Yoga that includes gentle stretches and meditation may help alleviate the symptoms of fibromyalgia, a small study finds.
Background
No cure exists for fibromyalgia, a chronic pain syndrome characterized by multiple tender points, fatigue, insomnia, anxiety, depression, and memory and concentration problems. Some 11 to 15 million Americans have the debilitating condition, about 80% to 90% of them women, according to background information in the study.
The Study
Twenty-five women diagnosed with fibromyalgia were enrolled in a two-hour yoga class that met once a week for eight weeks. Another group of 28 women diagnosed with the condition were put on a waiting list and told to continue their normal routine for dealing with fibromyalgia.
After eight weeks, the yoga group reported improvements in both physical and psychological aspects of fibromyalgia, including decreased pain, fatigue, tenderness, anxiety and better sleep and mood.
At the end of the study, about 4.5% in the yoga group reported being "very much better," 9.1% said they were "much better," 77% were "a little better" while 4.5% reported no change. In comparison, no one in the control group reported that they were "very much better" or "much better," 19.2% reported being a little better," and 38.5% reported "no change."
"The women were somewhat apprehensive when we started, but once they got into the rhythm of it they found it to be very helpful." said lead study author James W. Carson, PhD, a clinical psychologist and pain specialist at Oregon Health & Science University in Portland. "They came back after the first week reporting less pain, better sleep and feeling encouraged for the first time in years. That type of change continued to build over the course of the program." The study was published in the journal Pain.
About The Yoga Program
The yoga sessions evaluated in the study included 40 minutes of gentle stretching and poses, 25 minutes of meditation, 10 minutes of breathing techniques, a 20-minute lesson on applying yoga principals to daily life and coping with fibromyalgia and 25 minutes of group discussion. Participants were also encouraged to practice at home with a DVD on most days.
The yoga women practiced in the study is called Yoga of Awareness, a type of yoga developed by Dr. Carson, a yoga and meditation in structor, and his wife, study coauthor Kimberly Carson. Dr. Carson taught the class. (Dr. Carson reported no financial considerations that would cause a conflict of interest.)
Yoga of Awareness draws from the Kripalu school of yoga, Dr. Carson said, which emphasizes the "inner dimensions" of yoga, such as accepting pain and being willing to learn from pain and stressful circumstances, being mentally "present in the moment" and learning to distinguish between actual events and the mind's tendency to 'catastrophize" pain—that is, thinking it's the worst pain ever when really it's manageable, he said.
Previous research showed Yoga of Awareness improved pain, fatigue, sleep and mood in women with breast cancer, Dr. Carson said.
Possible Explanation
It's unknown what aspects of Yoga of Awareness are the most beneficial, but Dr. Carson said he believes the exercise, meditation and the social aspects all contribute.
"It's the combination that has a synergistic effect," Dr. Carson said. "Our mind and body are very connected, but we are often not aware of that fact. Techniques like yoga really reinforce that connection and make us much more conscious of the fact that our thoughts and our feelings are affecting our body, and our body is affecting how we think and feel."
Fibromyalgia can be very difficult to treat, with many patients reporting little relief from medications, said Bruce M. Solitar, MD, a clinical associate professor of medicine in the division or rheumatology at NYU Langone Medical Center in New York City.
Yoga is probably worth trying, Dr. Solitar said. But he noted that patients in the study were in a yoga class specially tailored to their needs and said the class at a local yoga studio might be too intense.
Though it's unknown how much of the positive effect shown in the study is the placebo" effect of doing something that feels empowering versus something special about the yoga and meditation itself, which may be beside the point if people feel better, Dr. Solitar said.
"Many patients report that not much helps them, so anything that's positive is a very good thing," Dr. Solitar said.
Recommendations
If you have fibromyalgia and are looking for a yoga class, Dr. Carson recommends seeking out a class advertised as "gentle and making sure the instructor knows you have physical challenges so that poses can be modified.
Since many yoga classes don't incorporate much meditation, Dr. Carson also recommends seeking out a meditation class, which typically teaches breathing and/or concentration exercises to reduce stress and cope with pain.
