Interoception-Based Yoga for Chronic Pain: A Pilot Feasibility Study.

Abstract

Chronic pain has been linked to increased awareness of but decreased accuracy in detecting internal sensations. Interoception, the sense of signals from inside the body, may be a therapeutic target to improve pain. No studies have examined the feasibility of targeting interoceptive skills within a yoga intervention for chronic pain - where direct engagement with challenging sensations may be difficult - or whether yoga improves any measure of interoception among persons with chronic pain. The primary aim was to determine the feasibility and acceptability of a 6-week interoception-based yoga intervention in a population of mixed chronic pain. The second aim was to examine the preliminary effectiveness on 2 measures of interoception (interoceptive sensibility and interoceptive accuracy), pain and psychosocial outcomes. This was a single-arm feasibility study. Primary outcomes were feasibility and acceptability. Secondary outcomes included self-report measures of interoceptive sensibility (Multidimensional Assessment of Interoceptive Awareness, Version 2), pain intensity, pain interference, mindfulness, spiritual well-being and physical and mental health-related quality of life. Interoceptive accuracy was assessed with heartbeat counting. All measures were collected at baseline and after 6 weeks. The 6-week interoception-based yoga intervention demonstrated feasibility and high acceptability in a sample of mixed chronic pain. Twenty-six participants consented, 24 started the intervention (mean age 42.5 years, 75% female) and 19 (79%) completed 6-week post-intervention testing. The average attendance rate was 69%. There were no serious adverse events and acceptability ratings were high (>5/7). While not powered to make conclusions, preliminary analyses revealed a statistically significant increase in interoceptive sensibility and interoceptive accuracy, and reduction in pain (p's < .05). There were no correlations between the 2 measures of interoception. The intervention appears feasible and acceptable and shows promise for improving pain and multiple dimensions of interoception, especially those involved in consciously attending to the body. Future studies examining the efficacy of interoception-oriented yoga interventions for chronic pain are warranted. NCT06268197 Registered February 12, 2024.