Arthritis
33 Case Studies
21 Member Stories
29 Research

Does Yoga help Arthritis pain?

Having arthritis may make you feel handicapped and alone due to your unmanageable and unbearable condition. Yoga, a blend of physical exercise and mental relaxation or meditation methods, dates back more than 5,000 years to ancient India. Today, people around the world practice distinct styles of yoga on a regular basis. Among them are many people with arthritis, who find yoga heals their joints, relieves their symptoms and promotes relaxation. Recent research shows that regular yoga practice can decrease pain and improve function in people with arthritis. With its gentle stretches and weight-bearing immunity moves, yoga can help build muscle strength and improve posture and balance.Yoga presents an option without consuming any medications. Taking care of yourself in Arthritis through yoga, and dietary modifications can be a big part of treatment that will not only boost your health and immune system but will also make you feel good and happy. 


Arthritis is a chronic, disabling, long term condition that can greatly compromise many aspects of a person's life. It is a chronic inflammatory disease whose prevalence is more than 21% all over the world affecting around 47 million people. Arthritis is characterized by pain, swelling, redness, reduced quality of life, stiffness, fatigue, depression, and loss of physical function. There are 100 different forms of arthritis and related diseases and the most common type includes rheumatoid arthritis (RA), osteoarthritis (OA), psoriatic arthritis (PsA) and fibromyalgia.

Recovery of patients suffering from arthritis depends on several physical and psychological factors, besides pharmacological treatment. Generally, the treatment for arthritis involves three major modalities that include drugs (nonsteroidal anti-inflammatory drugs) and disease-modifying osteoarthritis drugs, nonpharmacological interventions (including exercise, weight loss, education, and physical therapy), and surgical interventions.


There are several hundred scientific trials have been published on yoga in major medical journals. [1-5] They verify that yoga is a safe and effective method to improve physical activity that also has significant psychological benefits because of its meditative nature. Just like other forms of exercise, yoga can increase muscle strength, improve flexibility, improve respiratory endurance, and enhance equilibrium. Yoga can also be correlated with greater vitality and fewer bodily aches and pains.[6] Ultimately, yoga is associated with enhanced stress, depression, and emotional strain. In summary, yoga is related to a wide assortment of physical and mental benefits which may be especially beneficial for persons living with a chronic illness.

What are the benefits of doing Yoga for arthritis?

Yoga as an alternative management for arthritis is becoming increasingly popular, where it can help ameliorate chronic pain conditions like arthritis. Mind-body interventions like yoga are found to be beneficial for decreasing both acute and chronic stress levels in conditions in various types of arthritis. Yoga exercise for arthritis increases flexibility and muscle strength, physical balancing, improves fitness and relieves pain.


Yoga for rheumatoid arthritis and various other types of arthritis can benefit the whole body by reducing distress, lowering blood pressure, and by regulating metabolism. There are many traditional paths of yoga, which include bhakti, tantra, kundalini, mantra, jnana, karma, raja yoga, and others, all of which have their own techniques to awaken these connections. Yoga is proved to be effective in stress and arthritis. Some studies show that practicing yoga can decrease the stress level by downregulating the levels of cortisol and upregulating the levels of serotonin, dopamine, and endorphins all of which are useful in reducing pain and swelling.  Yoga improves the levels of multiple immune globulins and natural killer cells by decreasing the inflammatory markers such as C-reactive protein and other inflammatory cytokines in the blood that are known to regulate inflammation in arthritis.

Recent research has also shown that those who practice yoga regularly have higher levels of leptin and adiponectin in their bodies; both of these natural chemicals are known to work together to alleviate inflammation in the body.


Physical activity is a vital part of the successful treatment of osteoarthritis (OA) and rheumatoid arthritis (RA), according to treatment guidelines released by the American College of Rheumatology. In men with osteoarthritis, exercise is safe and doesn't exacerbate pain or aggravate disease.In reality, exercise may play an integral role in promoting joint health, because people who don't exercise often suffer more joint distress than those who do.16 The health and psychological benefits of exercise are widely known.However, regular physical activity is particularly important for those who have arthritis, who frequently have diminished muscle strength, physical vitality, and endurance, in part because of their arthritis and the inclination to be sedentary.Being sedentary can started a downward spiral in which pain increases, resulting in more inactivity which contributes to greater pain and impairment. The emotional benefits of exercise like stress reduction, fewer depressive symptoms, improved working and well-being and improved immune function also lead to greater overall health [7]

What Yoga Asanas are best for Arthritis?

It's always best to work with a yoga expert knowledgable in arthritis. These are some poses that are good for arthritis.

1.       Bridge pose - Bridge pose is a safe and rejuvenating yoga posture for beginners. Lie down in a supine position on the floor, then bend your knees, while keeping your feet on the floor, then, slowly lift your buttocks or hips toward your belly button off the floor until your thighs are about parallel to the floor.

Benefits - It helps relieve knee pain, back pain, stretches and strengthens the front and back of the  body.

2.       Childs pose

For relieving back pain and calming the mind, spend some time in Child's pose. Kneel with both the knees directly under your hips on the mat and feet toes pointing behind you with the big toes touching each other. Keep your hands straight on the mat, or folded under your forehead. Child’s pose is also found to be an effective yoga therapy for rheumatoid arthritis patients.

Benefits – Help relieve pain in your back, knees and calms your mind.

3.       Tree pose

It is one of the easiest poses that involve standing and putting all the body weight on one leg while keeping the other foot on the shin bone of the standing leg. You can keep your arms folded in front of your chest, or move them upwards in the air. Repeat the same with the other leg.

Benefits:  Tones and strengthens the muscles, knees and hip joints, and improve your balance.

4.       Supine twisting

It is a stomach revolving posture where you lie on your back, draw your one knee toward your chest, and bend it cross outside of the opposite foot on top of it. Do not lift your shoulders and keep it rooted to the earth. Extend your hand outside opposite to the bent knee and gaze toward the hand. Hold and breathe into the twist, and then switch to the other side. 

Benefit: Massages the spine, releases stress and strengthens the legs while stretching the hamstrings. Also, it provides relief from pain and stiffness caused due to arthritis.

5.       Pelvic tilt

Lie on your back with your knees bent and the soles of your feet touching the floor. Take a deep breath, lift your tailbone and buttocks slightly while exhaling, and hold it for a few minutes. Inhale as you relax into the floor.

Benefits: The pelvic tilt helps cope up with balance problems, strengthens the muscles in the back and the knee.

Yoga comes in many different forms and involves different postures that are coordinated with breathing and meditation exercises. Self-help by means of dietary interventions and yoga exercises can help in the management of different forms of arthritis including rheumatoid arthritis. Dietary interventions like a gluten-free vegan diet, followed by a lactovegetarian diet, and the daily practice of yoga have proven its effectiveness in reducing joint pain, improving joint flexibility and function and lowering the levels of stress and tension to promote better sleep in patients with Rheumatoid arthritis.

Scientific Studies in Yoga for Arthritis

1. Yoga for managing knee osteoarthritis in older women: a pilot randomized controlled trial.[8].


In this study, 36 Eligible participants suffering from Knee osteoarthritis were randomly assigned to an 8-week yoga program involving group and home-based sessions or wait-list control. The yoga intervention program was composed of one 60-minute Hatha yoga session which included asanas (poses) in the seated, supine, and standing positions, pranayama (breathing); and meditation. Only one session was conducted in a week that lasted for eight weeks.

The primary outcome measures included measuring knee OA pain, stiffness, and function. Whereas, the secondary outcomes evaluated the physical function of the lower extremities, body mass index (BMI), quality of sleep (QOS), and quality of life (QOL). Data were collected at baseline, 4 weeks, 8 weeks, and 20 weeks. The results showed participants in the treatment group exhibited significantly greater improvement in WOMAC pain, stiffness, and repeated chair stands at 8 weeks and 20 weeks when compared to 4 weeks of treatment. Sleep disturbance was found to be improved, however, the PSQI total score at 20 weeks declined significantly.


2. A Yoga Strengthening Program Designed to Minimize the Knee Adduction Moment for Women with Knee Osteoarthritis: A Proof-Of-Principle Cohort Study.[9].

In this study, forty-five women over age 50 with symptomatic knee osteoarthritis, were enrolled in a 12-week (3 sessions per week) customized yoga program. Yoga program included postures like squats (different feet positions); lunges (different feet and arm positions) supported lunges; and transitions from standing to and from standing, sitting, and lying. Quadriceps strengthening, postures including supine bridges and heel raises were incorporated to target the hamstrings and ankle plantar flexors respectively. All the participants completed stretches focusing on hip, knee and ankle musculature in supine.

Primary outcome measures included self-reported pain and physical function and knee strength. Secondary measures included mobility (six-minute walk, 30-second chair stand, stair climbing), fitness (submaximal cycle ergometer test), and clinical gait analysis using motion capture synchronized with electromyography and force measurement.

At the end of the 12-week program, during the follow-up, participants experienced reduced pain, increased knee extensor strength, and increased flexor compared to baseline. The secondary outcome measures were also improved with increased mobility on the six-minute walk when compared to baseline. Overall, the proposed program may be useful in improving pain, strength, and mobility in women with knee osteoarthritis.

Summary

Yoga is the union of mind and spirit that brings balance to the body and promotes healing. The most common forms of yoga for arthritis involve the Hatha yoga which is a part of Iyengar Yoga. Yoga has proved its theoretical efficacy in reducing both physiological and psychological comorbidities associated with arthritis-like pain and stiffness. Yoga can help realign the skeletal structure, strengthen the muscles around the joints, at the cellular level and may reduce fluid pressure. All of these aspects of Yoga are found to improve strength, balance, flexibility, and relaxation in the general adult population. Yoga is currently recommended along with conventional treatment to promote joint flexibility and lower stress that can potentially benefit individuals with arthritis in general. To sum up, yoga can be a meaningful and enjoyable alternative to traditional types of exercise like aerobics or aquatic exercise with significant health benefits. Yoga can play an significant role in reducing tension and frustration that leads to pain and disability, and increasing positive feelings and health . Drug treatments for OA and RA have improved markedly in the past couple of years. Despite this, arthritis can't be cured, as well as the best medications and medical care can only help so much. There's a great demand for extra activities patients can do to decrease pain, disability, and take charge of the general impact arthritis might have in their lives. Therefore, the evidence indicates that, when coupled with a program of good medical care, yoga can provide significant additional physical and mental health benefits for arthritis patients. 

References

References

1. Jeter PE, Slutsky J, Singh N, Khalsa SBS. Yoga as a Therapeutic Intervention: A Bibliometric Analysis of Published Research Studies from 1967 to 2013. J Altern Complement Med. 2015;21(10):586-592. doi:10.1089/acm.2015.0057.

2. Moonaz SH, Bingham CO, Wissow L, Bartlett SJ. Yoga in Sedentary Adults with Arthritis: Effects of a Randomized Controlled Pragmatic Trial. J Rheumatol. 2015;42(7):1194-1202. doi:10.3899/jrheum.141129.

3. Madanmohan, Thombre DP, Balakumar B, et al. Effect of yoga training on reaction time, respiratory endurance and muscle strength. Indian J Physiol Pharmacol. 1992;36(4):229-233. http://www.ncbi.nlm.nih.gov/pubmed/1291472. Accessed March 21, 2018.

4. Schell FJ, Allolio B, Schonecke OW. Physiological and psychological effects of Hatha-Yoga exercise in healthy women. Int J Psychosom. 1994;41(1-4):46-52. http://www.ncbi.nlm.nih.gov/pubmed/7843867. Accessed March 21, 2018.

5. Gauchard GC, Jeandel C, Tessier A, Perrin PP. Beneficial effect of proprioceptive physical activities on balance control in elderly human subjects. Neurosci Lett. 1999;273(2):81-84. http://www.ncbi.nlm.nih.gov/pubmed/10505621. Accessed March 21, 2018.

6. Miller JJ, Fletcher K, Kabat-Zinn J. Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. Gen Hosp Psychiatry. 1995;17(3):192-200. http://www.ncbi.nlm.nih.gov/pubmed/7649463. Accessed March 21, 2018.

7. https://www.hopkinsarthritis.org/patient-corner/disease-management/yoga-for-arthritis/      Steffany Moonaz, PhD RYT500, Susan J. Bartlett, PhD, and Clifton O. Bingham III, MD Edited by Dana DiRenzo, MD 3/21/18 

8. Wood C. Mood change and perceptions of vitality: a comparison of the effects of relaxation, visualization and yoga. J R Soc Med. 1993;86(5):254-258. http://www.ncbi.nlm.nih.gov/pubmed/8505745. Accessed March 21, 2018.

9.       Cheung C1, Wyman JF, Resnick B, Savik K. Yoga for managing knee osteoarthritis in older women: a pilot randomized controlled trial.1. BMC Complement Altern Med. 2014 May 18;14: 160.

10.       Elora C. Brenneman., Alexander B. Kuntz., Emily G. Wiebenga, and Monica R. Maly. A Yoga Strengthening Program Designed to Minimize the Knee Adduction Moment for Women with Knee Osteoarthritis: A Proof-Of-Principle Cohort Study. PLoS One. 2015; 10(9): e0136854.

11.   https://www.doyouyoga.com/asana-for-arthritis-91837/

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