VANCOUVER, B.C. – Yoga may be an effective adjunct to medical treatment for patients with fibromyalgia, Malinda L. Breda, Ph.D., reported at the annual meeting of the American Psychosomatic Society.
There are many reasons why yoga is an attractive treatment for fibromyalgia, which affects about 6 million Americans. Current therapies provide inadequate symptom relief, and a recent meta-analysis concluded that optimal treatment regimens should include nonpharmacologic interventions such as exercise (Ann Behav Med. 1999;21:180-91).
But although conventional exercise can alleviate symptoms for some fibromyalgia patients, it actually worsens them in others. Yoga, with its meditative, low-impact approach, may be better for these patients than conventional exercise. Moreover, data suggest that yoga may be beneficial in other medical conditions, including obsessive-compulsive disorder, osteoarthritis, carpal tunnel syndrome, chronic fatigue syndrome, and other pain conditions, noted Dr. Breda of the California School of Professional Psychology, San Diego.
Of 38 adults who met the 1990 American College of Rheumatology criteria for fibromyalgia, 19 were randomized to an experimental yoga group, and 19 controls were put on a waiting list.
The yoga intervention consisted of 8 weeks of classical hatha yoga, taught by a certified instructor who had experience with fibromyalgia patients, she said.
The 90-minute sessions emphasized gentle poses and breath work designed to match individual ability and were followed by relaxation/meditation exercises. Classes were conducted twice weekly, and subjects practiced at home with a video the other 5 days of each week. Class attendance was consistently high, with patients averaging 14 of 16 sessions. At-home practice adherence was slightly less impressive, with a mean of 3 of 5 days with yoga practice.
Instructor visual analog scale ratings, used to check manipulation, revealed significant improvement across sessions in patients' ability to perform the postures, Dr. Breda reported.
Patients completed a variety of assessments of pain, fatigue, sleep quality, and disability at baseline, 4 weeks, and 8 weeks.
Compared with controls, significant improvements were seen in the yoga group on the visual analog scale and the Pain Rating Index on ranked values, both for pain; the Multidimensional Assessment of Fatigue scale; the Pittsburgh Sleep Quality Index; and the Fibromyalgia Health Assessment Questionnaire.
The yoga group did not show significant improvements over time in disability, depression, or active coping scores. The control group showed no significant differences over time, except for worsening anxiety.