Yoga is effective for treating chronic pain in veterans with Gulf War Illness at long-term follow-up


Author: Santiago Allende1,2, Danielle C Mathersul3,4,5, Jay R Schulz-Heik3,6, Timothy J Avery3,7, Louise Mahoney3, Peter J Bayley3,8

Affiliation: <sup>1</sup> War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA, USA. sallende@stanford.edu.

<sup>2</sup> Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. sallende@stanford.edu.

<sup>3</sup> War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.

<sup>4</sup> School of Psychology, Murdoch University, Murdoch, WA, 6150, Australia.

<sup>5</sup> Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Murdoch University, Murdoch, WA, 6150, Australia.

<sup>6</sup> Peninsula Behavioral Health, CA, Palo Alto, 94306, USA.

<sup>7</sup> Department of Veterans Affairs, Peninsula Vet Center, Menlo Park, CA, 94025, United States of America.

<sup>8</sup> Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Conference/Journal: BMC Complement Med Ther
Date published: 2023 Sep 13
Other:
 Volume ID: 23   ,  Issue ID: 1   ,  Pages: 319   ,  Special Notes: doi: 10.1186/s12906-023-04145-y.   ,  Word Count: 274  
    Background:

Clinical Practice Guidelines for Gulf War Illness (GWI) recommend integrative health approaches such as yoga for relief from symptoms, yet little is known about the long-term efficacy of yoga in reducing symptoms of GWI. Here, we evaluated the long-term efficacy of yoga and cognitive-behavioral therapy (CBT) chronic pain treatment in a randomized controlled trial (RCT) of 75 Veterans (57 men, 42-71 ± 7.1 years of age) with Gulf War Illness (GWI).



Methods:

Participants received either 10 weeks of yoga or 10 weeks of CBT for chronic pain. The primary outcome measures were pain severity, and pain interference (Brief Pain Inventory-Short Form). The secondary outcome measures were fatigue, as indicated by a measure of functional exercise capacity (6-Minute Walk Test), depression, autonomic symptom severity, and quality of life. Piecewise linear mixed models were used to examine study hypotheses.



Results:

Compared to the CBT group, yoga was associated with greater reductions in pain severity during the 6-month follow-up period (group × time interaction: b = 0.036, se = 0.014, p = .011). Although we did not find between-group differences in the other primary or secondary outcome measures during follow-up (p's > 0.05), exploratory analyses revealed within-group improvements in pain interference, total pain (an experimental outcome variable which combines pain severity and interference), and fatigue in the yoga group (p's < 0.05) but not in the CBT group.



Conclusions:

This is the first study to report long-term follow-up results of yoga as a treatment for GWI. Our results suggest that yoga may offer long-term efficacy in reducing pain, which is a core symptom of GWI.



Trial registration:

Secondary analyses of ClinicalTrials.gov NCT02378025.



Keywords: Chronic pain; Fatigue; Gulf war illness; Long-term outcomes; Randomized clinical trial.



PMID: 37704984 DOI: 10.1186/s12906-023-04145-y