I was sad to miss the Yoga in Health Care conference last week. To make up for this I thought I’d research more and share some of the evidence I found for yoga therapy.
“Yoga therapy is the process of empowering individuals to progress toward improved health and well-being through the application of the teachings and practices of Yoga.”
Yoga in general has a philosophy which aims to enhance the wellbeing of both your mind and body. Yoga therapy is slightly different in that it utilises specific yoga practices with the aim of gaining therapeutic results of improving certain ailments, be them physical or mental.
The term ‘yoga therapy’ was coined in the 1920s by Swami Kuvalyananda.
Since this time numerous research studies have shown that yoga can have a significant impact improving our flexibility and balance, respiratory function, cardiovascular health, mental wellbeing and cognitive performance – and so much more. Moreover, those who practice yoga often see improvements in deeper aspects of life such as their purpose and spirituality.
These improvements are particularly pertinent given that they are risk factors to many noncommunicable, lifestyle-related, diseases. It is these diseases which present the greatest burden on our health system.
I couldn’t possible fit in all the health benefits of yoga in one post, and feel I am already waffling on and getting over excited typing to much – so let’s get to it! I’ve picked a few areas of health which there is evidence yoga can improve.
Yoga for mental health:
One randomised controlled trial (the highest form of clinical evidence which can be gained from a single study), showed that yoga significantly reduced the clinical symptoms of mild to moderate depression after an 8-week course 1. Moreover, this was seen when patients were not on any other more traditional forms of therapy.
A review published in 2016 aimed to identify if any style of yoga was more beneficial in the management of depression 2. This study again only included papers of randomised controlled studies. They showed there was no significant difference between the styles of yoga, and all had positive outcomes. Therefore, the style of yoga used should be based upon personal preference and local availability. This is even more pertinent when you consider it is the form of exercise you enjoy the most which you will stick to.
There is growing evidence that yoga can be beneficial in reducing anxiety.
One study demonstrated that twice weekly yoga sessions for 2 months significantly lowered anxiety levels in women 3.
Fascinatingly one study involving 64 women with post-traumatic stress disorder (PTSD) who practiced yoga once a week showed significant improvements in their symptoms 4. Astonishingly 52% of those in the study no longer met the criteria for PTSD. The exact physiological mechanisms by which yoga has its therapeutic effects are unknown. It is possible that mindfulness and being present in the moment are important factors.
There is growing recognition of the beneficial effects of yoga on mental health conditions within the yoga community. As such there are specific courses for yoga teachers now which aim to help them teach to those with mental health conditions and deepen their understanding of how to accommodate people seeking yoga for this purpose. Several, for example, are aimed at providing yoga teachers with the knowledge to facilitate them in providing trauma-informed classes for veterans. This, in my opinion, is awesome.
Yoga for stress management:
A common reason for people to take up yoga is to reduce their stress levels and feel more relaxed.
Several studies have repeatedly shown yoga reduces the secretion of cortisol 5,6. Cortisol is the body’s primary stress hormone.
The knock-on effects of this can be vast, including improved executive function in older adults 6, less fatigue and perceived stress 7.
Another study involving 131 participants demonstrated that 10 weeks of yoga practice helped to lower stress and anxiety levels whilst improving quality of life and mental wellbeing 8.
Yoga for back pain:
In the NHS there is a body called NICE which governs guidance to physicians on the management of conditions, and which are cost effective. NICE recommends offering yoga to patients as a first step in the management of lower back pain. There is even a programme called ‘Yoga for Healthy Lower Backs’ developed by yoga and back pain specialists. This is particularly relevant as not all styles of yoga and postures would be suitable for those with lower back pain.
‘Yoga for Healthy Lower Backs’ now has over 350 teachers throughout the UK. It is a 12-week course which is commissioned (which means it is available) in some areas of the country on the NHS.
For more information see: https://www.yogaforbacks.co.uk/
Yoga for cardiovascular health:
A recent meta-analysis (where the results from multiple studies in a topic are combined to provide more conclusive evidence on the subject) published in 2019 showed that yoga is a worthwhile antihypertensive management option and generates best results when breathing techniques and meditation are involved in the practice 9.
High blood pressure aka hypertension is one of the main causes of heart attacks and strokes. Therefore, reducing your blood pressure to the ‘normal’ range can reduce your risk of these conditions.
Yoga for sleep:
Good sleep quantity and quality are vital for overall health and wellbeing. I’m currently reading Matthew Walker’s ‘Why We Sleep’ after it being on my ‘to-read list’ for ages. It’s fascinating and I thoroughly recommend it to anyone with an interest in sleep. Needless to say, sleep is vital.
There is evidence that yoga can aid improved sleep. One study involved comparing participants who practice yoga, drank herbal tea or did nothing. Those in the yoga group took less time to fall asleep, slept for longer and felt more-rested in the morning 10. The precise physiological mechanism by which yoga improves sleep is unclear. A possible influencing factor is yoga increases the secretion of melatonin 11, a hormone involved in the regulation of sleep-wake cycles
Yoga for strength:
Not only does yoga increase your flexibility, it can improve your strength.
One study involved participants practicing 24 cycles of sun salutations six days a week for 24 weeks. Following this intervention upper and lower body strength exercises increased significantly from baseline in both male and female participants12.
Another study showed a 12 week Hatha yoga course improved cardiorespiratory endurance, muscle strength and endurance and flexibility in a larger study with 173 participants 13.
This is not a comprehensive list, just a few areas which I wanted to highlight today, but honestly there is so, so much more and I am conscious this is already one of the longest blog posts I have written!
Modern medicine is amazing, it has eradicated worldwide diseases and has the potential to save us from life threatening infections and injuries. This said, there is an ever-growing burden of non-communicable diseases on our health care systems worldwide, with them being responsible for 70% of all global deaths. The majority of these conditions are preventable with a healthy lifestyle.
In England alone 15.4 million people live with a long-term chronic disease. This utilises:
- 50% of all GP appointments
- 70% of the health care budget
- 70% of hospital bed use 14.
By using lifestyle interventions, such as yoga, in a synergistic collaboration with modern medicine we can provide less invasive, less expensive, more sustainable treatment options to our patients and lessen the burden on our health care systems in the process.
During my research for this blog post I came across this book:
Principles and Practice of Yoga in Health Care Paperback – June 2016 – by Sat Bir Khalsa, Lorenzo Cohen, Timothy McCall and Shirley Telles.
I have not read it yet so cannot comment on the content. The title and content page is, however, fascinating to me and one I’m definitely adding to me ‘to read’ list.
- Prathikanti, S. et al. Treating major depression with yoga: A prospective, randomized, controlled pilot trial. PLoS One 12, e0173869 (2017).
- Cramer, H., Lauche, R., Langhorst, J. & Dobos, G. Is one yoga style better than another? A systematic review of associations of yoga style and conclusions in randomized yoga trials. Complement. Ther. Med. 25, 178–187 (2016).
- Javnbakht, M., Hejazi Kenari, R. & Ghasemi, M. Effects of yoga on depression and anxiety of women. Complement. Ther. Clin. Pract. 15, 102–104 (2009).
- van der Kolk, B. A. et al. Yoga as an Adjunctive Treatment for Posttraumatic Stress Disorder. J. Clin. Psychiatry 75, e559–e565 (2014).
- García-Sesnich, J., Flores, M., Ríos, M. & Aravena, J. Longitudinal and immediate effect of Kundalini Yoga on salivary levels of cortisol and activity of alpha-amylase and its effect on perceived stress. Int. J. Yoga 10, 73 (2017).
- Gothe, N. P., Keswani, R. K. & McAuley, E. Yoga practice improves executive function by attenuating stress levels. Biol. Psychol. 121, 109–116 (2016).
- Michalsen, A. et al. Rapid stress reduction and anxiolysis among distressed women as a consequence of a three-month intensive yoga program. Med. Sci. Monit. 11, CR555-561 (2005).
- Smith, C., Hancock, H., Blake-Mortimer, J. & Eckert, K. A randomised comparative trial of yoga and relaxation to reduce stress and anxiety. Complement. Ther. Med. 15, 77–83 (2007).
- Wu, Y. et al. Yoga as Antihypertensive Lifestyle Therapy: A Systematic Review and Meta-analysis. Mayo Clin. Proc. (2019). doi:10.1016/j.mayocp.2018.09.023
- Manjunath, N. K. & Telles, S. Influence of Yoga and Ayurveda on self-rated sleep in a geriatric population. Indian J. Med. Res. 121, 683–90 (2005).
- Harinath, K. et al. Effects of Hatha Yoga and Omkar Meditation on Cardiorespiratory Performance, Psychologic Profile, and Melatonin Secretion. J. Altern. Complement. Med. 10, 261–268 (2004).
- Bhutkar, M. V, Bhutkar, P. M., Govind, ;, Taware, B. & Surdi, A. D. How Effective Is Sun Salutation in Improving Muscle Strength, General Body Endurance and Body Composition? Asian Journal of Sports Medicine 2, (2011).
- Lau, C., Yu, R. & Woo, J. Effects of a 12-Week Hatha Yoga Intervention on Cardiorespiratory Endurance, Muscular Strength and Endurance, and Flexibility in Hong Kong Chinese Adults: A Controlled Clinical Trial. Evid. Based. Complement. Alternat. Med. 2015, 958727 (2015).
- Yoga In The NHS: Working Towards The Inclusion Of Yoga Within The NHS. Available at: https://themindedinstitute.com/yoga-in-healthcare/yoga-into-nhs/. (Accessed: 23rd February 2019)