Yoga Provides Relief for Chronic Pain

Summary
Fibromyalgia is a syndrome causing severe and chronic pain in muscles and connective tissues. It is characterized by a poor response to currently available drugs and can put a significant financial burden on the healthcare system. Psychological factors are often associated with symptoms of chronic pain. Hence, exercises and coping-skills education are recommended in the management of fibromyalgia. A recent study showed that a comprehensive yoga program that included physical postures, breathing exercises and meditation was useful for this condition. The symptomatic improvement experienced by the yoga group was clinically significant compared to the control group which did not participate in yoga.

Introduction
Fibromyalgia is a painful and chronic condition affecting millions of Americans today. Drugs relieve symptoms in only 30 percent of patients with fibromyalgia, and just 20 percent of people taking drugs experience functional improvement. Exercise and psychological training to improve management of the condition are recommended along with drugs. Yoga is a physical practice that addresses both body and mind. The methods used in yoga go beyond just physical postures; they also include breathing exercises and meditation. The present study attempted to find if ‘‘Yoga of Awareness” — a comprehensive program including breathing exercises, meditation, easy yoga poses, yoga-based coping presentations, and group discussions — was helpful to fibromyalgia patients.

Methodology
* Fifty-three women over the age of 21 years, who had fibromyalgia for more than a year and had been in therapy for at least three months, were selected. Of these, 25 were in the yoga group while 28 received standard care.
* Those in the yoga group participated in a weekly two-hour group class. This included gentle stretching, mindfulness meditation, breathing techniques, presentations on coping and group discussions. They continued practice at home for 20 to 40 minutes the remaining days of the week. The control group did not participate in yoga during the course of the study.
* Standard questionnaires were used to assess the patients’ overall feeling of change, fibromyalgia symptoms and related problems, and pain-coping strategies.
* Physical examinations tested the tender points on the body as well as strength and balance of the patients.

Results
* Scores on a Fibromyalgia Impact Questionnaire Revised (FIQR) dropped from 48.2 at baseline to 35.49 after study in the yoga group. In the control group, the baseline score was 49.26 and the after-study score was 48.69.
* For those who practiced yoga, the FIQR item for pain was reduced by 24.1 percent in general, with 50 percent of the yoga practitioners recording more than 30% reduction in pain.
* On the Patient Global Impression of Change scale, 4.5 percent in the yoga group stated that they were “very much better,” and additionally, 9.1 percent said they were ‘‘much better.” No one in control group indicated this.
* Nobody in the yoga group indicated that they were “much worse,” but 7.7 percent in the control group indicated that they were ‘‘much worse.”

Next steps/Shortcomings
The findings of this pilot study are promising, but whether the beneficial effects of yoga last for a long time is not known. There could be a placebo effect in the yoga group. Further, this study relies on self-reporting by participants. The small sample size of participants also could be considered a limitation. More research including long-term follow-up of participants and testing the physiological and psychological aspects of chronic pain would be useful.

Conclusion
Yoga is a body-mind discipline. The physical exercises performed in yoga may improve body posture and might also produce relaxation responses, namely improved oxygen volume and reduced heart rate. This might correct the dysfunction of the autonomic nervous system and lead to stress reduction. Yoga also promotes a healthy acceptance of pain and a willingness to learn from it. This might improve coping skills of the patient suffering from chronic pain. The present study indicates that a comprehensive yoga program, not just including physical exercise and meditation but also teaching coping skills, can be an important element in management of a difficult and painful condition like fibromyalgia.

For More Information:
A Pilot Randomized Controlled Trial of the Yoga of Awareness Program in the Management of Fibromyalgia
Publication Journal: PAIN, August 2010
By James W. Carson; Kimberly M. Carson; Oregon Health & Science University, Portland, Oregon

*FYI Living Lab Reports Are Summaries of the Original Research.

 


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