Flexibility And Range Of Motion
Rheumatoid arthritis most often affects the hands, ankles, and knees, which can limit range of motion and pose challenges to everyday activities. This can result in sedentary living and immobility, which can contribute to other health complications like weight gain.
Yoga can make it easier for a person to move and engage in physical activity without pain. Specifically, yoga has been shown to improve balance, hand grip, flexibility, and strength. These benefits make it easier for a person to walk and engage in other physical activities, which boost overall physical health.
Comparison To Prior Reviews
To the best of our knowledge, this is the first systematic review and meta-analysis to evaluate the effectiveness of yoga in RA. Several years ago, one review included eight studies has examined the effects of yoga on rheumatic conditions, and the authors concluded that yoga is a useful add-on therapy for treating RA and the most significant benefits of yoga was practiced in a combination of physical postures, regulated breathing, meditation, and yoga philosophy . While the authors of this previous review cannot perform a meta-analysis, the increased number of publications in recent years allowed for a meta-analysis at this point, and effect estimates could be provided. Overall, our meta-analysis found that yoga may improve the physical function and disease activity for patients with RA, and the meta-analyses showed no differences between the yoga and non-exercise controls including usual care. However, the results found are inconsistent with previous literature reports.
Yoga For Treating Rheumatoid Arthritis: A Systematic Review And Meta
- 1The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- 2Kunming Municipal Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China
- 3Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
- 4Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
Purpose: Rheumatoid arthritis is a pervasive inflammatory autoimmune disease that seriously impairs human health and requires more effective non-pharmacologic treatment approaches. This study aims to systematically review and evaluate the efficacy of yoga for patients with RA.
Methods: Medline , Cochrane Library, EMBASE , and Web of Science database were screened through for articles published until 20 July 2020. Randomized controlled trials of yoga in patients with RA were included. Outcomes measures were pain, physical function, disease activity, inflammatory cytokines, and grip strength. For each outcome, standardized mean differences and 95% confidence intervals were calculated.
Result: Ten trials including 840 patients with RA aged 3070 years were identified, with 86% female participants. Meta-analysis revealed a statistically significant overall effect in favor of yoga for physical function , disease activity and grip strength . No effects were found for pain, tender joints, swollen joints count or inflammatory cytokines .
Recommended Reading: How Much Fish Oil Should I Take For Arthritis
What Should I Bring To My First Yoga Session
Wear comfortable clothing that allows for full movement of the body. If the clothing is too loose, the instructor will be less able to guide you in proper alignment, but it should also not be restrictive. Clothing specially designed for yoga is available, but unnecessary. Yoga is traditionally practiced barefoot, though it may be possible to wear socks at the start of class, until the body warms up. Sticky mats are used in modern yoga practice to provide some cushioning and prevent slipping. Some studios or gyms will supply mats for general use. You may want to inquire about this in advance. Also, be sure to bring water or an empty container for filling, in case they are not supplied. It is important to stay hydrated during any physical activity.
Yoga Styles You May Want To Avoid
1. Bikram and hot yoga The Indian guru Bikram Choudhury developed this precise style, in which 26 specific yoga postures are done in a room maintained at 105 degrees F and 40 percent humidity. While the heat is said to facilitate stretching, its also fatiguing, something people with RA dont need more of, Fishman says. Whats more, the exact regimen of Bikram poses doesn’t allow for much adaptation, and some of the poses put particular stress on the joints.
Classes advertised more generically as hot yoga may be held at slightly lower temperatures, around 85 degrees, but sometimes incorporate faster-paced sequences, which could also be overly taxing for those with RA. Nonetheless, some people with RA do find the heat relaxing for the joints, as long as they dont over do it. Julia Chayko enjoyed Bikram for several years before settling into more gentle hatha classes.
3. Power yoga This fitness-based style of yoga aims to develop strength and flexibility. Power yoga is a vigorous style that typically includes poses that are more demanding than other types of yoga. Perhaps because of its difficulty, the German study singled out power yoga as the style practitioners are most likely to be injured doing.
Don’t Miss: What Can You Use For Arthritis In Your Hands
Benefits Of Yoga For Arthritis
So why does yoga really benefit folks with arthritis? Lets get into it!
First off, heres a quick summary of all the benefits yoga often provides for folks with arthritis:
Dont just take my word for this science backs me up!
Specifically, Johns Hopkins Arthritis Center designed and conducted a large, randomized, controlled trial of how yoga can help sedentary adults with arthritis. The study presented important evidence showing that yoga appears to be effective, safe, feasible, and enjoyable for people with both rheumatoid arthritis and osteoarthritis.
Hot Yoga Not Suitable For Rheumatoid Arthritis
Practicing yoga is a safe and effective form of exercise, but its important to consult a doctor to make sure that its appropriate for you. Especially if you suffer from rheumatoid arthritis, a rheumatologist or orthopedist should be consulted before you begin. In addition to discussing your goals and limitations, they should also check to see if you have any other medical conditions that could limit your participation.
For some, hot yoga can be too intense. This is not the case for everyone. People with RA should avoid a high-heat room and do yoga in a room that is less than 85 degrees. In general, higher temperatures make it easier to perform yoga postures, but some people with RA find that higher temperatures are easier on the joints. While the temperatures are high enough to cause discomfort, you should not avoid practicing yoga because of your RA. If you find that your condition is worsening, you should stop the exercise.
While yoga can help relieve symptoms of chronic RA, it can also aggravate the condition. While it can help people with RA feel more comfortable performing physical activities, high-intensity workouts can cause pain. Those with rheumatoid arthritis should start out slow and gradually increase their fitness levels. Practicing yoga with a plant-based diet rich in antioxidants can be beneficial for arthritis sufferers. Additionally, massage can help manage joint pain.
Recommended Reading: What Are The Different Kinds Of Arthritis
Assessment Of Risk Of Bias In Included Studies
The quality and risk of bias in included studies were assessed independently by 2 reviewers using the Cochrane risk-of-bias tool, which includes the following domains: selection bias, performance bias, detection bias, attrition bias, reporting bias, and other bias . Discrepancies were rechecked by a third reviewer and consensus achieved by further discussion.
Where Can I Find More Information
Listed below are 3 articles from our group concerning Yoga and Arthritis and Rheumatic Diseases:
Don’t Miss: How To Reduce Rheumatoid Arthritis Pain
Risk Of Bias And Quality Assessment
The risk of bias for each study is shown in detail in Table 3. Five RCTs did not report an adequate form of randomization and the allocation concealment of these five RCTs remained unclear . Four RCTs were judged as unclear for performance bias. In four RCTs , detection bias remained unclear. Incomplete outcome data four RCTs were judged as unclear due to a lack of data detail. The risk of reporting bias was low in only two of the included RCTs .
Table 3. Risk of bias assessment.
Start With A Qualified Yoga Instructor
No matter what type of yoga you decide to try, youre encouraged to begin with a qualified instructor. Save the yoga videos for later, when youre more confident with your yoga practice. If possible, find an instructor who has experience working with people with chronic conditions like arthritis. This may require a call to the studio ahead of time.
Before class starts, tell the instructor about which joints are affected by arthritis or injuries. He or she should be able to show you ways to modify poses before or during class.
If it hurts, stopYoga stretches muscles, and stretching can feel uncomfortable. Joint pain, however, is a sign of a possible injury and should be avoided. Dont do a pose if it causes pain, even if it seems like everyone else in the class can do it.
Don’t Miss: What Drugs Are Used For Arthritis
The Physical Benefits: What Patients Say About Regular Yoga For Their Arthritis
Yoga offers many benefits for individuals living with arthritis. It can reduce joint stiffness, improve range of motion, and help with flexibility. For these reasons, people with arthritis often practice yoga first thing in the morning and before bed when joint pain/stiffness is often at its worst. But it can be helpful when practiced at any time of day.
Eileen Davidson, a 35 year old mother with rheumatoid arthritis, includes yoga poses in her daily stretching routine.
Yoga helps alleviate morning stiffness and pain and deep breathing exercises really help reduce my anxiety, said Davidson, who is also a member of Arthritis Research Canadas Arthritis Patient Advisory Board.
She cant do every yoga pose because of her rheumatoid arthritis. Instead, she focuses on the ones that give her the biggest benefits without causing pain.
Sometimes I do yoga in my chair if I feel like getting up off the ground that day may be a challenge, she said.
Jon Collins is another member of the Arthritis Patient Advisory Board who practices yoga to help with his osteoarthritis and psoriatic arthritis. He incorporates several poses into his daily exercise program and has discovered some big benefits.
Susan Le is 34, living with lupus and the mother of a toddler. She practices flow, hatha, restorative, yoga nidra, and yoga for kids. She chooses the type of yoga based on her energy level. Flow or hatha if she has more energy. Slower hatha, restorative or nidra if she is feeling tired.
Research: Yoga Therapy Significantly Reduces Disease Activity And Improves Sympathovagal Balance In Rheumatoid Arthritis Patients
A recent study published in The Journal of Alternative and Complementary Medicine tested the efficacy of a 12-week yoga therapy regimen as a complementary treatment modality for patients recently diagnosed with rheumatoid arthritis.
The study found that, compared to a control group, participants who practiced 12 weeks of a prescribed yoga therapy practice showed a statistically significant reduction in disease activity as well as a statistically significant improvement in sympathovagal balance.
Following a series of very simple yoga postures, breathing exercises, and meditation practices, participants practicing yoga as an adjunct to standard medical treatment showed an overall shift toward parasympathetic nervous system predominance. The parasympathetic nervous system is the rest-and-digest branch of the autonomic nervous system.
While further research is still needed, this study is promisingparticularly because not all rheumatoid arthritis patients respond to traditional treatments.
Review Of Studies Examining The Use Of Yoga For Treating Rheumatoid Arthritis
An electronic search of the PubMed database was conducted using the following keywords: yoga and rheumatoid arthritis, meditation and rheumatoid arthritis, mindfulness meditation and rheumatoid arthritis, and yogic breathing and rheumatoid arthritis. Eight studies were identified, including 2 randomized controlled studies, 2 non-randomized, matched-group studies, 2 non-randomized studies in which the groups were not matched, and 2 single-group studies. Details of the studies are discussed below.
Between groups, differences after 2 months were not significant for any outcome measures. After 6 months, psychological distress and well-being showed a significant group × time interaction . Linear regression models revealed that from baseline to 2 months, each one-day increase in practice was associated with an improvement of depressive symptoms by 0.03 .
The study was well-designed although additional objective measurements could have been added. The authors identified limitations of the study as a small sample size, inadequate attention to the control group, and a floor effect. The improvement observed in the MBSR group may not have been due to the effect of intervention but rather other factors, such as group interaction, which was lacking in the control group. Additionally, all participants with a history of depression were assigned to the control group, which may have affected the results. Effect sizes were not calculated.
The Benefits Of Yoga For Everyone Are Numerous Especially You With Ra
There are many different types of yoga so find the one that best suits your needs. Hatha yoga is a good place to start if you are new to yoga. As an individual living with Rheumatoid Arthritis myself the slower pace, longer holding times in postures and an emphasis on proper body alignment and placement has been extremely beneficial to me both physically and mentally.
Dont let this progressive illness prevent you from trying new things, and keep in mind that the greatest thing a person with RA can do is continue to participate in daily movement-type activities.
This blog was created by Jennifer Smeddy, M.Ed., RYT 500 who has been practicing yoga for over twenty-five years and was formally diagnosed with RA in 2021. She believes that her passion lies in helping others develop strong personal practices and creating space to be happy and healthy. Jennifer is someone who enjoys hiking, reading and spending time with her family. She is currently the director and a lead instructor at LeadingYoga.com teaching online yoga classes and yoga teacher training certification coursework.
If you like this blog share it with your friends! If you have any thoughts or comments get in touch with us wed love to hear from you!
You May Like: Can Psoriatic Arthritis Cause Heart Problems
How To Practice The 12
These very simple asanas and pranayama practices helped downregulate participants nervous system and reduce inflammation, disease activity, and sympathetic nervous system activity.
Participants began by warming up many of the bodys major joints through a series of simple practices called Sukshma Vyayama. These practices included:
Squatting into Chair Pose
Following their simple asana practice, participants lay down in Relaxation Pose for eight minutes.
After resting in Savasana, participants then continued with a few soothing breathing exercises:
Alternate Nostril Breathing
Moon-Piercing Breath/Left Nostril Breath
Humming Bee Breath
Following pranayama practice, participants practiced meditation by chanting the sound of AUM for five minutes.
Yoga Poses To Avoid With Arthritis
If you have arthritis, you should avoid poses that can potentially cause any flare ups. For some, this may include poses that require you to balance on one foot or bend your joints, such as your knees, more than 90 degrees. For others, it may be challenging to hold postures for extended periods of time.
Some yoga types, such as Kundalini or Ananda, may involve lengthy meditation or breathing exercises that could be difficult for someone with arthritis to sit through.
Keep in mind, there are a ton of different forms of arthritis and they often have slightly different treatments. The asanas Id recommended for those with osteoarthritis are different from the poses Id recommend for those with rheumatoid arthritis.
Holding poses for a long time to strengthen static muscles is great for osteoarthritis. On the other hand, for rheumatoid arthritis you dont want to be holding poses for that long. People with moderate to severe rheumatoid arthritis should avoid high-intensity yoga postures, and prolonged immobility in seated or lying positions.
Now before I get into the poses, remember: arthritis is no joke. Even with these yoga pose suggestions, its super important to learn and practice them under the supervision and guidance of a yoga instructor or a yoga therapist.
Don’t Miss: How To Know What Type Of Arthritis You Have
Can I Practice Yoga At Home
Even when thinking about doing yoga at home, it is very important for people to speak first with their doctors. For patients with arthritis it is important to speak with their rheumatologist or orthopedist about any particular concerns they may have. It is also important to speak with your medical doctor to see if there are any other concerns .
We generally recommend that people have their first yoga experience with an instructor in person. As you become more confident and experienced, you may want to supplement classes with home practice. There are also many yoga books and videos available, but they do not necessarily address the needs of arthritis patients. We worked with the Arthritis Foundation to develop a video titled Arthritis-Friendly Yoga, which can be found through stores and online retailers. You can also visit their website. While the video is safe for most patients with arthritis, it cannot provide the same level of supervision and individual attention offered by working with a qualified instructor.
The Worst Yoga For Arthritis
Some types of yoga, like vinyasa, involve quickly moving from pose to pose and count as an aerobic workout. For these, its best to regularly practice so you can build up strength and flexibility before trying faster motions or more weight-bearing moves.
Remember to always avoid poses that hurt. These might require joints to bend too much on the knees or wrists, require balancing on one foot or getting up off the ground. Some types of yoga that involve longer breathing sessions can also aggravate the joints because they require a person to remain in the same pose for longer.
If you are new to yoga and have arthritis, it is best to avoid yoga classes such as:
Don’t Miss: What To Do For Arthritis In The Shoulder