Effectiveness of yoga as an adjunctive intervention for alleviating symptoms of fibromyalgia a narrative review

Authors

DOI:

https://doi.org/10.12775/QS.2026.56.72563

Keywords

fibromyalgia, yoga, mind-body therapy, chronic widespread pain, complementary therapy, minimal clinically important difference

Abstract

Background. Fibromyalgia is a chronic syndrome characterized by widespread musculoskeletal pain, fatigue, sleep disturbance, cognitive complaints, and psychological distress. Pharmacological options have only modest effect sizes and are limited by adverse events. The 2017 revised European Alliance of Associations for Rheumatology (EULAR) recommendations gave a strong-for recommendation only to aerobic and strengthening exercise. Yoga, integrating physical postures, breath regulation and meditative attention, has been proposed as an adjunctive intervention.

Aim. To synthesize PubMed-indexed evidence on whether yoga, used as an adjunct to standard care, has a clinically meaningful effect on symptoms of fibromyalgia.

Material and methods. PubMed was searched up to April 2026 for randomized controlled trials (RCTs), pilot controlled trials, single-arm pilots and systematic reviews or meta-analyses on yoga in adults with fibromyalgia. Findings were interpreted against published MCID thresholds.

Results. Two randomized controlled trials with active wait-list comparison, one randomized between-group comparison, several uncontrolled or single-arm pilots and five systematic reviews informed the synthesis. The Yoga of Awareness RCT reported a 31.4% improvement in FIQR total at end of an 8-week intervention, with reductions in pain, fatigue, and pain catastrophizing. Other trials reported smaller or mixed effects. Adverse events were uncommon and mild.

Conclusions. The available evidence is limited to a small number of RCTs and several uncontrolled pilots, almost exclusively in women. Within this restricted evidence base, supervised gentle yoga programmes appear safe and may produce reductions in fibromyalgia impact and pain that approach or exceed published MCID thresholds. Yoga should therefore be considered an adjunct within a multimodal approach in which exercise remains the primary non-pharmacological intervention, not a substitute for guideline-recommended care.

References

1. Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nature Reviews Rheumatology. 2020;16(11):645-660. https://doi.org/10.1038/s41584-020-00506-w. PMID: 33024295.

2. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Häuser W, Katz RL, Mease PJ, Russell AS, Russell IJ, Walitt B. 2016 revisions to the 2010/2011 fibromyalgia diagnostic criteria. Seminars in Arthritis and Rheumatism. 2016;46(3):319-329. https://doi.org/10.1016/j.semarthrit.2016.08.012. PMID: 27916278.

3. Heidari F, Afshari M, Moosazadeh M. Prevalence of fibromyalgia in general population and patients, a systematic review and meta-analysis. Rheumatology International. 2017;37(9):1527-1539. https://doi.org/10.1007/s00296-017-3725-2. PMID: 28447207.

4. Wolfe F, Walitt B, Perrot S, Rasker JJ, Häuser W. Fibromyalgia diagnosis and biased assessment: sex, prevalence and bias. PLoS One. 2018;13(9):e0203755. https://doi.org/10.1371/journal.pone.0203755. PMID: 30212526

5. Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, Häuser W, Fluß E, Choy E, Kosek E, Amris K, Branco J, Dincer F, Leino-Arjas P, Longley K, McCarthy GM, Makri S, Perrot S, Sarzi-Puttini P, Taylor A, Jones GT. EULAR revised recommendations for the management of fibromyalgia. Annals of the Rheumatic Diseases. 2017;76(2):318-328. https://doi.org/10.1136/annrheumdis-2016-209724. PMID: 27377815.

6. Bidonde J, Busch AJ, Schachter CL, Overend TJ, Kim SY, Góes SM, Boden C, Foulds HJA. Aerobic exercise training for adults with fibromyalgia. Cochrane Database of Systematic Reviews. 2017;6(6):CD012700. https://doi.org/10.1002/14651858.CD012700. PMID: 28636204.

7. Steen JP, Kannan V, Zaidi A, Cramer H, Ng JY. Mind-body therapy for treating fibromyalgia: a systematic review. Pain Medicine. 2024;25(12):703-737. https://doi.org/10.1093/pm/pnae076. PMID: 39093008.

8. Theadom A, Cropley M, Smith HE, Feigin VL, McPherson K. Mind and body therapy for fibromyalgia. Cochrane Database of Systematic Reviews. 2015;2015(4):CD001980. https://doi.org/10.1002/14651858.CD001980.pub3. PMID: 25856658.

9. Carson JW, Carson KM, Jones KD, Bennett RM, Wright CL, Mist SD. A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia. Pain. 2010;151(2):530-539. https://doi.org/10.1016/j.pain.2010.08.020. PMID: 20946990.

10. Carson JW, Carson KM, Jones KD, Mist SD, Bennett RM. Follow-up of Yoga of Awareness for fibromyalgia: results at 3 months and replication in the wait-list group. The Clinical Journal of Pain. 2012;28(9):804-813. https://doi.org/10.1097/AJP.0b013e31824549b5. PMID: 22751025.

11. Kumar A, Kumar U, Yadav RK, Singh A, Venkataraman S, Khan MA, Bhatia R. Role of Medical Yoga Therapy in Attenuating Pain and Corticomotor Plasticity in Fibromyalgia Patients: A Randomized Controlled Trial. International Journal of Yoga. 2025;18(3):293-300. https://doi.org/10.4103/ijoy.ijoy_41_25. PMID: 41743303

12. da Silva GD, Lorenzi-Filho G, Lage LV. Effects of yoga and the addition of Tui Na in patients with fibromyalgia. Journal of Integrative and Complementary Medicine. 2007;13(10):1107-1113. https://doi.org/10.1089/acm.2007.0615. PMID: 18166122.

13. Curtis K, Osadchuk A, Katz J. An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness, and changes in cortisol levels in women with fibromyalgia. Journal of Pain Research. 2011;4:189-201. https://doi.org/10.2147/JPR.S22761. PMID: 21887116.

14. Lazaridou A, Koulouris A, Devine JK, Haack M, Jamison RN, Edwards RR, Schreiber KL. Impact of daily yoga-based exercise on pain, catastrophizing, and sleep amongst individuals with fibromyalgia. Journal of Pain Research. 2019;12:2915-2923. https://doi.org/10.2147/JPR.S210653. PMID: 31802932.

15. Hennard J. A protocol and pilot study for managing fibromyalgia with yoga and meditation. International Journal of Yoga Therapy. 2011;21:109-121. https://doi.org/10.17761/ijyt.21.1.ah8r9t4x57p6247p. PMID: 22398352.

16. Carson JW, Carson KM, Jones KD, Lancaster L, Mist SD. Mindful Yoga pilot study shows modulation of abnormal pain processing in fibromyalgia patients. International Journal of Yoga Therapy. 2016;26(1):93-100. https://doi.org/10.17761/1531-2054-26.1.93. PMID: 27797669.

17. Langhorst J, Klose P, Dobos GJ, Bernardy K, Häuser W. Efficacy and safety of meditative movement therapies in fibromyalgia syndrome: a systematic review and meta-analysis of randomized controlled trials. Rheumatology International. 2013;33(1):193-207. https://doi.org/10.1007/s00296-012-2360-1. PMID: 22350253.

18. Lauche R, Cramer H, Häuser W, Dobos G, Langhorst J. A systematic overview of reviews for complementary and alternative therapies in the treatment of the fibromyalgia syndrome. Evidence-Based Complementary and Alternative Medicine. 2015;2015:610615. https://doi.org/10.1155/2015/610615. PMID: 26246841.

19. Cramer H, Lauche R, Langhorst J, Dobos G. Yoga for rheumatic diseases: a systematic review. Rheumatology (Oxford). 2013;52(11):2025-2030. https://doi.org/10.1093/rheumatology/ket264. PMID: 23934220.

20. Durusoy E, Ünal E. The role of yoga as mind-body exercise in fibromyalgia management: a systematic review. Complementary Therapies in Medicine. 2025;95:103290. https://doi.org/10.1016/j.ctim.2025.103290. PMID: 41176184.

21. Bennett RM, Bushmakin AG, Cappelleri JC, Zlateva G, Sadosky AB. Minimal clinically important difference in the fibromyalgia impact questionnaire. The Journal of Rheumatology. 2009;36(6):1304-1311. https://doi.org/10.3899/jrheum.081090. PMID: 19369473.

22. Bennett RM, Friend R, Jones KD, Ward R, Han BK, Ross RL. The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties. Arthritis Research and Therapy. 2009;11(4):R120. https://doi.org/10.1186/ar2783. PMID: 19664287.

23. Tashjian RZ, Deloach J, Porucznik CA, Powell AP. Minimal clinically important differences (MCID) and patient acceptable symptomatic state (PASS) for visual analog scales (VAS) measuring pain in patients treated for rotator cuff disease. Journal of Shoulder and Elbow Surgery. 2009;18(6):927-932. https://doi.org/10.1016/j.jse.2009.03.021. PMID: 19535272.

Quality in Sport

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2026-05-30

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DANIEK, Justyna, KRĘCINA, Filip, KACZMAREK, Weronika, FITZ, Emilia, BRZEŹNIAK, Mikołaj, GIL, Kacper, DRELICH, Krzysztof, KARBOWNICZEK, Aleksander, MOKRACKA, Julia and GRABARCZYK, Alicja. Effectiveness of yoga as an adjunctive intervention for alleviating symptoms of fibromyalgia a narrative review. Quality in Sport. Online. 30 May 2026. Vol. 56, p. 72563. [Accessed 31 May 2026]. DOI 10.12775/QS.2026.56.72563.

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Vol. 56 (2026)

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Medical Sciences

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Copyright (c) 2026 Justyna Daniek, Filip Kręcina, Weronika Kaczmarek, Emilia Fitz, Mikołaj Brzeźniak, Kacper Gil, Krzysztof Drelich, Aleksander Karbowniczek, Julia Mokracka, Alicja Grabarczyk

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