Rebecca Powell-Doherty, Ph.D. discusses how yoga can play a role in the management of chronic disease. Learn how the science backs up yoga for pain management, psychological outlook, and mobility in the chronically ill.
Yoga for Chronic Disease Management
Previously in this series, we’ve taken a close look at the benefits of yoga and, specifically, yogic breathing for stress management and short-term wound healing. While yoga practitioners are experiencing these benefits every day, the scientific understanding of how all this works is just starting to grow. However, there’s one area of yogic benefit where the literature, at least in terms of recognition, is actually quite prolific: chronic disease. Studies on everything from heart disease to chronic back pain to ulcerative colitis have explored yoga’s impact.
However, I’d like to focus on a subsection of this and carefully explore how yoga impacts diseases that have an autoimmune component; that is, diseases that stem from the immune system attacking its own body. This includes diseases such as rheumatoid arthritis (RA), Crohn’s disease, Multiple Sclerosis (MS), and many others.
For those living with these kinds of diseases, the reality is often chronic pain, fatigue, impaired mobility and neurological dysfunction, dietary restrictions, and unsettling and/or embarrassing symptoms. Living in this way day in and day out also increases the likelihood that these individuals may experience anxiety, depression, and decreased social interaction. Now, depending on the disease, there are a great many therapies offered by modern medicine that can help control or alleviate any variety of disease-associated symptoms. However, even in the most well-managed scenario, flare-ups do occur, and it can often be difficult to get things back under control. While yoga is not a cure or even a management plan by itself, the scientific evidence is mounting that it can benefit in conjunction with medical therapies.
Understandably, the vast majority of the literature in this area focuses on diseases such as RA and MS: diseases with a movement component, regardless of the underlying pathology. For example, a review and meta-analysis from back in 2013 (Musculoskelet Care 11(2013):203-2017) examined seventeen different studies that looked at the effects of yoga for lower back pain (cause unspecified), RA, and fibromyalgia. In all cases, yoga significantly improved pain outcomes and evaluations of psychological perspective. In addition, more tangible functional outcomes (such as grip strength and range of motion indicators) were measured in numerous studies, and while the results were not always significant, mild to moderate improvements were seen in yoga participants across the board.
It’s exciting to note that this analysis looked at multiple systems and styles of yoga (Hatha, Iyengar, Viniyoga, etc), and the style of choice didn’t really matter. Couple this kind of evidence with a solid RCT, and suddenly we’ve really got something! Naturally, several investigators did just that. Back in 2011, Telles et al (BMC Research Notes (2011) 4:118) showed improvements in rheumatoid factor levels (a biomarker of active RA) after a single week of yoga intervention, and Moonaz et al (J Rheumatol (2015) 42(7): 1194-1202) showed long-term improvements (eight weeks and nine months) in flexibility, walking capacity, strength, and perceived quality of life in previously sedentary adults of all ages with RA or osteoarthritis.
More recently, just this year in fact, both Razazian (Med Sci Sports Exerc. 2016 May;48(5):796-803) and Dehkordi (J Clin Diag Res. 2016 June; 10(6):VC01-05) demonstrate that low impact exercise, such as yoga or swimming, is beneficial for fatigue, depression, pain, and controlling uncomfortable nerve sensations (tingling or burning) in individuals with MS, when combined with standard medications.
Now, as a yoga practitioner, you might be thinking that this sort of thing is obvious to you, and that may be absolutely true! However, medicine relies on peer-reviewed, scientific evidence like this to determine what is safe and beneficial for patients, which means studies like these are essential if we ever hope to fully integrate modalities like yoga and meditation into western medical thinking! We should also note that these studies focus on movement. This is unlike studies we’ve examined previously where breath work was the real requirement. None of it is particularly complicated, but getting on the mat or in the pool does seem to be the key. So if you’re struggling with something like RA or MS, consider working with your medical specialist and a knowledgeable yoga teacher to pick a style of yoga you love and find a routine that works for you.