Yoga Alleviates Pain and Improves Function in Fibromyalgia Patients

Philadelphia, PA, 14 October, 2010 – Fibromyalgia (FM) is a debilitating condition affecting 11–15 million individuals in the US alone. FM carries an annual direct cost for care of more than $20 billion and drug therapies are generally only 30% effective in relieving symptoms and 20% effective in improving function. Standard care currently includes medications accompanied by exercise and coping skills approaches. In a study published in the November issue of PAIN, researchers report patients participating in a “Yoga of Awareness” program showed significantly greater improvement in FM symptoms and functioning compared to patients on a standard FM care program.

“Although yoga has been practiced for millennia, only recently have researchers begun to demonstrate yoga’s effects on persons suffering from persistent pain,” commented lead investigator James W. Carson, PhD, Oregon Health & Science University. “The Yoga of Awareness program stands in contrast to previous multimodal interventions with FM patients in that it integrates a wide spectrum of yoga-based techniques – postures, mindfulness meditation, breathing exercises, application of yogic principles to optimal coping, and group discussions.…the findings of this pilot study provide promising preliminary support for the beneficial effects of yoga in patients with FM.”

Given the much higher prevalence of FM in females (80–90%), researchers chose to include only women in this study. 53 women at least 21 years of age participated. To be eligible, patients had to meet the following criteria: be diagnosed with FM by American College of Rheumatology (ACR) criteria for at least 1 year and be on a stable regimen of pharmacologic and/or non-pharmacologic treatment for FM for at least 3 months. The patients were randomized; 25 participated in the Yoga of Awareness program, while 28 received standard care.

Yoga of Awareness is an innovative, comprehensive yoga program, which for the purposes of this study was tailored to address pain, fatigue, sleep disturbance, and emotional distress in FM. Each Yoga of Awareness class included approximately 40 minutes of gentle stretching poses, 25 minutes of mindfulness meditation (e.g., awareness of breath, awareness of awareness itself), 10 minutes of breathing techniques (e.g., full yogic breath, breathing into sensation), 20 minutes of didactic presentations on the application of yogic principles to optimal coping, and 25 minutes of group discussions (e.g., experiences while practicing yoga at home).

After the yoga program was completed, both groups were assessed for fibromyalgia symptoms and functional deficits, overall improvement in fibromyalgia symptoms, physical tests of fibromyalgia symptoms and functional deficits such as tender points, strength and balance deficits, and a number of pain coping strategies.

Following treatment, women assigned to the yoga program showed significantly greater improvements on standardized measures of FM symptoms and functioning, including pain, fatigue, and mood, and in pain catastrophizing, acceptance, and other coping strategies.

Dr. Carson and colleagues observed, "In addition, the results suggested the yoga intervention led to a beneficial shift in how patients cope with pain, including greater use of adaptive pain coping strategies (i.e., problem solving, positive reappraisal, use of religion, activity engagement despite pain, acceptance, relaxation) and less use of maladaptive strategies (i.e., catastrophizing, self-isolation, disengagement, confrontation).”

To bring these benefits to the patient community, Dr. Carson has planned a training course for yoga teachers who want to build their skills for working with individuals who have chronic pain conditions.

The article is “A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia” by James W. Carson, Kimberly M. Carson, Kim D. Jones, Robert M. Bennett, Cheryl L. Wright, and Scott D. Mist. It appears in PAIN, Volume 151, Issue 2 (October 2010) published by Elsevier. doi:10.1016/j.pain.2010.08.020

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Notes For Editors
Full text of the article is available to journalists upon request. Contact Christine Rullo at 215-239--3709 or painmedia@elsevier.com for a copy. Journalists wishing to set up interviews with the authors should contact Jim Newman, Media Relations, Oregon Health & Science University, at newmanj@ohsu.edu or 503-494-8231

About The Authors
James W. Carson
Department of Anesthesiology and Peri-operative Medicine, Oregon Health & Science University, Portland, OR, USA

Kimberly M. Carson
School of Nursing, Oregon Health & Science University, Portland, OR, USA

Kim D. Jones
School of Nursing, Oregon Health & Science University, Portland, OR, USA
Department of Medicine, Division of Arthritis & Rheumatic Diseases, Oregon Health & Science University, Portland, Oregon, USA

Robert M. Bennett
School of Nursing, Oregon Health & Science University, Portland, OR, USA
Department of Medicine, Division of Arthritis & Rheumatic Diseases, Oregon Health & Science University, Portland, Oregon, USA

Cheryl L. Wright
School of Nursing, Oregon Health & Science University, Portland, OR, USA

Scott D. Mist
School of Nursing, Oregon Health & Science University, Portland, OR, USA

About PAIN®
PAIN®, the official journal of the International Association for the Study of Pain® (IASP®), publishes 12 issues per year of original research on the nature, mechanisms, and treatment of pain. This peer-reviewed journal provides a forum for the dissemination of research in the basic and clinical sciences of multidisciplinary interest and is cited in Current Contents and MEDLINE. It is ranked 1st out of the 25 journals in the ISI Anesthesiology category according to the Journal Citation Reports 2010.
www.painjournalonline.com

About The International Association for The Study Of Pain® (IASP®)
Founded in 1973, IASP® is the world's largest multidisciplinary organization focused specifically on pain research and treatment. It is the leading professional forum for science, practice, and education in the field of pain bringing together scientists, clinicians, health care providers, and policy makers to stimulate and support the study of pain and to translate that knowledge into improved pain relief worldwide. IASP currently has more than 7,500 members from 130 countries and in 85 chapters.
www.iasp-pain.org

About Elsevier

Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence,and ClinicalKey—and publishes over 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

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Media Contact
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Elsevier Health Sciences Journals
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