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Mindfulness Therapy Offers Limited Fibromyalgia Relief

A new study finds modest symptom improvement with a yoga and meditation program – but experts say some should still try it.

By Jennifer Davis

1/5/11 A meditation and yoga program designed to reduce stress failed to provide significant relief for people with fibromyalgia, according to a new study in the journal Pain.

“We were surprised. We had a predecessor study where we found strong effects and we expected to find them again. What we found was only half the size of the effects we expected,” explains Stefan Schmidt, PhD, of the University Medical Center in Freiburg, Germany. But Schmidt says that his results may have been skewed by the measuring technique he used, which exhausted patients suffering from the chronic pain condition.

Schmidt’s eight-week study involved 177 women split into three groups. One group did the mindfulness program, which involved mediation and yoga exercises and learning to adopt a different attitude about life with fibromyalgia. One control group was taught relaxation and stretching exercises and another control group was put on a waiting list for treatment and not given any intervention. All three groups reported a small to medium improvement in their quality of life.

“Patients in the mindfulness group showed consistently the largest improvement in all measures, so we are quite sure that the intervention worked well. Almost all these improvements were also significant if we compared health status before the mindfulness intervention with health status after the intervention. The only thing we couldn't show was that these improvements were better than that of the control group,” Schmidt explains.

Schmidt says he thinks the monitoring system researchers used might have affected the results. Participants complained they were exhausted after wearing a vest, having their walking and breathing monitored and having to fill out lengthy questionnaires.

Stephen T. Wegener, PhD, an associate professor in the department of physical medicine and rehabilitation at The Johns Hopkins School of Medicine in Baltimore says you would hope that if a treatment were robust and effective, then reporting problems wouldn’t negate the benefits. Still, he says he wouldn’t rule out mindfulness therapy for all patients simply because this study didn’t show a blockbuster benefit.

“It may be that different treatments work for different people,” Wegener says. “Some patients have more or less pain or fatigue so it’s likely that different people will benefit from different approaches.”

He says this study may also have been hampered by the fact that participants didn’t get to pick the treatment – but instead were randomly assigned to it.

“There’s considerable literature that [shows] if people choose and get the treatment they want, they tend to have better outcomes,” Wegener says. “It may be important in a [condition] like fibromyalgia that there be more careful patient-treatment matching, particularly if we think fibromyalgia has to do with a disorder of pain perception and sensation. People’s preferences and desires and expectations will shape their sensations and perceptions.”

Wegener says patients also need to realize that just because an approach doesn’t work for everyone, doesn’t mean they shouldn’t try it.

“It may be there are particular individuals that would benefit from this approach,” Wegener says. “As part of a comprehensive treatment program, these things fit in quite well.”

Schmidt agrees. “Everybody who feels that there is no more positive development with his or her disease should try these methods. You only find out by trying and many others so far had tremendous success with this approach.”

Anita
25 Jan 2011, 19:46
I have recently been taking a mushroom supplement called Ganoderma or reishi mushroom for the past month to help with my fibromyalgia which I have had for 25 years or more. This supplement comes in a capsule, coffee, tea, or hot chocolate.I met a woman who has been taking this and her fibromyalgia symptoms are completely gone after 25 years of this disabilitating muscle disorder. I too will give it a try. I have also been involved in a Silver Sneakers program for exercise, and strength training, and water activities. I find I can only do a limited amount of activity otherwise I too suffer from more pain. It's sometimes hard to judge what is too much activity.
Medical & Theraputic uses of Mindfulness
20 Jan 2011, 05:16
Mindfulness is being used in a wide variety of setttings. Have a look at: http://www.mindfulnet.org/page10.htm

There is also alot of scientific research into it - see: http://www.mindfulnet.org/page4.htm

Research into the impact of mindfulness on fibromyalgia includes:

Astin JA, Berman BM, Bausell B, Lee WL, Hochberg M, Forys KL., The efficacy of mindfulness meditation plus Qigong movement therapy in the treatment of fibromyalgia: a randomized controlled trial, Journal of Rheumatology . 2003 Oct; 30(10):2257-62.

Goldenberg, D.L., Kaplan, K.H., Galvin-Nadeau, M., The Impact of Meditation-Based Stress Reduction Program on Fibromyalgia , General Hospital Psychiatry , 15, 284-289, 1993.

Goldenberg, D.L., Kaplin, K.H., Galvin-Nadeau, M., A Controlled Study of a Stress-Reduction, Cognitive-Behavioral Treatment Program in Fibromyalgia, Journal of Musculoskeletal Pain , 2: 53-66, 1994.

Grossman, P., Tiefenthaler-Gilmer, U., Raysz, A., & Kesper, U. (2007). Mindfulness training as an intervention for fibromyalgia: Evidence of post-intervention and 3-year follow-up benefits in well-being. Psychotherapy and Psychosomatics, 76(4), 226-233.

Kaplan, K., Goldenberg, D., & Galvin-Nadeau, M. (1993). The impact of a meditation Based stress reduction program on fibromyalgia. General Hospital Psychiatry, 15(5), 284-289.



Lush E., Salmon, P., Floyd, A., et al. (2007). Mindfulness meditation for symptom reduction in fibromyalgia: psychophysiological correlates. Annals of Behavioral Medicine, 33, Supplement 1, S107-S107.
Sephton S.E., Lynch G., Weissbecker, I., Hi, I., Salmon, P. (2001). Effects of a mediation program on symptoms of illness and neuroendocrine responses in women with fibromyalgia, Psychosomatic medicine 63:91-92.

Sephton SE , Salmon P , Weissbecker I , Ulmer C , Floyd A ,Hoover K , Studts JL ., Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: results of a randomized clinical trial, Arthritis Rheum , 2007 Feb 15;57(1):77-85.

Weissbecker, I. Salmon, P., Studts, J. L., Floyd, A. R., Dedert, E. A., & Sephton, S. E. (2002). Mindfulness-Based Stress Reduction and sense of coherence among women with fibromyalgia. Journal of Clinical Psychology in Medical Settings, 9(4), 297-307.
Mona
13 Jan 2011, 20:13
I exercise and take my med's and according to my doc's I should not be able to function with the high level of meds that I am on but that is the only way I can! But when I flare and fatigue; I can not function or think and can barely breath; at that point; I can't even think about exercise! I have to use ice for pain and than brake out pain meds and up the predizone! I could only wish that people who write article or make inappropriate comments or point out that you park in the handicap spots and I could go on; had to live a day like this! It takes a really strong will to live and I mean that! I understand why some people take their lives! Because living like this; can get to be to much for one person to handle!
dorie
13 Jan 2011, 15:32
I have to somewhat agree with Kelly. When the pain is out of control it takes over your mind as well as your body. I have not found yoga to help, in fact the positions made my fibro worse. The only thing that helps me, besides my meds (and they only help some) is exercise. In my case it is swimming. I not only feel good as I'm doing it but if I can keep to my schedule of one day on, one or two days off, I do feel some relief. Whether it is the actual exercise, the seratonin released or whatever, it does help me. I feel much worse if I don't get any exercise. Walking helps also.

I think that now that they know that it is caused by an over active nervous system, at least that's the latest I've heard, they need to really word on pain relief. I've had this pain for 12 years and it has ruined my life. I can't work, limits my volunteering and my self esteem is non-existent. Please pray for a cure.
kelly
06 Jan 2011, 14:15
what bothers me about these studies is that doctors then think that ALL fms patients can have some relief with what is really just, "learn to live with it," which is b.s. when you are in agony. maybe what i have isn't fms because it doesn't respond to anything but medication. getting my mind off it doesn't make it go away, and is impossible to achieve when it's massive pain. maybe they need to stop acting like there is a quick fix to fms -- if it really is about the body's pain signals, that's physical and requires physical relief. it's not mental. sounds like they are still saying it's all in your head and you can cure it with attitude. that kind of approach pisses me off - they used to say the same thing about depression, too.

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