Updated February 04, 2015.
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Yoga, which means "to yoke or to unite", originated in ancient India. The practice focuses on unifying and harmonizing the mind, body, and spirit. Yoga remained an Eastern practice that focused primarily on spiritual enlightenment until after World War I when interest in it began to shift west. But, it was actually after World War II when yoga became increasingly popular as a fitness routine. Yoga teacher Richard Hittleman was credited with introducing yoga to a large audience in the United Kingdom through his television programs in the 1960s and 1970s.
Now, yoga classes are readily available, as are books, DVDs, and websites created by numerous teachers and experts.
With growing interest in yoga in western countries came a greater awareness of its potential physical health benefits. Yoga no longer was simply a spiritual practice. It become part of holistic medicine -- a branch of alternative or complementary medicine that integrates the mind and body for the purpose of treating the whole person, not just a disease or condition. Arthritis is included in the list of chronic diseases that may be helped by yoga, physically and psychologically. Let's look more closely at the different types of yoga, the potential benefits for people with arthritis, and what scientific trials have concluded.
Types of Yoga
There are two main aspects to yoga: pranayama (breathing) and asanas (postures). While several misconceptions are connected to the practice of yoga suggesting it requires nearly impossible flexibility, you need to know that there are several types of yoga with varying levels of difficulty.
It makes sense that gentler, easier, doable types of yoga would be of greater interest to people living with joint pain, joint stiffness, and physical limitations associated with arthritis. According to information provided by Johns Hopkins, types of yoga recommended for most arthritis patients include:
Ananda - gentle; prepares you for meditation; affirmations in combination with poses
Anusara - anatomically-based (alignment); focuses on opening the heart.
Integral - gentle, includes poses, breathing, chants, meditation while integrating mind, body, and spirit
Iyengar - focuses on alignment of poses; uses props
Stage one of Kripalu - stage one focuses on learning poses, meditation, and understanding the body for physical healing
Sivananda - gentle and slow, includes poses, breathing, chants, meditation
Viniyoga (private lessons) - individualized, with coordinated breathing and movement, focusing on adaptation
Chair Yoga - modified poses that can be done in a seated position
Johns Hopkins does not recommend the following types of yoga for people with arthritis: Ashtanga, Bikram, and Kundalini.
Scientific Studies of Yoga for Arthritis
Numerous studies to evaluate the beneficial effects of yoga on rheumatoid arthritis or osteoarthritis are lacking. But, there are some, which serve to supplement the anecdotal evidence which exists.
According to the Journal of Evidence-Based Complementary & Alternative Medicine (2014), a systematic search of studies from 2010 to June 2013 was performed to assess whether yoga was an effective approach for managing arthritis. Nine studies were found to meet inclusion criteria for the analysis -- 5 from the United States and 4 from India. Six of the 9 studies showed evidence of positive changes in psychological and physiological outcomes associated with arthritis.While those are promising results, it must be noted that there were problems with the studies: not all studies used randomized, controlled design, some had small sample size, different outcomes were evaluated, and yoga interventions were non-standardized.
Study results from a Hatha yoga exercise program for managing osteoarthritis in older women with knee osteoarthritis was published in BMC Complementary and Alternative Medicine (2014). Researchers concluded that a weekly yoga program with home practice is "feasible, acceptable, and safe" for older women with knee osteoarthritis. Improvements occurred in pain, stiffness, sleep disturbance, and repeated chair stands at 8 weeks.
According to a report published in Rheumatology (Oxford 2013), randomized, controlled trials comparing yoga to control interventions in patients with rheumatic diseases were assessed. Eight trials involving 559 subjects were included in the analysis which found: low evidence for effects of yoga on pain and low evidence of effects on disability in two trials for fibromyalgia; very low evidence for effects of yoga on pain and disability in three trials for osteoarthritis; very low evidence for effects of yoga on pain in two trials for rheumatoid arthritis; no evidence of effects on pain in one trial for carpal tunnel syndrome. Researchers concluded they could only make weak recommendations for yoga as an ancillary therapeutic approach for these conditions.
In the Clinical Journal of Pain (2013), the impact of Iyengar yoga twice a week for 6 weeks on Health Related Quality of Life compared to usual care was assessed in young adults with rheumatoid arthritis. Researchers determined that there was significantly greater improvement on Health Related Quality of Life, pain disability, mood, and fatigue in the yoga group.
In Rheumatic Disease Clinics of North America (2011), a review of studies published from 1980 to 2010 focusing of yoga as an intervention for arthritis, identified 11 studies for consideration - 4 randomized, controlled trials and 4 non-randomized, non-controlled. Researchers concluded that evidence was strongest for reducing symptoms (tender joints, swollen joints, pain) and disability, and for improved self-efficacy and mental health.
Chair yoga was evaluated in a group of community-dwelling, older adults with osteoarthritis and results were published in the Journal of Gerontological Nursing (2012). Chair yoga was found to be effective for improving physical function and reducing stiffness, but was not effective for reducing pain, nor for improving symptoms of depression.
Interested? Looking for a Yoga Class?
The Yoga Alliance website provides a list of certified yoga instructors in your region. You can contact an instructor to inquire about yoga classes or private instruction. You can also search online for yoga studios in your area. Beginner or gentle yoga classes are often offered at local YMCAs, local gyms or health clubs, senior centers, or community centers as well.
Wherever you decide to go, meet with the instructor to discuss your condition, physical limitations, and goals. Let the instructor get to know you, so that he or she can help you meet your expectations.
Make sure you know the type of yoga practiced in the class, if your instructor is certified, and the level of difficulty of a particular class. You can ask if the instructor has experience teaching people with arthritis or if a class is available that teaches modified poses for people with limitations.
The Bottom Line
There is enough evidence in clinical trials to suggest that yoga may benefit some people with arthritis and serve as an ancillary approach to help manage the disease. However, the studies have not been structured in a way that could define what type of yoga is most effective or the optimal setting or optimal duration for yoga. If you are interested, connect with an instructor who can make recommendations for you. Learn from a qualified instructor. See how yoga fits into your lifestyle. Experience it.
Yoga for Arthritis. Steffany Haaz MFA, RYT. Johns Hopkins. 6/23/2009.
Yoga as an alternative and complementary approach for arthritis: a systematic review. Sharma M. Journal of Evidence-Based Complementary & Alternative Medicine. January 2014.
Yoga for managing knee osteoarthritis in older women: a pilot randomized controlled trial. Cheung C et al. BMC Complementary and Alternative Medicine. May 2014.
Yoga for rheumatic diseases : a systematic review. Rheumatology (Oxford). Cramer H. et al. November 2013.
Impact of Iyengar yoga on quality of life in young women with rheumatoid arthritis. Evans S. et al. Clinical Journal of Pain. Novemeber 2013.
Chair yoga: benefits for community-dwelling older adults with osteoarthritis. Parl J. et al. Journal of Gerontological Nursing. May 2012.
Yoga for arthritis: a scoping review. Haaz S. et al. Rheumatic Disease Clinics of North America. February 2011.
Alternative Answers to Arthritis & Rheumatism. Anne Charlish. Reader's Digest. Yoga. Page 44-45. Copyright 1999.