Can Yoga Help Arthritis?

Do you suffer with the daily struggle of arthritis? Or perhaps a loved one is facing the difficulties of this frustrating condition. While there is no magic cure and treatment often involves a holistic approach, the good news is that there is a growing field of evidence which suggests yoga might be a big piece of the puzzle when it comes to managing arthritis.

What is Arthritis?

Feeling a bit less supple is a normal part of aging. However, for the 25% of the population that suffers from arthritis symptoms go far beyond stiffness and can include; painful joint swelling, reduced range of movement, and extreme stiffness. Arthritis can appear in one specific area of the body or it can affect multiple areas.

Normally arthritis is considered an older person’s condition, but there are some instances in younger people as well.

Women tend to be afflicted more than men and there is an increased incidence in those who are overweight. Despite there being over 100 different possible types of arthritis, the two commonly diagnosed forms are osteoarthritis (OA)and rheumatoid arthritis (RA).

RA is actually classed as an autoimmune disorder as it involves the immune system unhelpfully attacking its own healthy cells and tissues creating inflammation. In addition to the symptoms of stiffness and swelling, sufferers of RA may also experience fatigue or appetite issues due to the immune response.

Why do we get it?

Our joints are built with a protective, “shock absorber” known as cartilage. In healthy individuals, cartilage acts as a buffer against the wear and tear of everyday life and movements. For example, the stress of repetitive movements like walking and typing or to cushion intense impacts caused by running and jumping. When cartilage decreases, we are left without this cushion and the symptoms of OA may kick in.

The breakdown of cartilage is a somewhat natural during aging, hence why those over 65’s are more effected than younger age groups.

However, injuries, infections, genetic dispositions, and being a professional athlete may increase the chances of OA developing. 

For RA, the autoimmune variety, scientists are still unsure as to the exact causes, but genetic markers may also play a part.

What is the conventional arthritis treatment?

With arthritis, as with many chronic conditions, the usual treatment protocol focuses on symptom suppression rather than a cure.

In addition, the severity of symptoms usually dictates the appropriate response. For some the aid of ice and heat may be sufficient. For others, mobility assistance may be required in combination with various painkillers and anti-inflammatories. Steroids may be also be prescribed, and in the case of RA, immunosuppressants are often offered.

For more severe cases surgical interventions may be recommended, including either joint replacements or joint fusions, which carry their own risks. 

While these pharmacological interventions may ease daily life in some people, there is no escaping the potential side effects of these options. It is important to seek a holistic approach when dealing with chronic conditions such as arthritis. 

Are there any natural alternatives?

Luckily, because arthritis is such a common, potentially debilitating condition, there has been a lot of research conducted into finding additional treatment options which may work independently or in combination with the above options. 

These include physical therapy, diet, massage, acupuncture amongst others.

Physical therapy

The Arthritis Foundation explained that the goal of physical therapy regarding arthritis is to get people up and moving again. Whether this be climbing a mountain, or just taking the stairs, the aim is to facilitate mobility of effected joints and therefore hopefully limit stiffness and pain.

Diet

The dietary focus for arthritis, is on anti-inflammatory foods. This is because in cases of OA the main cause of symptoms stems from inflammation around the joints. 

This diet does not have to be restrictive and dull however, as the Mediterranean diet is suggested as an ideally balanced, nutrient dense, and delicious option.

Not only is this diet recommended for arthritis, it also comes top of numerous trials looking at the prevention of chronic disease via nutrition.

There is also some interesting new evidence that berries are powerhouses of nutrition when it comes to fighting the pain and inflammation associated with both OA and RA. Additionally, some people find turmeric and fish oils to be of benefit, when included as part of a healthy med-style diet.

Massage

Who doesn’t love a relaxing massage at the end of a long, hard day. But now there is even more benefit to massage therapy- evidence suggests it can aid joint mobilisation, pain reduction and reduced inflammation, making it an amazing add on treatment option.

Acupuncture

While more evidence is needed to achieve a conclusive answer, anecdotally acupuncture has helped numerous sufferers of OA reduce the impact of the pain on their day to day lives. The mechanisms are thought to include reduced inflammation and the release of pain-relieving endorphins.

Where does yoga fit in?

The ancient practice of yoga, which incorporates mindful movement, breath co-ordinated stretches, strengthening and balancing exercises, contains many elements deemed helpful in the management of arthritis. 

Despite inactivity being a common response to the increased pain which OA and RA brings, evidence shows this reduced movement actually increases symptoms through the stiffening and immobility of joints and surrounding muscles/ tissues.

Yoga is an accessible, adaptable exercise system which can be enjoyed by everybody. It may be a more appealing and manageable option to many who would be unprepared to enter the gym or unwilling to exercise alone.

Not only is this practice of physical benefit, the unique additional aspect of yoga, is its ability to influence our mental state. This mind-body integration is useful to anyone suffering from a chronic condition. By reducing stress and increasing mindfulness, individual pain perceptions can reduce and the overall physical, emotional, financial and social burden of having arthritis can also be lessened.

What does the evidence say?

Yoga is beneficial both in the prevention of further damage to the supportive cartilage, as well as increasing blood flow and range of movement in cases where damage may have already occurred.

Increased strength

There have been numerous studies looking into the potential benefits of yoga in the treatment of arthritis. One study looked at hand grip strength improvements after participants followed a three month yoga programme. 

Hand grip strength is used as a measure of overall strength, which is important in musculoskeletal conditions such as arthritis.  The study showed that just three months of practising a well-rounded yoga session including physical postures, breathwork and relaxation, caused a significantly important increase in strength.  

Less pain

In a large study over 250 participants, pain levels were reduced with yoga more than when physiotherapy was conducted. The reduction in pain was not only during activities, but also during periods of inactivity, known as ‘resting pain’. 

This led to improvements in overall quality of life scores and increased social and physical activities, which both have positive impacts on general health outcomes.

Less inflammation

In a study focusing purely on RA, only 8 weeks of yoga practice was needed to reduce inflammation associated pain scores in RA patients. Yoga is thought to reduce inflammatory states by increasing oxygenation, nutrient delivery to muscles and tissues, and lowering cortisol levels.

Reduced stress

Stress can exacerbate OA and cause a flare up of symptoms in RA, due to the connection between the immune system, inflammation, and pain.

Mind body integrated practices such as yoga offer a stress reducing exercise system with as many mental as physical benefits. The physical activity of the yoga postures has shown to reduce levels of circulating cortisol, one of the main stress hormones.

Reductions in cortisol lead to increased immunity, reduced inflammation, and better pain management.

Additionally, the mental benefits of the practice, through activities such as controlled breathing and full body relaxation, can reduce individual perception of pain, induce deeper, more restorative sleep and lessen symptoms of RA.  

Not only do these mind-body effects impact arthritis in a positive way- they also support us in the aging process generally, making us more resilient to life’s inevitable ups and downs.

A soothing yoga sequence to ease arthritis

When it comes to arthritis, certain styles may be of more benefit than others, for example in the case of RA, while hatha, Iyengar and restorative may be recommended, other more extreme styles such as bikram and power yoga may not be as suitable if appropriate alterations are not made.

The main key is to find an experienced teacher who can adjust the postures to suit your specific requirements.  There are also many online resources as a great starting point. Below is a short and simple practice which can be fitted in to a busy daily lifestyle to ensure you gain the benefits of this wonderful ancient practice, either as a preventative for or treatment of arthritis.

1. Alternate Nostril Breathing 

 Nadi Shodhana

 Breathe into your right nostril, while lightly closing your left nostril with your ring finger, pause at the top and then change fingers, closing your right nostril with your thumb, now breathe out through your left nostril.

 Repeat 10 times on each side then breathe normally. This breathing practice, or pranayama is brilliant at switching on the parasympathetic nervous system and therefore reducing circulating cortisol which is great for the conditions of RA and OA.

2. Ocean Breath Variation I Close Up 

 Ujjayi Pranayama Variation I Close Up

This is a great breathe to practice throughout the day, as well as during your yoga class. It encourages us to breathe deeply from the diaphragm rather than the shallow breathing we usually do from higher up in the chest.

This deep belly breathing is a great way to oxygenate the body fully, slow the heartrate and lower blood pressure, as well as reducing stress in support of arthritis.

3. Marichi Pose C I 

 Marichyasana C I

This twist is great at lengthening out the spine and encourages a gentle spinal twist. Inhale to reach tall through the back of the body and exhale to twist, placing your left arm around your right knee as your arms join together behind your back, breathe deeply here for 5-10 breathes, before repeating on the other side.  

4. Head to Knee Pose 

 Janu Sirsasana

 This forward fold is good for the nervous system, is a gentle inversion which supports immunity and oxygenation of the blood and this posture allows a deep stretch of the hamstrings and the musculature surrounding the hip.

 Sit with your legs straight in front of you, bend your right leg and bring the foot to the inner left thigh. From here inhale to reach your arms overhead and exhale to fold forward, hinging from the hips and reaching towards your ankle, sending your head in the direction of your knee. Hold for 5-10 breathes and then repeat on the other side.

5. Tree Pose 

 Vrksasana

Tree posture is a strong standing balance, which builds stability and strength in the standing leg, and also acts as a hip opener and spine stretch. Stand on your right leg, spreading your weight evenly though the foot, as you inhale, press your left foot firmly into your inner right leg, either above or below the knee, but avoiding the joint itself.

Bring your hands into prayer position and lift overhead. If you are wobbly you can bring your foot onto the floor or use a wall for support. Switch to the other side after 5-10 breaths.  

6. Cobra Pose

 A great chest opener and backbend, which builds strength in the upper body and encourages blood flow to muscles and joints.

Lying on your front with your hands either side of your chest, on an inhale lift up through your chest, straightening out through your arms.  Relax your shoulders down from your ears and on an exhale lengthen the body forwards to lower.  Repeat 5-10 times

7. Warrior Pose I 

 Virabhadrasana I

This posture will strengthen your legs and encourage blood flow. Bend your left knee directly over the ankle and step back with your right leg as far as is comfortable.

On an inhale reach your arms overhead and look up towards your hand if comfortable on your neck. Exhale and repeat on other side after 5-10 breaths.

8. Fish Pose Block Upper Back 

 Matsyasana Block Upper Back

 A great way to open the chest and also a good inversion, placing a block, cushion or bolster under your upper back as you lean back and place the back of your head on the mat, breathe deeply into chest and rise slowly bringing your head up last to avoid dizziness.

9. Cat Cow Pose 

 Bitilasana Marjaryasana

So good for the spine, inhale to open the chest, and lift your head and neck , exhale to tuck your tail bone under, round your spine and gaze towards your naval. Practice this  5-10 times.

10. Thunderbolt Pose Eagle Arms 

 Vajrasana Garudasana

 This should feel nice for the shoulders which can get tight from immobility. Sitting on your heels, lift your arms in front of you with elbows parallel to the floor, reach your right elbow behind your left and let your palms touch. Sit and breathe like this for 5-10 breaths, unravel and try the other side.

11. Corpse Pose 

 Savasana

Finally, enjoy 5 or so minutes of deep relaxation, lying comfortably on the floor, with shoulders down away from the ears, arms away from the body, palms facing up. Breathe deeply into the lower belly and let stress melt away as you enjoy the benefits of your practice. Namaste.

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