Pilates and Yoga for Chronic Pain
Exercise is a crucial component to optimally
managing fibromyalgia symptoms. However, exercise as it is
commonly prescribed, often results in a flare of pain, fatigue,
poor sleep and low mood. Two recent studies report that the
average 40 y/o with fibromyalgia has fitness findings expected
for a healthy 80 y/o. The good news is that the spiral of
deconditioning can be reversed without inducing a symptom flare.
The fibromyalgia research team at OHSU are pain researchers and
clinicians who have developed and tested multiple exercise
programs for people with chronic pain and fibromyalgia over the
last 3 decades. We film real patients completing the exercise
routines and offer them to you for home exercise on DVD. Our
latest DVD is Pilates and yoga.
Five research studies, including one from our
team, support modified Pilates and/or yoga for fibromyalgia.
Over 25 studies in other chronic pain conditions support Pilates
and/or yoga. Pilates was developed by Joseph Pilates early in
the 20th century as a means of rehabilitation and
strengthening, originally for injured dancers and athletes.
method seeks to develop controlled movements from a strong
“core”—the abdomen, lower and upper back, hips, buttocks, and
inner thighs, also called the “powerhouse”. All movements begin
from the center and flow outward to the limbs, following the
principle that energy originating from the center should
coordinate movement of the extremities. Hence, Pilates is
referred to as “controlled movement from a strong core”. The
method, as tested and demonstrated in the DVD, is a home-based
mat routine, meaning that expensive equipment is not required.
The exercises are performed by sitting in a chair, standing or
lying on a mat. Research has demonstrated the following benefits
of Pilates in fibromyalgia and chronic pain: reduction in back
and tender point pain, improved mood and sleep quality, reduced
body fat, and an overall improvement in fibromyalgia symptom
severity and physical function. Pilates is philosophically
congruent with many ancient traditions of yoga and thus they are
often taught together.
The Sanskrit word yoga means “union” - the
union of mind and body in awareness. When someone has chronic
pain, sometimes the mind and body struggle against each other in
fruitless attempt to ignore or reduce pain.
Yoga is a mind/body discipline that over several
millennia had been practiced primarily for the purpose of
deepening and broadening one’s awareness - especially awareness
of personal choices contributing to mental and physical
wellbeing vs. suffering . Historically, meditation has been the
primary yoga practice for developing such awareness. In recent
decades, however, as the physical exercises of yoga have become
popularized in Western countries, the term “yoga” has largely
become identified with this single practice. Nonetheless,
meditation, breathing exercises, and other strategies to enhance
awareness remain central to the traditional practice of yoga.
The yoga poses in our DVD are modified, gentle versions of
physical poses, strong emphasis is placed on meditation,
breathing exercises, and principles of yoga philosophy. The
practice targets pain (eg, specific breathing techniques),
fatigue and sleep disturbance (eg, “yogic sleep” meditation),
and emotional distress (eg, calming fear of pain by briefly
observing pain sensations to see if they shift). Practicing
gentle stretching, strengthening and relaxation offered in the
Pilates/yoga DVD will help improve your ability to move
throughout the day with less pain and fatigue.
yoga is a generally beneficial and gentle therapeutic modality,
some poorly trained yoga instructors may demand unrealistic
poses for their students, especially those who are more elderly
or suffering from arthritis or fibromyalgia etc. Then there are
some novice students, the "aggressive over-achievers", who do
harm to themselves by trying to do too much too soon.