Can Yoga Enhance Fibromyalgia Treatment?

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A 12-week study of patients with fibromyalgia revealed that while all exercise helped, those who combined yoga with aerobics experienced the most significant improvement in pain and disease activity.

As patients often exhibit impaired physical fitness, experts recommend incorporating exercise into the care strategy.

“In general, exercise is regarded as a transformative approach to the treatment of fibromyalgia, as well as a means of achieving holistic improvement in the health of individuals affected by this condition,” wrote a team of investigators led by Ömer Şevgin, Ph.D., assistant professor in the Department of Physiotherapy and Rehabilitation at Üsküdar University, Turkey.

However, the type and intensity of exercise is important to consider. For example, high-intensity programs are not recommended, as patients with fibromyalgia tend to have a lower exercise tolerability.

Investigators assessed the impact of three different exercise regimens — aerobic exercise alone, aerobic exercise combined with resistance training, and aerobic exercise combined with yoga — on pain and disease activity in patients with fibromyalgia.

“Among the numerous treatment options available, exercise is notable for its lack of adverse effects and its capacity to enhance patients’ physical fitness while providing more enduring symptom alleviation,” investigators explained.

The intervention lasted 12 weeks and was designed with patient needs in mind. Participants initiated the program at a lower intensity and gradually increased exertion levels, based on individual exercise tolerance. Aerobic exercise was performed once a week for 30 to 40 minutes and then three days a week for 30 to 40 minutes for the remainder of the intervention. In addition to aerobic exercise, the resistance program was incorporated two days a week and the yoga group practiced an average of twice a week.

Changes in disease activity were determined using the Fibromyalgia Impact Questionnaire (FIQ), and pain was measured using the McGill Melzack Pain Questionnaire (MMPQ). Other information, such as age, height, body weight and marital status, were also collected.

A total of 60 patients were randomly assigned to aerobic exercise (20 individuals), aerobic and yoga (20 individuals), or aerobic and resistance training (20 individuals). No significant differences were observed regarding sociodemographic data across groups, and the FIQ scores and MMPQ measurements were comparable at baseline.

Investigators observed statistically significant changes in FIQ and MMPQ scores within and between groups post-intervention, with all three groups demonstrating reductions in pain and disease activity. However, patients in the aerobic exercise plus yoga group reported significantly lower pain levels and disease activity scores when compared with the other two groups.

The addition of resistance training did not show a significant difference in pain reduction compared with aerobic exercise alone.

Investigators wrote that the self-reported design of the study limited the findings. Additionally, they did not obtain follow-up data post-intervention and were therefore unable to determine the duration of the positive effects of the exercises. They also noted that other information — such as employment status, education, race/ethnicity, and clinical data including diagnosis, medical history and medications — were not collected.

Despite this, they emphasized the study was the first to determine the efficacy of aerobic exercise in combination with yoga or resistance training on pain and disease activity outcomes among this patient population.

“It is crucial to gain insight into the impact of diverse exercise modalities and combinations on fibromyalgia, as this will facilitate the diversification of treatment approaches and the individualization of treatments,” investigators concluded. “The findings of our study may contribute to the development of more effective and holistic approaches to fibromyalgia.”