In the 2017 National Health Interview Survey (NHIS) the number of American adults participating in yoga grew from 9.5% in 2012 to 14.3% in 2017. There’s Bikram, Hatha, Iyengar, and yes, even goat yoga. It can be overwhelming trying to decide if yoga is right for you. You may even question if it’s safe or you may have a health condition and are wondering if you can still attempt yoga. People practice yoga for many different reasons like health and wellness, specific conditions such as a musculoskeletal injury, or because a health care provider recommended it. The most common reasons people practice yoga is for stress management, back pain, and arthritis. 

Is it safe? 
Yoga typically incorporates various body postures (asanas) in a sequence, in addition to breathing techniques (pranayama) and meditation (dyana). There is always a risk of injury with any kind of physical activity; and with yoga, minor sprains and strains are possible. You should always inform the instructor of any current injuries or conditions so that poses can be modified. Yoga is all about your practice and therefore it will vary from day to day or even morning to evening. It’s important to listen to your body and go at your pace, especially when first starting. 

What does science say about…

Low back pain and Yoga: 
Back pain is the number one reason individuals seek alternative forms of treatment. In 2017, the American College of Physician (ACP) released recommendations on chronic low back pain that state “clinicians and patients should initially select non-pharmacological treatment with exercise,” which includes not only a multidisciplinary approach, but mindfulness, spinal manipulation, and yoga.

Based on the 2017 ACP guidelines, low quality evidence showed that Iyengar yoga moderately reduced pain compared to usual care at 24 weeks and compared to exercise it only mildly decreased pain. Iyengar yoga typically incorporates the use of props such as chairs, blocks, blankets, etc. so that poses can be modified. 

In a 2011 randomized trial comparing yoga, stretching, and a self-care book, both yoga and stretching were found to be more effective than a self-care book in improving function and decreasing symptoms up to 26 weeks.

Arthritis and Yoga:  
The American College of Rheumatology suggests the use of non-pharmacological interventions such as exercise for the medical management of knee osteoarthritis. A 2018 meta-analysis found that regular yoga practice can help reduce symptoms, improve function, and general wellness in individuals with rheumatoid and knee arthritis. 

A pilot study found Iyengar yoga to benefit pain and disability in obese individuals over the age of 50 diagnosed with knee arthritis. Another small pilot study that analyzed qualitative and quantitative results for young adults with rheumatoid arthritis who participated in Iyengar yoga found that there was significant improvement in pain disability, vitality, mental health, depression, and selfefficacy. The results of future studies will be essential as these are based on small samples. 

General wellness and Yoga: 
The research on this is limited as there are many aspects of health and wellness. However, early data shows it may help people manage stress, improve resilience, eat better, and develop a more active lifestyle. In the 2012 National Health Interview Survey, where thousands of Americans are interviewed regarding their health and illness-related experiences, 80 percent reported reduced stress while practicing yoga. Yoga is a mind body practice and therefore it improves muscular strength and flexibility, promotes blood flow, and bone health. Yoga can also help promote balance and body awareness. 

This is by no means a comprehensive list of the research done on yoga and health care conditions. Yoga is not something that should be done in lieu of seeking medical attention for a specific ailment. You can always consult your health care provider, such as a physical therapist, regarding any complementary treatment you are considering. In most instances, yoga is a safe form of physical exercise when practiced appropriately. When it comes to your health, be proactive so that you can make the bestinformed decisions. 

Namaste. 

    References:  

    • Americans who practice yoga report better wellness, health behaviors. National Center for Complementary and Integrative Health. https://nccih.nih.gov/news/press/11042015. Published September 24, 2017. Accessed January 24, 2019. 
    • Kolasinski SL, Garfinkel M, Tsai AG, Matz W, Dyke AV, Schumacher HR. Iyengar Yoga for Treating Symptoms of Osteoarthritis of the Knees: A Pilot Study. The Journal of Alternative and Complementary Medicine. 2005;11(4):689-693. doi:10.1089/acm.2005.11.689. 
    • NCCIH. National Center for Complementary and Integrative Health. https://nccih.nih.gov/. Accessed January 24, 2019. 
    • Qaseem A, Wilt TJ, McLean RM, Forciea MA, for the Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. ;166:514–530. doi: 10.7326/M16-2367 
    • Sherman KJ, Cherkin DC, Wellman RD, et al. A Randomized Trial Comparing Yoga, Stretching, and a Self-care Book for Chronic Low Back Pain. Arch Intern Med. 2011;171(22):2019–2026. doi:10.1001/archinternmed.2011.524 
    • Wang Y, Lu S, Wang R, et al. Integrative effect of yoga practice in patients with knee arthritis. Medicine. 2018;97(31). doi:10.1097/md.0000000000011742. 
    • Woodyard C. Exploring the therapeutic effects of yoga and its ability to increase quality of life. International Journal of Yoga. 2011;4(2):49. doi:10.4103/0973-6131.85485. 
    • Yoga: In Depth. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/yoga/introduction.htm. Published November 8, 2018. Accessed January 20, 2019. 

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