relaxed breathing and address inhibiting factors such as long hours seated with a compressed diaphragm and unchecked stress.


We need to develop mindful awareness of breathing, the body, emotions, and thoughts, and learn to discriminate between first arrow pain and second arrow pain.

An integrated approach to resolving these problems

As perhaps you can see, everything influences everything else. The dysfunctional expressions of the three primary roots -- Gravity, Breathing, & Mind -- often arise in unison and routinely reinforce and perpetuate one another.

For this reason it's essential to adopt an integrated approach in our effort to resolve them. What I have witnessed again and again is that by resolving one of these dysfunctional expressions, it's possible (and likely) that we have a positive impact on the others.

For example, by making improvements in postural distortion we can decrease pain and anxiety, and thus the mind can become more at ease.

Or by addressing paradoxical breathing we can greatly improve the postural tendency toward hyperflexion and thus its myriad problems can begin to resolve, to say nothing of the calming impact on the nervous system.

Or by developing mindful awareness we can dramatically release the grip of wanting everything to be different than it is, reduce regret and anxiety and reactivity and we can learn to discriminate between the actual sensory perception of pain and our secondary reaction to it, which often compounds the pain.

Resolving one dysfunctional expression can, and often does, promote resolution of the other two.

I am currently in the process of developing of a comprehensive self-treatment methodology so that individuals can resolve many of these problems on their own using online course work.

The first public offerings of this methodology are 3 self-paced online courses collectively called, The Blueprint Series.

The courses in the Blueprint Series address gravity, breathing and mind, by focusing on:

  1. Correcting the physical aspects of postural distortion that can impair proper breathing
  2. The concept of Progressive Ease to overcome the no pain, no gain mindset and to get off the treadmill of re-aggravation
  3. The gentler and lesser known method of Active Isolated Stretching
  4. The correction of pelvic torsion (aka a twisted pelvis) which can be responsible for much intractable and unexplained pain

The Blueprint series

The 3 courses of the Blueprint Series...

Stretching Blueprint for Pain Relief and Better Flexibility

Postural Blueprint for Correcting Pelvic Torsion

Toning Blueprint for Restoring Muscular Balance

...form a continuum that focuses a resolving the gravity and postural distortion aspect of the Gravity-Breathing-Mind triad, while passively including the breathing and mind aspects.

These 3 courses guide individuals through a process that mirrors the guidance I would provide during an extended series of in-person appointments.

(Currently I am not seeing clients for in-person appointments in order to focus full-time on this course work.)

The first course in the series -- Stretching Blueprint for Pain Relief and Better Flexibility: The Complete Guide to Active Isolated Stretching -- is now available.

If you are unfamiliar with the terms, Active Isolated Stretching and Progressive Ease, then I urge you to take the time to check out the Stretching Blueprint. It is unlike anything you've ever tried before. You can take the first 2 lessons of the course for free starting with Lesson 1 here.

The remaining two courses will be released in 2022:

  • Postural Blueprint for Correcting Pelvic Torsion 
  • Toning Blueprint for Restoring Muscular Balance

In 2022 I will also offer a course in mindfulness meditation. This will include techniques for improving relaxed breathing.

You can start using a number of my free guided meditations right away by clicking here.

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Anatomy Images Courtesy of BIODIGITAL

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Stephen O'Dwyer, cnmt

Neuromuscular Therapist & Pain Relief Researcher

Stephen O'Dwyer, CNMT


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