An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness, and changes in cortisol levels in women with fibromyalgia
Open accessAbstract
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.
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The Describing, Acting-with-awareness, and Non-judging facets tend to show similar positive associations with psychological health.
“The Describing, Acting-with-awareness, and Non-judging facets are often similarly associated with better psychological health.”
From Mindfulness is associated with psychological health and moderates the impact of fibromyalgia (2019) · cites this paper as [13]
The Five Facet Mindfulness Questionnaire section names all three facets and says that its subscales correlate with aspects of psychological functioning. It gives a positive association for Describing, but does not establish positive associations for Acting with awareness and Non-judging or show that the three are similarly associated with psychological health. The Results section reports improvement in Describing, not a comparison of those associations. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe five facets of mindfulness have different relationships with health outcomes.
“These facets of mindfulness differ in their associations with health outcomes.4–10,13–17”
From Mindfulness is associated with psychological health and moderates the impact of fibromyalgia (2019) · cites this paper as [13]
The study sample had higher average total FFMQ scores than other community and clinical samples.
“Our sample had higher average total Five Facet Mindfulness Questionnaire (FFMQ) scores than other community and clinical samples in studies that measured FFMQ5,7,10,13,15,17”
From Mindfulness is associated with psychological health and moderates the impact of fibromyalgia (2019) · cites this paper as [13]
Yoga has been shown to reduce pain in other pain-centric conditions, such as fibromyalgia, rheumatic diseases, and multiple sclerosis.
“In particular, yoga, which may partially exert its salubrious effects through enhanced interoceptive awareness [10], has been shown to reduce pain in other pain-centric conditions, such as fibromyalgia [11], rheumatic diseases [12], and multiple sclerosis [13].”
From Yoga is effective for treating chronic pain in veterans with Gulf War Illness at long-term follow-up (2023) · cites this paper as [11]
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- Authors
- Curtis, K., Osadchuk, & Katz, J.
- Affiliations
- York University (CA)
- Corresponding author
- Curtis, Kathryn
- Venue
- Journal of Pain Research
- Publisher
- Informa UK Limited
- Published
- 2011-07
- Volume
- 4
- Pages
- 189
- ISSN
- 1178-7090 (ISSN-L)
- PMC
- PMC3160832
- OpenAlex
- W2146711614
- Cited by
- 150
- References
- 71
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 8 · 2023: 11 · 2022: 6 · 2021: 11 · 2020: 6 · 2019: 7 · 2018: 7 · 2017: 10 · 2016: 18 · 2015: 16 · 2014: 18 · 2013: 9 · 2012: 10
- FWCI
- 8.10
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Pain Research (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- YorkSpace (York University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- fibromyalgia, yoga intervention, salivary cortisol, pain catastrophizing, pain acceptance, mindfulness, psychological functioning, women, mediation, adrenal insufficiency, chronic widespread pain, anxiety and depression, fatigue, mediation analysis, time series design, women's health, chronic pain management, mindfulness-based interventions, chronic pain
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