Fibromyalgia Bends to Yoga

Oct. 16, 2010— -- A little bit of yoga may take away some of the debilitating symptoms of fibromyalgia, results of a pilot study show.

Patients who stretched and meditated once a week as part of the "Yoga of Awareness" pilot program had significantly greater improvements in symptom scores, including pain, fatigue, and depression, than those who were wait-listed for the program, according to James Carson, of Oregon Health & Science University in Portland, and colleagues.

They reported their findings online in the journal Pain.

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"The findings of this pilot study provide promising preliminary support for the beneficial effects of yoga in patients with fibromyalgia," Carson said in a statement.

The literature supporting yoga's beneficial in effects in a host of conditions has been growing.

For fibromyalgia patients in particular, yoga may fulfill a need for both exercise and coping skills, which are required for treatment in conjunction with pharmacy, the researchers said.

For this study, they enrolled 53 female patients with fibromyalgia, who were either randomized to the eight-week Yoga of Awareness program or were wait-listed and got the standard of care. They chose women because the condition tends to be more prevalent in this gender.

Some of the women were taking medication to mitigate their symptoms.

Each class included 40 minutes of gentle stretching, 25 minutes of mindfulness meditation, 10 minutes of breathing techniques, 20 minutes of lessons on applying yogic principles to coping strategies, and 25 minutes of group discussions.

The women also were told they could practice yoga at home. Their mean age was 53.7 years and their average time since diagnosis was 11.6 years.

The researchers found that the women who practiced yoga had greater improvements in symptoms and functioning, including pain, fatigue, mood, pain catastrophizing, acceptance and other coping strategies.

Based on the fibromyalgia impact questionnaire, overall improvement significantly favored those in the yoga program. These women also had significantly greater improvements in symptoms based on this scale.

They also had significantly better improvements on subscales measurements of pain, fatigue, stiffness, depression, poor memory, anxiety, tenderness, poor balance, and environmental sensitivity.

Based on the Patient Global Impression of Change scale, yogis had greater overall improvements, as well as significant gains in strength compared with those who were wait-listed.

There were also significant improvements on measures of coping, including pain catastrophizing and problem-solving.

This implies that coping "doesn't rely on a circumscribed set of skills that 'teach to the test,' but rather may be produced by a wide variety of approaches," the researchers wrote, noting that coping strategies were drawn from the yoga tradition. These "differ markedly" from standard cognitive behavioral therapy coping skills, they said.

In terms of potential mechanisms for the association, the researchers said that yoga cultivates an acceptance of and a willingness to learn from pain and other stressful experiences.

Yoga also has been shown to produce effects similar to aerobic exercise, potentially improving the fatigue that plagues fibromyalgia patients.

More work is needed to determine which of these mechanisms may have mediated the improvement seen in the study, as well as what, if any, biological changes underlie improvement in fibromyalgia symptoms, the researchers said.

Their study was limited in its generalizability due to a small sample size. It was also limited by a lack of follow-up and reliance on self-reported data.

"This pilot study provides promising support for the potential benefits of a yoga program for women with fibromyalgia," the researchers concluded.