Role of Medical Yoga Therapy in Attenuating Pain and Corticomotor Plasticity in Fibromyalgia Patients: A Randomized Controlled Trial

Objective: Fibromyalgia (FM) is an idiopathic progressive musculoskeletal pain syndrome affecting 2%–8% of the global population, predominantly females. Symptoms such as morning stiffness, brain fogging, and sleep disturbances are also common in the FM patients. There is no permanent cure of the disease except for temporary symptomatic relief by few FDA-approved medications. The aim of the current study was to investigate the effect of 4 weeks of regular and supervised medical yoga therapy (MYT) on pain status, lumbar flexion, and corticomotor excitability (CME) in FM patients. Methods: It is an assessor-blinded, randomized controlled trial where the pain was assessed both subjectively and objectively; lumbar flexibility and CME of both male and female FM patients of yoga and waitlisted group were also assessed and compared before and after 4 weeks of MYT and same course of standard care therapy. We have used pressure modality of quantitative sensory testing for objective assessment of pain. Corticomotor parameters were assessed using transcranial magnetic stimulation. Block randomization and opaque concealed envelope method was performed for randomizing and allocating patients in the yoga and waitlisted groups. Parametric tests were applied for the inter-and intragroup comparisons. Results: Demographic and clinical parameters of FM patients of both the arms were comparable at baseline (age: waitlisted group = 36.76 ± 9.20; yoga group = 35.71 ± 8.46; P > 0.05). Pain profile of the patient showed significant improvement, and tender point counts were also found to be reduced in the patients administered with MYT. In the waitlisted group, no significant changes were noted. A significant increase in lumbar flexion was reported bilaterally only after MYT. Former stayed unaltered in the waitlisted group. Moreover, improvements in some CME parameters of FM patients of the yoga group were also recorded. Such cortical changes were not marked in the waitlisted group. Conclusions: MYT can alleviate pain, improve flexibility, and alter CME in FM patients more than the standard therapy. MYT can be adopted in day-to-day lifestyle for symptomatic relief by FM patients.