How Does Yoga Work on Pain Dimensions? An Integrated Perspective in 2 Individuals With Fibromyalgia.

CONTEXT: The effectiveness of yoga has been studied in fibromyalgia (FM) using improvement in its 5 key dimensions-pain, quality of life, sleep, depression, and disability-as outcome measures. Studies have demonstrated an improvement in the psychosocial dimensions of pain after yoga practice, but these findings failed to reach statistical significance. Although studies have shown the efficacy of yoga in the modulation of pain, no study has yet investigated how it acts on each dimension of pain.

OBJECTIVE

The study intended to investigate the dimensions of pain-sensory, evaluative, and/or affective-and which psychological comorbidities-anxiety and/or depression-that Hatha yoga affects in individuals with FM.

DESIGN

The research team performed 2 case studies.

SETTING

The study occurred at the GIFT Institute of Integrative Medicine (Pisa, Italy).

PARTICIPANTS

Participants were 2 patients at the institute who had FM.

INTERVENTION: At baseline (T0), participants were prescribed 8 mo of pharmacological treatment. At 2 mo after baseline (T1), they participated in an 8-h, mind-body, psychoeducational course (PEC) for self-management of chronic pain. Each participant was contacted by phone every week for 2 mo after the PEC (ie, until 4 mo from baseline (T2). For the next 2 mo, participants had no contact with a health care practitioner, to sustain a deeper PEC program. Participants then took a 2-mo Hatha yoga program from months 6 (T3) to 8 (T4).

OUTCOME MEASURES: Sensorial, affective, and evaluative dimensions of pain were investigated using the Italian Pain Questionnaire, and depression and anxiety were investigated using the Hospital Anxiety Depression at T0, T1, T2, T3, and T4. The IPQ was administered weekly, before and after each yoga session.

RESULTS

Hatha yoga proved to be an effective means of relieving pain in FM. In particular, a measurable improvement in scores occurred for the affective dimension of pain after only 4 yoga sessions; this effect remained stable throughout the remainder of the program.

CONCLUSIONS

Monitoring the affective dimension of pain should be included in an integrated approach to pain, and Hatha yoga may be beneficial in the pain management of FM participants.