Background: Chronic pain conditions are pervasive, debilitating, and costly problems across the globe, yet medical treatments often fail to relieve the patients of pain. As a result, complementary treatments, such as yoga, are often used in an attempt to reduce pain and disability. Yoga seems to be effective in short-term relief of pain and, in some cases, helps alleviate psychological comorbidities associated with pain, such as depression and anxiety. The purpose of the current study was to evaluate the efficacy of an eight-week Forrest Yoga intervention on pain interference, pain severity, and psychological outcomes. Methods: Seventy-nine participants were randomly assigned to yoga or usual care and completed a battery of self-report assessments at baseline, mid-intervention (4-weeks), post-intervention (8-weeks), and follow-up (16-weeks). Measures of pain interference, pain severity, number of painful body parts, sensory and affective experience of pain, psychological flexibility, pain catastrophizing, fear of movement, depression and anxiety, and social support were included. Results: There were significant reductions in pain interference and activity avoidance in the yoga group compared to usual care post-intervention. Differences trended towards significance for pain severity and number of painful body parts. Compared to usual care, yoga participants showed significant early reductions in pain interference, pain severity, number of painful body parts, affective experience of pain, depression, overall fear of movement, and activity avoidance. Compared to usual care, these changes were not maintained at 16-weeks (2 months following the intervention). Conclusions: The yoga intervention provided some relief of pain and pain-related problems while the intervention was ongoing but did not provide sustained relief.

Pain interferes with people's daily lives and often limits the extent to which they can pursue goals and engages in activities that promote well-being. The present study test how optimism affects and is affected by pain interference and activity among older women. Every three months for two years, middle- and older-age women (N = 199) complete daily diaries at home for a seven-day period, reporting their daily pain, pain interference, and activity. Optimism was measured at baseline and end-of-study. Multilevel models test the between- and within-person relationships among pain, optimism, pain interference and activity. Pain best predicted pain interference and optimism best predicted activity. Accumulated activity and pain interference across the study predicted longitudinal changes in optimism over two years. Optimism may play a protective role in disruptions caused by pain, leading to decreased pain interference and increased activity. In turn, less interference and more activity feed forward into increased optimism, resulting in a cycle that enhances optimism and well-being among older women.

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Depressive symptoms are common in individuals with multiple sclerosis (MS), and are frequently exacerbated by pain; however, spiritual well-being may allow persons with MS to more effectively cope with pain-related deficits in physical and role functioning. We explored the associations between spiritual well-being, pain interference and depressive symptoms, assessing each as a potential mediator, in eighty-one patients being treated for MS, who completed self-report measures: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, Pain Effects Scale, and Center for Epidemiologic Studies Depression Scale Revised. At the bivariate level, spiritual well-being and its subscale of meaning and peace were negatively associated with depression and pain interference. In mediation models, depression was not related to pain interference via spiritual well-being, or to spiritual well-being via pain interference. Pain interference was related to depression via spiritual well-being and meaning/peace, and to spiritual well-being and meaning/peace via depressive symptoms. Finally, spiritual well-being and meaning/peace were related to depression via pain interference, and to pain interference via depressive symptoms. For patients with MS, a multi-faceted approach to treatment that includes pain reduction and promotion of spiritual well-being may be beneficial, although amelioration of depression remains a critical task.

Individuals experiencing chronic pain are at greater risk for suicidal behavior. The mechanism of action for this association is unexplored, but may involve the influence of pain on interpersonal functioning. We examined the mediating role of unsatisfied interpersonal needs on the relation between pain severity and interference, and suicidal behavior. Low income, uninsured participants completed self-report measures of pain severity and interference, thwarted interpersonal needs and suicidal behavior. Our hypotheses were partially supported; in simple mediation models, an indirect only effect existed for both thwarted belongingness and perceived burdensomeness in the relation between pain severity and pain interference and suicidal behavior. These effects did not persist in multiple mediation analyses. Our findings suggest that, for patients experiencing pain, assessment and improvement of the quantity and quality of interpersonal relationships may reduce risk for suicide ideation and attempts.

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