Daily yoga practice may provide relief from pain, reduce negative thoughts about pain, and ease sleep problems in some patients with fibromyalgia (FM), according to a pilot study.
The positive effects of this activity were higher in patients with lower anxiety who engaged in more regular, self-paced practice at home, the study showed.
The researchers said yoga is a safe and gentle exercise modality that could work as an effective complement to conventional therapies used to manage FM.
The study, titled “Impact of daily yoga-based exercise on pain, catastrophizing, and sleep amongst individuals with fibromyalgia,” was published in the Journal of Pain Research.
Researchers from Brigham and Women’s Hospital at Harvard Medical School conducted the study, in which 36 women with fibromyalgia, mean age close to 49, completed a 6-week program of yoga-based exercises.
The program was inspired by Satyananda, a traditional form of yoga that brings together elements of asanas (physical exercises), pranayama (breathing exercises), pratyahara (mind-focusing practices), and meditation (breathing awareness, awareness of senses, awareness of thoughts, and yoga nidra).
Once a week, participants took part in 1.5-hour group classes with a yoga instructor. On the remaining days, they were asked to practice 30 minutes of yoga at home, guided by video.
The yoga exercises were specifically tailored to be gentle enough not to trigger new pain or soreness, yet be able to reduce FM symptoms such as pain and sleep disturbances. The exercises also were designed to lighten negative thoughts, including catastrophizing — the inability to stop thinking about pain, its amplification, and feelings of helplessness.
Participants’ psychosocial well-being and FM symptoms were evaluated before and after participation in the program using patient-reported questionnaires, daily diaries, and wrist actigraphy (for sleep measurements).
Despite substantial variability in symptoms and the amount of home practice among participants, the patients overall reported a significant alleviation in their pain after completing the 6-week program.
Notably, those patients who exercised more at home experienced greater pain relief. The greatest benefit was observed in those who practiced 25 minutes a day or more (28% of patients), compared with those who practiced for less time.
Similar to pain alleviation, the yoga exercises also led to a reduction in both sleep disturbance and fatigue as rated by patients, even though sleep efficiency did not change, as measured by actigraphy. Such results are especially important, the researchers said, as “patients with sleep disturbance are more likely to develop chronic pain, and degree of sleep disturbance predicts severity of FM symptoms.”
Changes in pain catastrophizing also varied considerably among individuals. but in general, those thoughts were eased after practicing yoga. Women who reported a greater reduction in catastrophizing along the course of the program also noted having more pronounced relief in fibromyalgia symptoms.
No changes in patient-reported anxiety or the overall impact on FM symptoms were noted.
Additional analysis found a possible influence of initial anxiety and catastrophizing levels on yoga’s effects. Patients with greater catastrophizing levels and lower anxiety before practicing yoga reported greater benefits in terms of pain and fatigue relief, and better sleep efficiency after completing the program.
“This pilot study suggests that yoga-based exercise can be effective in decreasing pain, catastrophizing, and sleep disturbance in some FM patients, particularly those who are willing to engage in a more consistent home self-paced practice. As uptake of Satyananda yoga in FM can be variable, future research should potentially explore the efficacy of other yoga styles and protocols,” the researchers said.
Additionally, patients with a greater tendency for catastrophizing but relatively low general anxiety could be more likely to benefit from yoga, although this requires a more thorough investigation before being applied to clinical practice, the investigators said.
“Overall, yoga, as a safe, gentle, and adaptable exercise option, could be a beneficial tool to complement the conventional therapies currently used to manage FM symptoms,” the team concluded.