Women with fibromyalgia who participated in an 8-week yoga program reported significant improvements on measures of fibromyalgia symptoms and function, based on data from a pilot study of 53 women. The results were published online on Oct. 14 in the journal Pain.
More effective fibromyalgia treatments are needed.
The positive findings have become the basis of a grant proposal to the National Institutes of Health to fund a larger clinical trial, said lead investigator and lead study author James Carson, Ph.D.
Many fibromyalgia patients find standard medical care ineffective for reducing their symptoms, including pain and fatigue, Dr. Carson of Oregon Health and Science University in Portland said in an interview.
More effective treatments for fibromyalgia are needed, said Dr. Carson. “Exercise is often prescribed for fibromyalgia, but for many patients it is hard to find an exercise program that is tolerable for them. Yoga poses done in a gentle way may be a good option,” he said.
Dr. Carson and colleagues randomized 53 women who met the American College of Rheumatology criteria for fibromyalgia in an 8-week Yoga of Awareness program (25 women) or standard care (28 women). The program consisted of gentle yoga poses, modified as needed to accommodate conditions such as knee osteoarthritis or carpal tunnel syndrome (Pain 2010;151:530-9).
The primary outcome measure was the total score on the Fibromyalgia Impact Questionnaire Revised (FIQR). After 8 weeks, the mean FIQR total score dropped from 48.32 at baseline to 35.49 in the yoga group (a statistically significant difference), compared with a change from 49.26 at baseline to 48.69 in the control group. More than half (56%) of the yoga group had at least a 30% reduction in overall FIQR scores, which is slightly more than twice the 14% reduction that is recommended to show clinical significance, the researchers noted. In addition, 50% of patients in the yoga group had at least a 30% reduction in the pain subscale of the FIQR.
The Patient Global Impression of Change (PGIC) scale scores for overall improvement in fibromyalgia symptoms were significantly higher in the yoga group vs. the control group (5.05 vs. 3.69). The PGIC was measured only once, at the end of the study. As part of the PGIC, approximately 90% of the patients in the yoga group reported feeling “a little better,” “much better,” or “very much better,” compared with 19% of the controls.
The average age of the participants was 54 years, and 68% had been symptomatic for more than 10 years. Patients who were already engaged in a yoga practice, those who were too disabled for meaningful participation in the yoga program, and those who were scheduled for elective surgery were excluded from the study.
“The most surprising finding for us was that most patients became so fully engaged in the home yoga practices they were assigned,” Dr. Carson said. On average, the patients spent 40 minutes practicing yoga at home, including about 19 minutes of postures, 13 minutes of seated meditation, and 8 minutes of breathing exercises. Those who practiced more had better results on several of the study outcomes, he noted.
“This finding suggests that yoga practices, if taught in a tailored, accessible manner, are not only well tolerated and effective; they are practiced with an unexpected degree of enthusiasm,” he said.
The results also showed that patients in the yoga group were more likely to use positive pain-management strategies such as problem solving, religion, acceptance, and relaxation, and less likely to resort to negative pain-management strategies such as self-isolation, disengagement, and catastrophizing.
“We are preparing a grant proposal to the National Institutes of Health to fund a larger clinical trial that will include comparison with another active treatment, so that we can make sure that the improvements seen in this first study can be reliably replicated in another group of patients, and that the improvements are not attributable to simply receiving extra attention from caregivers or to a placebo effect,” Dr. Carson said.
“We also planning to study important changes that the yoga program may produce in neurally-based abnormal pain processes that are key to the pathophysiology of fibromyalgia,” he said.
The researchers had no financial conflicts to disclose.