Feasibility and acceptability of an interoception-based yoga intervention for chronic pain

Chronic pain is characterized by pain persisting for longer than 3 months, affects approximately 20% of the United States adult population and is associated with significant disability, psychological distress and economic costs. In recent years, individuals with and providers for chronic pain are increasingly utilizing complementary and integrative approaches as an adjunct to pharmacological pain treatments. Among these practices, yoga, an ancient mind-body practice originally designed to help people reach self-realization, has seen the largest increase in utilization for pain management. The term ‘yoga’ encompasses a broad system of practices, of which modern yoga often falls under the umbrella of Hatha yoga that includes the combination of physical postures (asana), breathing strategies (pranayama) and meditation techniques (dhyana). In this work, we use the term yoga to refer to the Hatha system of yoga. Multiple clinical trials have demonstrated the feasibility and efficacy for yoga-based interventions on improving pain-related functioning in various chronic pain populations. However, little remains understood regarding how yoga improves pain outcomes, or which practices are useful strategies for specific pain populations. Interoception, the process of perceiving, attending to and interpreting sensations from within the body, has garnered increased interest as a potential means by which yoga may improve pain. Thus, interoceptive skills in the context of yoga for pain management will serve as the focus of this work. The studies presented in this dissertation will examine the role of interoception in mind-body practice and chronic pain. In Chapter 1, we provide a general introduction to the fields of yoga, interoception and chronic pain to inform the rest of this work. In Chapter 2, we review the scope of the emerging literature that has sought to examine the behavioral and neural correlates of interoception in relation to mind-body practices and pain, with an emphasis on identifying emerging patterns relevant to yoga-based interventions. In Chapter 3, we present our findings linking changes in self-reported interoception to improved functional clinical outcomes after interdisciplinary pain treatment, the current best practice recommendation for chronic pain management. These data are presented as a useful comparison for other modalities that seek to train interoceptive skills in chronic pain. The primary focus of this work is presented in Chapter 4 in which we examine the feasibility, acceptability and preliminary efficacy of an interoception-based yoga protocol following the kosha model from the yoga tradition on multiple dimensions of interoception and pain. In Chapter 5, we conclude by discussing future directions of this work.

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Kinesiology

Grantor

University of Illinois Urbana-Champaign

Year dc:date

2025

Author dc:creator

• Voss, Stephanie

Contributors dc:contributor

• Gothe, Neha P
• Petruzzello, Steven J
• Allen, Jacob M
• Addington, Elizabeth L
• Lehovec, Linda

• chronic pain
• yoga
• interoception

Statement dc:rights

• Copyright 2025 Stephanie Voss

Language dc:language

en, eng

Handle dc:identifier

https://hdl.handle.net/2142/129390

OAI record oai:identifier

https://www.ideals.illinois.edu/oai-pmh?verb=GetRecord&metadataPrefix=etdms&identifier=oai%3Awww.ideals.illinois.edu%3A2142%2F129390