Effect of Supervised Yogic Intervention on Pain Status, Flexibility, and Corticomotor Excitability in Fibromyalgia Patients: A Unique Case Report

Abstract

Fibromyalgia is an idiopathic chronic widespread pain syndrome marked with specified tender points. There is no permanent cure of the disease. A 50-year-old man and his 49-year-old wife suffered from widespread pain, morning stiffness, sleep problems, and fatigue with complaints of brain fogging and forgetfulness from the past 13 and 26 years, respectively. Blood examinations were negative for rheumatic diseases; they were diagnosed with fibromyalgia. Supervised yogic intervention was administered to the couple for 4 weeks and assessed pain, flexibility, and cortical excitability before and after the intervention. Pain was assessed both objectively using quantitative sensory testing and subjectively using questionnaires. Flexibility and range of motion were assessed using the sit and reach test, Schober’s test, and goniometry. Corticomotor excitability was recorded using transcranial magnetic stimulation figure of 8 coils. Reduction in pain on the numerical rating scale and descriptors’ score was observed after yoga. There was an elevation in pressure pain thresholds, specifically at the painful areas using a digital algometer. Flexibility parameters showed an improvement in both the cases. The resting motor threshold was reduced by 2% of the maximum stimulus output; other corticomotor excitability parameters also showed some changes indicating the beneficial effect of yoga. At least 4 weeks of regular and supervised yogic intervention can harness pain relief, flexibility, and range of motion and improve corticomotor excitability in fibromyalgia patients.