Yoga Nidra for Chronic Pain

Overseen By Abigail Anderson, PT, DPT, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Central Florida

Disqualifiers: Non-English, Diabetes, Surgery, Blood disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 1 day

60 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether different types of Yoga Nidra, a guided relaxation practice, can help manage chronic pain. Participants will join one of three groups: standard Yoga Nidra, Yoga Nidra with a focus on accepting pain, or Yoga Nidra with pain acceptance and mental imagery. The trial seeks individuals who have experienced chronic pain in areas such as the neck or back for over three months, with recent pain rated at least 3 out of 10. As an unphased trial, this study provides a unique opportunity to explore innovative approaches to pain management.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Yoga Nidra is generally safe for most people. It aids in managing emotions, reducing stress, and improving sleep. Many studies have reported no unwanted or harmful effects, indicating it is well-tolerated.

When combined with pain acceptance, Yoga Nidra remains well-tolerated. Although detailed safety information is limited, using Yoga Nidra for various conditions has not raised significant safety concerns.

Adding motor imagery, the mental practice of movement, to Yoga Nidra with pain acceptance also appears safe. Studies have not identified any clear safety issues.

Overall, these methods are non-invasive and focus on guided relaxation, showing promise without major safety concerns. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Yoga Nidra techniques because they offer a unique, non-invasive approach to managing chronic pain. Unlike standard treatments, which often rely on medications like NSAIDs or opioids, Yoga Nidra is a meditative practice that induces deep relaxation and is thought to alter pain perception. The variations of Yoga Nidra being explored—including versions with pain acceptance intentions and motor imagery—aim to enhance the mind-body connection, potentially leading to better pain management without the side effects associated with traditional medications. This holistic approach could revolutionize how we think about chronic pain treatment, focusing on mental and emotional well-being alongside physical relief.

What evidence suggests that this trial's treatments could be effective for chronic pain?

Research has shown that Yoga Nidra, one of the treatments in this trial, can reduce pain and improve mood, sleep, and stress levels. Studies have also found it helps manage anxiety and depression. In this trial, participants may receive Yoga Nidra with a Pain Acceptance Intention, which involves accepting pain rather than resisting it, potentially aiding in better pain management. Another treatment arm combines Yoga Nidra with Pain Acceptance Intention and Motor Imagery, incorporating visualization techniques that might further enhance benefits by helping individuals imagine and process pain differently. Overall, these methods show promise in supporting pain management and improving quality of life. ^{2 3 4 6 7}

Who Is on the Research Team?

Abigail Anderson, PT, DPT, PhD

Principal Investigator

University of Central Florida

Are You a Good Fit for This Trial?

This trial is for individuals who have been experiencing chronic pain in areas like the neck, back, shoulder, hip, elbow, knee, wrist or ankle for over three months. Participants should rate their pain as at least a 3 out of 10 in intensity within the past day.

Inclusion Criteria

I have had chronic pain in my neck, back, or joints for over three months.

My pain level has been 3 or higher in the last day.

Exclusion Criteria

Non-English speaking

Unable to access internet or email

I do not have conditions that worsen with cold, such as high blood pressure or cold allergies.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants are randomly assigned to one of three interventions: yoga nidra, yoga nidra with pain acceptance, or yoga nidra with pain acceptance and motor imagery

1 day

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

1-2 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Yoga Nidra
• Yoga Nidra with Pain Acceptance Intention
• Yoga Nidra with Pain Acceptance Intention and Motor Imagery

Trial Overview The study compares three variations of Yoga Nidra: basic guided relaxation (Yoga Nidra Script Basic), with added focus on accepting pain (Yoga Nidra Acceptance Intention), and with both acceptance and motor imagery techniques (Yoga Nidra Acceptance Intention and Visualization).

How Is the Trial Designed?

Group I: Yoga Nidra Experimental Treatment 1 Intervention

This protocol is derived from The Origin and Clinical Relevance of Yoga Nidra (Pandi-Perumal, S. R. 2022) and is approximately 20 minutes total time.

Group II: Yoga Nidra and Pain Acceptance Intention Active Control 1 Intervention

Yoga Nidra plus a Pain Acceptance Intention.

Group III: Yoga Nidra with Pain Acceptance Intervention and Motor Imagery Active Control 1 Intervention

Yoga Nidra plus pain acceptance and motor imagery

Who Is Running the Clinical Trial?

University of Central Florida

Lead Sponsor

Trials

101

Recruited

1,191,000+

Published Research Related to This Trial

Yoga may provide small to moderate improvements in back-related function for individuals with chronic non-specific low back pain, with low-certainty evidence showing benefits at three to four months and six months after starting yoga.

However, the risk of adverse events, such as increased back pain, was found to be higher in those practicing yoga compared to non-exercise controls, indicating a need for caution in its application.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Yoga Treatment for Chronic Non-Specific Low Back Pain (2017). Whitehead, A., Gould Fogerite, S.[2019]

Yoga and meditation can significantly influence chronic pain by promoting relaxation and reducing hyper arousal in the nervous system, which helps alleviate muscle tension and improve overall well-being.

Practices like pranayama and asanas not only enhance physical health but also positively impact emotional and mental states, effectively reducing anxiety and depression associated with chronic pain, thereby improving quality of life.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perspectives on yoga inputs in the management of chronic pain. Vallath, N.[2022]

Yoga and related techniques can effectively aid in pain management by promoting self-awareness, relaxation, and improved lifestyle, which contribute to better control over pain.

The practice of yoga not only helps in physical pain relief but also enhances emotional well-being and self-acceptance, fostering independence and self-confidence in individuals dealing with pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pain management and yoga. Nespor, K.[2011]

A study involving 49 active-duty military personnel with chronic low back pain (cLBP) and/or chronic neck pain (cNP) found that both hatha and restorative yoga interventions were feasible and well-accepted, with over 90% of participants expressing enjoyment and satisfaction with the classes.

Participants who attended at least 50% of the yoga sessions experienced small to moderate improvements in pain severity, disability, and quality of life, suggesting that regular participation may enhance the effectiveness of yoga for managing chronic pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparing Types of Yoga for Chronic Low Back and Neck Pain in Military Personnel: A Feasibility Randomized Controlled Trial. Groessl, EJ., Casteel, D., McKinnon, S., et al.[2023]

An 8-week Hatha Yoga program significantly improved anxiety levels, self-compassion, and pain catastrophizing in 10 inpatients at a rehabilitation hospital, indicating its potential as a therapeutic intervention.

The study highlights the effectiveness of modified yoga practices for individuals with limited mobility, suggesting that such interventions can enhance psychological well-being and pain management in a clinical setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of a Specialized Yoga Program for Persons Admitted to a Complex Continuing Care Hospital: A Pilot Study. Curtis, K., Kuluski, K., Bechsgaard, G., et al.[2022]

A study involving 40 patients with chronic low back pain (CLBP) found that the laghu shankha prakshalana (LSP) yoga technique significantly reduced pain, disability, and anxiety while improving spinal flexibility compared to back pain specific asanas (BST).

The LSP technique was shown to be safe, with no reported adverse effects, and provided immediate benefits in managing CLBP symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of yogic colon cleansing (Laghu Sankhaprakshalana Kriya) on pain, spinal flexibility, disability and state anxiety in chronic low back pain. Haldavnekar, RV., Tekur, P., Nagarathna, R., et al.[2021]

Chronic pain and sleep disorders are interconnected, creating a cycle that can worsen both conditions, necessitating a comprehensive clinical management approach.

Effective treatment should include hygiene principles, cognitive and behavioral therapy, and medications that have both analgesic and hypnotic properties to address both pain and sleep issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Sleep disorder and pain: the good hypnotic]. Perrig, S., Espa-Cervena, K., Pépin, JL.[2018]

In a study involving 24 chronic pain patients, relaxation induction over 20 minutes resulted in significant reductions in both sensory and affective pain experiences, demonstrating its efficacy in pain management.

The control group, consisting of 22 similar patients, showed no significant changes, highlighting that the pain reduction effects were specifically due to the relaxation technique rather than other factors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changing chronic pain experience. Philips, HC.[2021]

A clinical trial involving 59 individuals with chronic low back pain showed that mindfulness meditation significantly reduced pain during evoked tests compared to a sham meditation, indicating its efficacy as a pain management strategy.

The pain relief from mindfulness meditation appears to occur through non-opioidergic mechanisms, as evidenced by reduced pain even during naloxone infusion, which blocks opioid effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The role of endogenous opioids in mindfulness and sham mindfulness-meditation for the direct alleviation of evoked chronic low back pain: a randomized clinical trial. Khatib, L., Dean, JG., Oliva, V., et al.[2023]

In a study involving four spinal cord injured patients with chronic pain, treatment focused on muscle relaxation and cognitive techniques to alter pain perception led to subjective reports of reduced pain and improved mood.

Staff observations indicated better attendance in rehabilitation programs and enhanced mood among patients, suggesting that psychological approaches can play a significant role in pain management and rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Relaxation techniques in treatment of chronic pain. Grzesiak, RC.[2011]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9033521/

The Origin and Clinical Relevance of Yoga Nidra - PMC Symptoms of mild-to-moderate anxiety and depression were significantly reduced (anxiety, P < 0.003; depression, P < 0.02) after 6 months of yoga nidra therapy ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S1744388125000209

A pilot study examining iRest yoga nidra as a mind-body ... Evidence in non-clinical samples also suggests that iRest Yoga Nidra is beneficial for reducing stress and improving mood, sleep and pain [54,55]. 2. The ...

3. karger.com karger.com/cmr/article-pdf/doi/10.1159/000549416/4462224/000549416.pdf

Yoga Nidra and Pain: A Between-, Within-Group Meta- ... The authors reported that improved pain self-management, enhanced self-efficacy, and, notably, dis-identification of persisting pain from ...

4. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1002/smi.70049

The Effects of an Online Yoga Nidra Meditation ... Recent research suggests that Yoga Nidra can support emotional regulation, stress reduction, and sleep improvement (Sharpe et al. 2021). However ...

5. liebertpub.com liebertpub.com/doi/pdf/10.1177/27683605251390728?download=true

Efficacy of Yoga Nidra in Managing Sleep Disorders Most studies reported significant improvements in key sleep parameters such as sleep onset latency, total sleep time, and sleep efficiency among participants ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12080877/

The Effects of an Online Yoga Nidra Meditation on Subjective ... Recent research suggests that Yoga Nidra can support emotional regulation, stress reduction, and sleep improvement (Sharpe et al. 2021). However ...

7. researchgate.net researchgate.net/publication/394330147_Effects_of_Yoga_Nidra_on_Physical_Mental_and_Emotional_Health_Outcomes_A_Systematic_Review_of_Randomized_Controlled_Trials

Effects of Yoga Nidra on Physical, Mental, and Emotional ... The mental outcomes indicated a decrease in anxiety and depression in 11 studies. Emotional enhancement was observed in six studies. No adverse ...