Yoga can be 'medicine' for fibromyalgia, with several studies showing benefit for pain and fatigue, but like any medicine it has to be the right type and right dosage. Yoga comes in many different styles, from very gentle and meditative to aggressively athletic.
In this article I review the science—and my personal and clinical experience—to help you choose the right form of yoga to ease fibromyalgia pain. (Spoiler alert: It is not the athletic strength-building form!) One of the biggest underlying contributors to fibromyalgia symptoms are tight and painful fascia and muscles stemming from a continually activated fight-or-flight response. In yoga, physical postures (asanas) are generally practiced in tandem with breathing techniques (pranayama) and meditation. The combination of gentle stretching and deep breathing lower the volume of the fight-or-flight response and ease tension in the muscles and surrounding fascia.
What does the research on yoga and fibromyalgia show?
Several studies show that yoga reduces pain and fatigue, and improves function, in fibromyalgia. All of these studies looked at fairly gentle styles of yoga practice
Eight weeks of Hatha yoga improved symptoms by about 30%, about the same percentage symptoms improvement seen in studies on the FDA approved medications!
A large study of the Hatha yoga style reported significant fibromyalgia pain reduction.
Women who participated in an 8-week Yoga of Awareness program—gentle poses, meditation, and breathing exercises—showed significant improvements in pain, fatigue, and mood.
What type of yoga should I choose?
When I recommend yoga to my patients, I sometimes have to do a little convincing, because patients are imagining the type of yoga that involves handstands and getting into pretzel shapes. But that is definitely not what I am recommending, and this is where choosing the right type makes all the difference. Make sure to avoid any classes that have Core, Power, Flow, or Hot in their title, as these tend to be more aggressive and intense and are an almost guaranteed flare! Instead look for classes that are gentle, slow, or restorative.
Generally, the best-tolerated forms of yoga for fibromyalgia are the gentler and slower-styles, such as Hatha, Iyengar, and Yin yoga. Hatha yoga is a gentle, basic yoga that includes stretching and breathing exercises, but no repetition of sequences of poses as seen in Flow or Vinyasa yoga. Iyengar yoga is a specialized type of Hatha yoga that is slow, methodical, and focused on correct musculoskeletal alignment in each posture, which lessens any chance of hurting yourself or generating more pain. I personally have found this precise and slow form of yoga to be a good way to build strength gently without injury or strain.
Yin yoga (also called restorative yoga) is my favorite type of yoga for fibromyalgia pain relief, since it is extremely gentle and involves primarily supported stretching poses. Yin yoga generally uses props such as pillows and bolsters to get you into a comfortable stretch where you rest for several minutes, allowing the fascia to melt and soften. In fact, Yin or Restorative yoga is essentially self-myofascial release and can be highly therapeutic for fibromyalgia. If you have never tried yoga for fibromyalgia, I highly encourage you to try Yin yoga. There are quite a few free videos on Youtube, but if at all possible it is best to start with live classes so the instructor can help guide you on how to make adjustments for your body. With Yin yoga it is really important to get just the right support so your body is comfortable and can really melt into the pose. Once you have learned the basics from a teacher and are familiar with the feeling of fascia comfortably stretching, you will be able to get a lot more from videos. When doing any yoga class—whether in person or with a video—make sure to listen to your body and skip any postures or stretches that don’t feel right for your body.