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Original Research

An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness, and changes in cortisol levels in women with fibromyalgia

, &
Pages 189-201 | Published online: 26 Jul 2011
 

Abstract

Objectives:

Fibromyalgia (FM) is a chronic condition characterized by widespread musculoskeletal pain, fatigue, depression, and hypocortisolism. To date, published studies have not investigated the effects of yoga on cortisol in FM. This pilot study used a time series design to evaluate pain, psychological variables, mindfulness, and cortisol in women with FM before and after a yoga intervention.

Methods:

Participants (n = 22) were recruited from the community to participate in a 75 minute yoga class twice weekly for 8 weeks. Questionnaires concerning pain (intensity, unpleasantness, quality, sum of local areas of pain, catastrophizing, acceptance, disability), anxiety, depression, and mindfulness were administered pre-, mid- and post-intervention. Salivary cortisol samples were collected three times a day for each of two days, pre- and post-intervention.

Results:

Repeated measures analysis of variance (ANOVA) revealed that mean ± standard deviation (SD) scores improved significantly (p < 0.05) from pre- to post-intervention for continuous pain (pre: 5.18 ± 1.72; post: 4.44 ± 2.03), pain catastrophizing (pre: 25.33 ± 14.77; post: 20.40 ± 17.01), pain acceptance (pre: 60.47 ± 23.43; post: 65.50 ± 22.93), and mindfulness (pre: 120.21 ± 21.80; post: 130.63 ± 20.82). Intention-to-treat analysis showed that median AUC for post-intervention cortisol (263.69) was significantly higher (p < 0.05) than median AUC for pre-intervention levels (189.46). Mediation analysis revealed that mid-intervention mindfulness scores significantly (p < 0.05) mediated the relationship between pre- and post-intervention pain catastrophizing scores.

Discussion:

The results suggest that a yoga intervention may reduce pain and catastrophizing, increase acceptance and mindfulness, and alter total cortisol levels in women with FM. The changes in mindfulness and cortisol levels may provide preliminary evidence for mechanisms of a yoga program for women with FM. Future studies should use an RCT design with a larger sample size.

Acknowledgements

We would like to thank Robin Hurlow and Claire Wicks for their expertise and commitment in the execution of the yoga program, and Dr Warren Nielson and Neil Pearson for their suggestions concerning fibromyalgia and appropriate asana practices for chronic pain, respectively. We would also like to thank Dr Rob Cribbie for his guidance in the statistical analysis. JK is supported by a Canadian Institutes of Health Research (CIHR) Canada Research Chair (CRC) in Health Psychology. KC was supported by a CIHR Frederick Banting and Charles Best Canada Graduate Scholarship – Master’s Award and a CIHR Strategic Training Grant Fellowship in Pain: Molecules to Community. Funds to conduct this study were provided by JK’s CIHR CRC in Health Psychology. This paper is derived, in part, from KC’s Master’s thesis.

Disclosure

The authors report no conflicts of interest in this work.