The Benefits of Yoga for People With Fibromyalgia

What Research Says & How to Get Started

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Yoga is one of the more commonly recommended forms of exercise for fibromyalgia (FMS). It can be a good, gentle way to stretch your body and loosen up tight muscles and joints. It also helps with balance and strength, and, as you become more advanced, it can provide you with a cardiovascular workout as well.

Some people treat yoga just as exercise, but when done in the traditional way, which emphasizes controlled breathing and awareness, it also can help you relax, calm and focus your mind, and deal with emotional turmoil.

Exercise is a difficult thing when you have this illnesses. Too much can cause symptom flares ranging from mild to massive. Be sure to talk to your doctor and learn how to start an exercise program before you begin a yoga regimen or any other activity.

Yoga for Fibromyalgia

A growing body of research suggests that people with FMS may benefit from yoga. Several reviews and meta-analyses of the available literature were published between 2012 and 2015. Some of their findings include:

  • Consistently positive results but possible flaws in study design of many (Lauche);
  • A small positive effect on fatigue in multiple fatigue-related conditions, including fibromyalgia (Boehm);
  • Positive effects of mindfulness activity (which can include yoga, if done mindfully) in depression that's comorbid with FMS (D'Silva);
  • A strong recommendation of meditative movement therapies (yoga, tai chi, qigong) for FMS (Langhorst 2012);
  • Meditative movement therapies reduced sleep disturbances, fatigue, depression, and functional limitations, but, contrary to some studies, did not appear to reduce pain (Langhorst 2013);
  • A medium-to-high effect on pain reduction from meditative movement therapies with a lack of negative side effects (Mist);
  • Encouraging physical and psychological improvements in multiple neurological disorders, including FMS, epilepsy, stroke, multiple sclerosis, Alzheimer's disease, and diseases of the peripheral nervous system (Mithra);
  • Evidence that yoga is safe and may result in improvements in pain and function in multiple musculoskeletal conditions, including FMS (Ward 2013);
  • Promising results for mind-body techniques including yoga, tai chi, breathing exercises, and Pilates and the need for studies comparing these techniques to conventional exercise approaches (Busch).

However, one review stated there was low evidence for an effect on pain and disability and gave only a weak recommendation (Cramer). Several stated a need for better study designs and larger studies. At least one cited a need for standardized methods, terminology, and reporting of details in order to make replication and comparison more effective (Ward 2014).

Insights from individual studies include:

  • A 32% improvement in scores on the revised Fibromyalgia Impact Questionnaire at the end of the study period and a 22% sustained improvement three months later, with those who did yoga more often seeing a greater benefit (Carson);
  • A need for yoga programs that are tailored specifically for FMS to help overcome concerns about classes being too physically demanding and that poses may cause too much pain (Firestone);
  • A possible increase in the stress-hormone cortisol, which is often abnormal in FMS (Carson).

This area of research has grown significantly since 2010. As it continues, we may see improvements in study design and more consistency between studies, which means we'll know more about not just how effective yoga is, but what types are most likely to benefit us, and possibly which FMS subgroups are likely to respond well.

Getting Started With Yoga

When starting yoga, as when starting any exercise routine, you should first check with your doctor to make sure it's safe for you. Once you've got the official okay, it's best to proceed very slowly. Try one or two simple poses a day and pay close attention to how they make you feel. Once you're sure it's not exacerbating symptoms, you can start slowly adding more.

Because you'll be starting so slowly, you'll probably want to either do it on your own or with a personal instructor. If you're doing a self-guided program, be sure you fully understand the poses before trying them, and be sure to start with simple ones that have you seated or lying on the floor. A video or a book with good pictures can help.

If you add upright poses, keep in mind that many people with FMS are prone to dizziness, especially upon standing. Focusing mainly on positions that are lying down, sitting, or standing in a very stable position may keep this from being a problem.

To help get you started, here's information from About.com Yoga Expert Ann Pizer:

For information on a yoga regimen designed to accommodate the symptoms of chronic fatigue syndrome (which are very similar to symptoms of FMS), see Yoga for Chronic Fatigue Syndrome.

More on Exercise for Fibromyalgia

Sources:

Boehm K, et al. Evidence-based complementary and alternative medicine: eCAM. 2012;2012:124703. Effects of yoga interventions on fatigue: a meta-analysis.

Busch AJ, et al. Current pain and headache reports. 2011 Oct; 15(5): 358–367. Exercise therapy for fibromyalgia.

Carson JW, et al. Clinical journal of pain. 2012 Nov-Dec;28(9):804-13. Follow-up of yoga of awareness for fibromyalgia: results at 3 months and replication in the wait-list group.

Cramer H, et al. Rheumatology. 2013 Nov;52(11):2025-30. Yoga for rheumatic diseases: a systematic review.

Curtis K, Osadchuk A, Katz J. Journal of Pain Research. 2011 July;2011(4):189-201. An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness, and changes in cortisol levels in women with fibromyalgia.

da Silva GD, Lorenzi-Filho G, Lage LV. Journal of Alternative and Complementary Medicine. 2007 Dec;13(10):1107-13. "Effects of yoga and the addition of Tui Na in patients with fibromyalgia."

D'Silva S, et al. Psychosomatics. 2012 Sep-Oct;53(5):407-23. Mind-body medicine therapies for a range of depression severity: a systematic review.

Firestone KA, et al. International journal of yoga therapy. 2014 Sep;24:117-24. Interest in yoga among fibromyalgia patients: an international internet survey.

Langhorst J, et al. Schmerz. 2012 Jun;26(3):311-7. Complementary and alternative therapies for fibromyalgia syndrome. Systematic review, meta-analysis and guideline. [Article in German. Abstract referenced.]

Langhorst J, et al. Rheumatology international. 2013 Jan;33(1):193-207. Efficacy and safety of meditative movement therapies in fibromyalgia syndrome: a systematic review and meta-analysis of randomized controlled trials.

Lauche R, et al. Evidence-based complementary and alternative medicine: eCAM. 2015;2015:610615. A systematic overview of reviews for complementary and alternative therapies in the treatment of the fibromyalgia syndrome.

Mishra SK, et al. Annals of Indian Academy of Neurology. 2012 Oct;15(4):247-54. The therapeutic value of yoga in neurological disorders.

Mist SD, Firestone KA, Jones KD. Journal of pain research. 2013;6:247-60. Complementary and alternative exercise for fibromyalgia: a meta-analysis.

Schmidt S, et al. Pain. 2011 Feb;152(2):361-9. Treating fibromyalgia with mindfulness-based stress reduction: results from a 3-armed randomized controlled trial.

Ward L, et al. Complementary therapies in medicine. 2014 Oct;22(5):909-19. Components and reporting of yoga interventions for musculoskeletal conditions: a systematic review of randomized controlled trials.

Ward L, et al. Musculoskeletal care. 2013 Dec;11(4):203-17. Yoga for functional ability, pain and psychosocial outcomes in musculoskeletal conditions: a systematic review and meta-analysis.

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