Fibromyalgia is a common widespread pain condition with several associated symptoms including headaches, fatigue, sleep problems, irritable bowel syndrome etc. Exercise is one of the best strategic approaches to this incurable condition.
Exercise helps improve symptoms, self efficacy and improves overall quality of life. Yoga is an ancient Indian form of exercise.
To be effective the yoga therapist needs to create an awareness of specific fibromyalgia symptoms s well as the co-existing conditions.
For example, the therapist teaches the patient that disturbed sleep increases pain, pain reduces functional capacities and poor functioning increases depression and anxiety.
Patient is educated that addressing one of the symptoms may lead to meaningful improvements in other symptoms as well.
Yoga positions should be chosen carefully so as not to aggravate the symptoms of pain. Exercise-induced pain in fibromyalgia patients is common. The exercise program should thus be gradual.
In most patients Vinyasa (flowing yoga) at a slower pace than used in general population is chosen. Calming postures such as balasana (child’s pose) should be chosen when the yoga becomes uncomfortable or painful.
Due to early morning stiffness, yoga positions may be difficult early after rising. The sessions should be thus scheduled later in the day.
Studies have shown that breathing exercises that are part of the yoga program may help ease the anxiety. Patient is taught that pain along with anxiety tends to inhibit deep breathing.
Yoga classes are generally begun with at least 5 minutes of centering and calming breaths. Of the breathing exercises rapid, energizing breathing such as kapalabhati may exacerbate anxiety but calming exercises such as nadi shodhana are helpful.
There have been studies analyzing the effects of yoga on fibromyalgia patients with depression. Asanas (yoga poses) that include chest-opening and back-bending help in openness, acceptance, and courage and ease depression.
Beneficial asanas include setu bandha sarvangasana (bridge pose), bitilasana (cow pose), urdhva mukha svanasana (upward-facing dog), supta baddha konasana (reclining bound angle) and supta virasana (reclining hero) and anuvittasana (standing backbend). Apart from these meditation also helps.
Pain relief or easing of the pain symptoms can improve sleep. Pain is also responsible for non restorative sleep. Restorative asanas that calm may help improve sleep. These include asanas such as supta baddha konasana (reclining bound angle), viparita karani (legs up the wall), balasana (child’s pose), and savasana.
The session is ended with a guided yoga nidra (yogic sleep) to help individuals with fibromyalgia relax and help get more restful sleep.
Inverted positions may draw in more blood to the head and may aggravate headaches and migraine. Asanas should be chosen accordingly.
Due to common dizziness in the fibromyalgia patients the inverted asanas are not to be practised except for supported viparita karani (legs up the wall).
Yoga poses should aim for standing balancing asanas that help build the core strength. These include the vrksasana (tree) and standing ardha pavana muktasana (wind relieving).