{"id":950,"date":"2020-09-13T06:58:19","date_gmt":"2020-09-13T06:58:19","guid":{"rendered":"https:\/\/www.diabetesasia.org\/magazine\/?p=950"},"modified":"2025-04-01T11:53:54","modified_gmt":"2025-04-01T06:23:54","slug":"yoga-for-anxiety","status":"publish","type":"post","link":"https:\/\/www.diabetesasia.org\/magazine\/yoga-for-anxiety\/","title":{"rendered":"Yoga for Anxiety and Mind"},"content":{"rendered":"<h2>Yoga for Anxiety and Mind<\/h2>\n<p><b>Yoga as therapy<\/b> uses\u00a0<a title=\"\" href=\"https:\/\/en.wikipedia.org\/wiki\/Yoga_as_exercise\">yoga as exercise<\/a>, consisting mainly of postures called\u00a0<a title=\"Asana\" href=\"https:\/\/en.wikipedia.org\/wiki\/Asana\">asanas<\/a>, as a gentle form of\u00a0<a title=\"Exercise\" href=\"https:\/\/en.wikipedia.org\/wiki\/Exercise\">exercise<\/a> and relaxation applied specifically to improve health. This form of\u00a0<a title=\"Yoga\" href=\"https:\/\/en.wikipedia.org\/wiki\/Yoga\">yoga<\/a> is widely practiced in classes and may involve meditation, imagery,\u00a0breathwork (pranayama),\u00a0and calming\u00a0<a title=\"Music\" href=\"https:\/\/en.wikipedia.org\/wiki\/Music\">music<\/a>.<\/p>\n<p>The primary analysis was completed in February and included noninferiority testing of Kundalini yoga vs. CBT(Cognitive behavior therapy) and superiority testing of this yoga type and CBT vs. stress education. Response at 12 weeks, as measured by the Clinical Global Impression\u2013Improvement Scale, was the primary outcome.<\/p>\n<p>Moderately Potent<\/p>\n<p>Results showed that response rates at 12 weeks were greater in the yoga group (54.2%) than in the stress education group (33.0%; odds ratio [OR], 2.45; 95% CI, 1.1 \u2013 5.4;\u00a0P\u00a0= .03), as well as in the CBT (70.8%) vs stress education group (OR, 5.0; 95% CI, 2.2 \u2013 11.82;\u00a0P\u00a0&lt; .001).<\/p>\n<p>The numbers needed to treat the yoga and CBT groups vs. the stress education group were 4.59 and 2.62.<br \/>\nHowever, on further testing, the researchers were unable to conclude that yoga was non-inferior to CBT. &#8220;Conversely, we were unable to conclude that the [response rate] of CBT was significantly higher&#8221; than yoga in a superiority test, they write.<\/p>\n<p>At the 6-month follow-up, the response rate was significantly higher for CBT vs stress education (OR, 3.56;\u00a0P\u00a0= .04) but not for yoga vs stress education (OR, 1.86;\u00a0P\u00a0= .34).<\/p>\n<p>Any of the participants reported any treatment-related serious adverse events (AEs). Regarding nonserious AEs that were &#8220;possibly&#8221; related to treatment, there were three reports of joint pain and one report each of tingling and vertigo in the yoga group; three reports of anxiety, two <a class=\"cl_ref_article_286485\" href=\"https:\/\/emedicine.medscape.com\/article\/286485-overview\">bulimia<\/a>\u00a0episodes, and one report of\u00a0<a class=\"cl_ref_article_286759\" href=\"https:\/\/emedicine.medscape.com\/article\/286759-overview\">depression<\/a> in the CBT group; and one report of anxiety in the education group.<br \/>\n&#8220;Overall, the available literature and our data support that [yoga] may be a helpful but only moderately potent intervention for GAD,&#8221; the investigators write.&#8221;Given the increasing costs of health care and barriers to accessing trained mental health care professionals, however, yoga may still have a role to play in GAD management as an intervention that is more easily accessible,&#8221;\u00a0 they add.<br \/>\nSimon agreed, noting that yoga may be beneficial for at least some patients in the short term.<\/p>\n<p>&#8220;More research is needed to understand who really can benefit the most from yoga and what can be done to help those responses last for a longer term,&#8221; she said.<br \/>\nAsked whether other types of yoga might be more effective or whether yoga plus CBT could be more effective than CBT alone, Simon said those are &#8220;open questions&#8221; that future studies should investigate.<br \/>\n&#8220;Good Signal&#8221;<\/p>\n<p>Commenting on the study for\u00a0Medscape Medical News,\u00a0Michelle B. Riba, MD, professor of psychiatry at the University of Michigan and past president of the American Psychiatric Association, noted that it is important to look at the size of a study&#8217;s patient population, the type of patient being evaluated, and the length of treatment.<\/p>\n<p><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/i0.wp.com\/img.medscapestatic.com\/thumbnail_library\/ht_200827_michelle_riba_120x156.jpg?resize=144%2C187&#038;ssl=1\" width=\"144\" height=\"187\" border=\"1\" data-src=\"https:\/\/img.medscapestatic.com\/thumbnail_library\/ht_200827_michelle_riba_120x156.jpg\" data-width=\"120\" data-height=\"156\" \/><\/p>\n<p class=\"fig-caption\">Dr. Michelle B. Riba<\/p>\n<p>&#8220;The devil&#8217;s always in the details,&#8221; said Riba, who was not involved with the research. She noted that the current participants were relatively young, mostly white, and mostly employed.<br \/>\n&#8220;This was a select group of people, many of whom had been on a psychotropic medication before coming in, so this group wanted to get some help. And even though this type of yoga didn&#8217;t do as well as CBT, it clearly could be an adjunct or for those who have financial difficulties or don&#8217;t want formal psychiatric care,&#8221; she said.<br \/>\nRiba pointed out that this was a small, &#8220;well-done pilot study of a critical diagnosis and evidence-based treatments for it.&#8221;<\/p>\n<p>Future studies can investigate whether yoga is better at the beginning of treatment for GAD (Generalized Anxiety disorder) or after CBT has been provided, she noted. The current study &#8220;is useful for further research,&#8221; she added.<br \/>\n&#8220;This type of yoga did pretty well in this population of people for a particular range of time. That was a good signal,&#8221; said Riba.<br \/>\nThe study was funded by the National Center for Complementary and Integrative Health. Simon reports having received grants from the National Institutes of Health, the US Department of Defense, the American Foundation for\u00a0<a class=\"cl_ref_article_2013085\" href=\"https:\/\/emedicine.medscape.com\/article\/2013085-overview\">Suicide<\/a> Prevention, the Patient-Centered Outcomes Research Institute, the Highland Street Foundation, and Janssen; personal fees from Vanda, Axovant Sciences, Springworks, Praxis Therapeutics, Aptinyx, Genomind, Wiley, and the Massachusetts General Hospital Psychiatry Academy; and royalties from Wolters Kluwer for contributions to\u00a0UpToDate. She has also performed grant reviews for the American Foundation for Suicide Prevention and reports having a spousal stock from G1 Therapeutics unrelated to the submitted work. Disclosures for the other study authors are listed in the original article. Riba is editing a psychiatry textbook in which Simon is contributing a chapter.<br \/>\nJAMA Psychiatry. Published online August 12, 2020.\u00a0Abstract<\/p>\n<p>At least three types of health claims have been made for yoga: magical claims\u00a0for medieval\u00a0ha\u1e6dha yoga, including the power of healing; unsupported claims of benefits to\u00a0organ systems from the practice of asanas; and more or less well-supported claims of specific medical and psychological benefits from studies of different sizes using a wide variety of methodologies.<\/p>\n<p>Systematic reviews\u00a0have found beneficial effects of yoga on\u00a0low back pain<sup id=\"cite_ref-CramerLaucheHaller2013_2-0\" class=\"reference\"><\/sup>\u00a0and\u00a0depression, but despite much investigation, little or no evidence for benefit for specific medical conditions.<sup id=\"cite_ref-Uebelacker_2010_4-0\" class=\"reference\"><\/sup> The study of\u00a0trauma-sensitive yoga has been hampered by weak methodology.<\/p>\n<div class=\"hatnote navigation-not-searchable\" role=\"note\"><a title=\"Yoga as exercise\" href=\"https:\/\/en.wikipedia.org\/wiki\/Yoga_as_exercise\">Yoga as exercise<\/a><\/div>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\">\n<p><a class=\"image\" href=\"https:\/\/en.wikipedia.org\/wiki\/File:Yoga_dimensions.svg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage aligncenter\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/8\/89\/Yoga_dimensions.svg\/370px-Yoga_dimensions.svg.png\" srcset=\"\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/8\/89\/Yoga_dimensions.svg\/555px-Yoga_dimensions.svg.png 1.5x, \/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/8\/89\/Yoga_dimensions.svg\/740px-Yoga_dimensions.svg.png 2x\" alt=\"\" width=\"370\" height=\"297\" data-file-width=\"947\" data-file-height=\"759\" \/><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Different schools teach yoga with an emphasis on aerobic exercise\u00a0(such as\u00a0Bikram Yoga), precision in the asanas (like\u00a0Iyengar Yoga), or spirituality (like\u00a0Sivananda Yoga)\u00a0Unbranded &#8220;hatha yoga&#8221; (not to be confused with medieval\u00a0ha\u1e6dha yoga) may teach any combination of these.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>Yoga\u00a0classes used as therapy usually consist of\u00a0asanas\u00a0(postures used for stretching),\u00a0pranayama\u00a0(breathing exercises), and relaxation in\u00a0savasana (lying down). The physical asanas of modern yoga are related to the medieval ha\u1e6dha yoga tradition, but they were not widely practiced in India before the early 20th century.<\/p>\n<p>The number of\u00a0schools and styles of yoga in the Western world has grown rapidly since the late 20th century. By 2012, there were at least 19 widespread styles from\u00a0Ashtanga Vinyasa Yoga\u00a0to\u00a0Viniyoga. These emphasize different aspects, including aerobic exercise, precision in the asanas, and spirituality in the\u00a0ha\u1e6dha yoga tradition.<sup id=\"cite_ref-Beirne_2014_9-0\" class=\"reference\"><\/sup> Schools with distinctive styles can illustrate these aspects. Thus,\u00a0Bikram Yoga\u00a0has an aerobic exercise style with rooms heated to 105\u00a0\u00b0F (41\u00a0\u00b0C) and a fixed sequence of 2 breathing exercises and 26 asanas performed in every session.\u00a0Iyengar Yoga emphasizes correct alignment in the postures, working slowly, if necessary with props, and ending with relaxation.\u00a0Sivananda Yoga\u00a0focuses more on spiritual practice, with 12 basic poses, chanting in\u00a0Sanskrit,\u00a0pranayama\u00a0breathing exercises,\u00a0<a title=\"Meditation\" href=\"https:\/\/en.wikipedia.org\/wiki\/Meditation\">meditation<\/a>, relaxation in each class, and importance placed on a <a title=\"Vegetarianism\" href=\"https:\/\/en.wikipedia.org\/wiki\/Vegetarianism\">vegetarian diet<\/a>.<sup id=\"cite_ref-Beirne_2014_9-1\" class=\"reference\"><\/sup><\/p>\n<h2><span id=\"Types_of_claim\" class=\"mw-headline\">Types of claim<\/span><\/h2>\n<p>At least three different types of claims of therapeutic benefit have been made for yoga from medieval times onwards, not counting the more general claims of good health made throughout this period: magical powers, biomedical claims for marketing purposes, and specific medical claims. Neither of the first two is supported by reliable evidence. The medical claims are supported by evidence of varying quality, from case studies to controlled trials and a systematic review of multiple trials.<sup id=\"cite_ref-FOOTNOTEBroad201239_and_whole_book_11-0\" class=\"reference\"><\/sup><\/p>\n<h3><span id=\"Magical_powers\" class=\"mw-headline\">Magical powers<\/span><\/h3>\n<p>Medieval authors asserted that\u00a0<a class=\"mw-redirect\" title=\"Ha\u1e6dha yoga\" href=\"https:\/\/en.wikipedia.org\/wiki\/Ha%E1%B9%ADha_yoga\">Ha\u1e6dha yoga<\/a> brought physical (and spiritual) benefits and provided magical powers, including healing. The <i>Hatha Yoga Pradipika<\/i> (HYP) states that asanas in general, described as the first auxiliary of ha\u1e6dha yoga, give &#8220;steadiness, good health, and a lightness of limb.&#8221; (HYP 1.17)\u00a0Specific asanas, it claims, bring additional benefits; for example,\u00a0Matsyendrasana\u00a0awakens\u00a0Kundalini\u00a0and helps to prevent\u00a0semen\u00a0from being shed involuntarily; (HYP 1.27)\u00a0Paschimottanasana &#8220;stokes up the digestive fire, slims the belly, and gives good health&#8221;; (HYP 1.29)\u00a0Shavasana\u00a0&#8220;takes away fatigue and relaxes the mind&#8221;; (HYP 1.32) while\u00a0Padmasana\u00a0&#8220;destroys all diseases&#8221; (HYP 1.47).<sup id=\"cite_ref-FOOTNOTEMallinsonSingleton2017108\u2013111_12-0\" class=\"reference\"><\/sup>\u00a0These claims lie within a tradition across all forms of yoga that practitioners can gain\u00a0supernatural powers.\u00a0Hemachandra&#8217;s\u00a0<i>Yogashastra<\/i> (1.8\u20139) lists magical powers, including healing and poison destruction.<\/p>\n<h3><span id=\"Biomedical_claims_for_marketing_purposes\" class=\"mw-headline\">Biomedical claims for marketing purposes<\/span><\/h3>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\">\n<p><a class=\"image\" href=\"https:\/\/en.wikipedia.org\/wiki\/File:Uttitha_Trikonasana.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage aligncenter\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/b\/b5\/Uttitha_Trikonasana.jpg\/220px-Uttitha_Trikonasana.jpg\" srcset=\"\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/b\/b5\/Uttitha_Trikonasana.jpg\/330px-Uttitha_Trikonasana.jpg 1.5x, \/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/b\/b5\/Uttitha_Trikonasana.jpg\/440px-Uttitha_Trikonasana.jpg 2x\" alt=\"\" width=\"220\" height=\"189\" data-file-width=\"679\" data-file-height=\"582\" \/><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Styles of yoga differ in their approach to the asanas.\u00a0Iyengar Yoga emphasizes correctness, seen here as a practitioner uses a\u00a0yoga brick\u00a0to attain correct alignment in\u00a0Utthitha Trikonasana.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>Twentieth-century advocates of some yoga schools, such as B. K. S. Iyengar, have for various reasons made claims about the effects of yoga on specific organs without adducing any evidence. The yoga scholar Suzanne Newcombe argues that this was one of several visions of yoga as, in some sense, therapeutic, ranging from medical to a more popular offer of health and well-being. <sup id=\"cite_ref-FOOTNOTENewcombe2019203-227,_Chapter_&quot;Yoga_as_Therapy&quot;_15-0\" class=\"reference\"><\/sup>The yoga scholar\u00a0Andrea Jain describes these claims of Iyengar&#8217;s in terms of &#8220;elaborating and fortifying his yoga brand&#8221;<sup id=\"cite_ref-FOOTNOTEJain201582\u201383_16-0\" class=\"reference\"><\/sup> and &#8220;mass-marketing,&#8221;\u00a0calling Iyengar&#8217;s 1966 book\u00a0<i>Light on Yoga<\/i> &#8220;arguably the most significant event in the process of elaborating the brand.&#8221;<sup id=\"cite_ref-FOOTNOTEJain201582\u201383_16-2\" class=\"reference\"><\/sup>\u00a0The yoga teacher Bernie Gourley notes that the book neither describes\u00a0contraindications systematically nor provides evidence for the claimed benefits.<sup id=\"cite_ref-17\" class=\"reference\"><\/sup> Jain suggests that &#8220;Its biomedical dialect was attractive to many.&#8221;\u00a0For example, in the book, Iyengar claims that the asanas of the\u00a0Eka Pada Sirsasana cycle<\/p>\n<blockquote class=\"templatequote\"><p>&#8230;tone up the muscular, nervous, and circulatory systems of the entire body. The spine receives a rich supply of blood, which increases the nervous energy in the <a title=\"Chakra\" href=\"https:\/\/en.wikipedia.org\/wiki\/Chakra\">chakras<\/a> (the various nerve plexuses situated in the spine), and the <a title=\"Flywheel\" href=\"https:\/\/en.wikipedia.org\/wiki\/Flywheel\">flywheels<\/a> in the human body machine. These poses develop the chest and make the breathing fuller and the body firmer; they stop the nervous trembling of the body and prevent the diseases that cause it; they also help to eliminate toxins by supplying pure blood to every part of the body and bringing the congested blood back to the heart and lungs for purification.<\/p><\/blockquote>\n<p>William J. Broad reviewed the history of such claims in his 2012 book <i>The Science of Yoga<\/i>. Broad argues that while the health claims for yoga began as\u00a0<a class=\"mw-redirect\" title=\"Hindu nationalist\" href=\"https:\/\/en.wikipedia.org\/wiki\/Hindu_nationalist\">Hindu nationalist<\/a> posturing, it turns out that there is ironic<sup id=\"cite_ref-FOOTNOTEBroad201239_and_whole_book_11-1\" class=\"reference\"><\/sup> &#8220;a wealth of real benefits.&#8221;<sup id=\"cite_ref-FOOTNOTEBroad201239_and_whole_book_11-2\" class=\"reference\"><\/sup><\/p>\n<h3><span id=\"Evidence-based_medical_claims\" class=\"mw-headline\">Evidence-based medical claims<\/span><\/h3>\n<p>Researchers have studied yoga&#8217;s medical and psychological effects as an exercise in a wide range of trials and observational studies, sometimes with careful controls, providing evidence of differing quality about yoga&#8217;s possible benefits. The physician and yoga therapist Timothy McCall has assembled an extensive list of studies, grouped by condition, providing evidence of varying quality for &#8220;117 Health Conditions Helped by Yoga&#8221;; he notes the &#8220;irony&#8221; that &#8220;in yoga therapy, we don&#8217;t treat medical conditions per se. We treat individuals.&#8221;<sup id=\"cite_ref-19\" class=\"reference\"><\/sup> The various types of claims, and the evidence for them, are discussed below.<\/p>\n<h2><span id=\"Types_of_activity\" class=\"mw-headline\">Types of activity<\/span><\/h2>\n<h3><span id=\"Remedial_yoga\" class=\"mw-headline\">Remedial yoga<\/span><\/h3>\n<div class=\"hatnote navigation-not-searchable\" role=\"note\">Further information:\u00a0<a title=\"Yoga using props\" href=\"https:\/\/en.wikipedia.org\/wiki\/Yoga_using_props\">Yoga using props<\/a><\/div>\n<p>Newcombe notes that Iyengar was sickly as a child and that yoga with his brother-in-law Krishnamacharya had improved his health; it had also helped his daughter,\u00a0Geeta, so his response to his students&#8217; health issues &#8220;was an intense and personal one.&#8221;\u00a0In effect, Newcombe argues, Iyengar was treating &#8220;remedial yoga&#8221; as analogous to\u00a0Henrik Ling&#8217;s medical gymnastics.<sup id=\"cite_ref-FOOTNOTENewcombe2019215_20-1\" class=\"reference\"><\/sup> As early as 1940, Iyengar used yoga to treat common conditions such as sinus problems, backache, and fatigue. Iyengar was willing to push people through the pain &#8220;to [show] them new possibilities.&#8221;\u00a0In the 1960s, he trained a few people such as Diana Clifton and\u00a0Silva Mehta to deliver this remedial yoga; particular asanas were used for different conditions, and non-remedial Iyengar Yoga teachers were taught to tell students that ordinary classes were not suitable for &#8220;serious health issues&#8221;\u00a0Mehta taught a remedial yoga class in the Iyengar Yoga Institute in\u00a0Maida Vale from its opening in 1984;<sup id=\"cite_ref-FOOTNOTENewcombe2019221_24-0\" class=\"reference\"><\/sup>\u00a0she contributed &#8220;Remedial Programs&#8221; for conditions such as\u00a0arthritis,\u00a0backache,\u00a0knee cartilage\u00a0problems,\u00a0pregnancy,\u00a0sciatica,\u00a0scoliosis\u00a0and\u00a0varicose veins\u00a0in the Mehtas&#8217; 1990 book\u00a0<i>Yoga the Iyengar Way<\/i>. However, Iyengar was deferential to Western medicine and its assessments, so in Newcombe&#8217;s view, Iyengar Yoga is &#8220;positioned as complementary to standard medical treatment rather than as an alternative.&#8221;<\/p>\n<p>Newcombe argues that yoga &#8220;largely avoided overt conflict with the medical profession in Britain by simultaneously professionalizing with educational qualifications and deferring to medical expertise.&#8221;\u00a0After\u00a0Richard Hittleman&#8217;s\u00a0<i>Yoga for Health<\/i>\u00a0series on\u00a0ITV from 1971 to 1974,\u00a0the series producer Howard Kent founded a\u00a0charity, the Yoga for Health Foundation, to &#8220;Research into the therapeutic benefits to be obtained by the practice of yoga&#8221;;\u00a0residential courses began in 1978 at\u00a0Ickwell Bury in Bedfordshire.<sup id=\"cite_ref-FOOTNOTENewcombe2019211_30-0\" class=\"reference\"><\/sup> The Foundation stated that yoga was not a therapy or cure but had &#8220;therapeutic benefits,&#8221; whether physical, mental, or emotional, and it worked especially with &#8220;the physically handicapped.&#8221; Newcombe notes that a third organization, the Yoga Biomedical Trust, was founded in\u00a0Cambridge\u00a0in 1983 by a biologist, Robin Monro, to research complementary therapies. He found it hard to obtain\u00a0<a class=\"mw-redirect\" title=\"Research funding\" href=\"https:\/\/en.wikipedia.org\/wiki\/Research_funding\">research funding<\/a>. In the 1990s, they moved to London, focusing on training yoga teachers in yoga as therapy and providing yoga as individualized therapy, using pranayama, relaxation, and asanas.<\/p>\n<h3><span id=\"Sports_medicine\" class=\"mw-headline\">Sports medicine<\/span><\/h3>\n<p>From the point of view of\u00a0sports medicine, asanas function as active stretches, helping to protect\u00a0muscles\u00a0from\u00a0injury; these need to be performed equally on both sides, the stronger side first if used for\u00a0physical rehabilitation.<\/p>\n<h2><span id=\"Research\" class=\"mw-headline\">Research<\/span><\/h2>\n<div class=\"hatnote navigation-not-searchable\" role=\"note\">Further information:\u00a0Clinical study design<\/div>\n<p>Much of the research on the therapeutic use of yoga has been in preliminary studies or clinical trials\u00a0of low methodological quality, including small sample sizes, inadequate\u00a0control, blinding, lack of\u00a0randomization, and high risk of\u00a0bias.<sup id=\"cite_ref-Uebelacker_2010_4-1\" class=\"reference\"><\/sup> Further research is needed to quantify the benefits and to clarify the mechanisms involved.<sup id=\"cite_ref-PenmanStevens2012_35-0\" class=\"reference\"><\/sup><\/p>\n<p>For example, a 2010 literature review on the use of yoga for\u00a0depression stated, &#8220;Although the results from these trials are encouraging, they should be viewed as very preliminary because the trials, as a group, suffered from substantial methodological limitations.&#8221;A 2015 <a title=\"Systematic review\" href=\"https:\/\/en.wikipedia.org\/wiki\/Systematic_review\">systematic review<\/a> on the effect of yoga on mood and the brain recommended that future clinical trials apply more methodological rigor.<\/p>\n<h3><span id=\"Mechanisms\" class=\"mw-headline\">Mechanisms<\/span><\/h3>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\">\n<p><a class=\"image\" href=\"https:\/\/en.wikipedia.org\/wiki\/File:YogaClass.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage aligncenter\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/7\/72\/YogaClass.jpg\/220px-YogaClass.jpg\" srcset=\"\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/7\/72\/YogaClass.jpg\/330px-YogaClass.jpg 1.5x, \/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/7\/72\/YogaClass.jpg\/440px-YogaClass.jpg 2x\" alt=\"\" width=\"220\" height=\"165\" data-file-width=\"1024\" data-file-height=\"768\" \/><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>A yoga class relaxing in\u00a0Supta Baddha Konasana. There is evidence that yoga relieves\u00a0stress by multiple mechanisms.<sup id=\"cite_ref-RileyPark2015_36-0\" class=\"reference\"><\/sup><\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>The practice of asanas has been claimed to improve flexibility, strength, and balance, alleviate stress and anxiety, and reduce the symptoms of lower back pain\u00a0without necessarily demonstrating the precise mechanisms involved.\u00a0A review of five studies noted that three psychological (positive affect,\u00a0mindfulness,\u00a0self-compassion) and four biological mechanisms (posterior\u00a0hypothalamus,\u00a0interleukin-6,\u00a0C-reactive protein,\u00a0and\u00a0cortisol) that might act on stress had been examined empirically, whereas many other potential mechanisms remained to be studied; four of the mechanisms (positive affect, self-compassion, inhibition of the posterior hypothalamus and salivary cortisol) were found to mediate yoga&#8217;s effect on\u00a0stress.<\/p>\n<h3><span id=\"Low_back_pain\" class=\"mw-headline\">Low back pain<\/span><\/h3>\n<p>Back pain is one reason people take up yoga, and since at least the 1960s, some practitioners have claimed that it relieved their symptoms.<\/p>\n<p>A 2013 systematic review on the use of yoga for\u00a0<a title=\"Low back pain\" href=\"https:\/\/en.wikipedia.org\/wiki\/Low_back_pain\">low back pain<\/a> found strong evidence for short- and long-term effects on pain, and moderate evidence for long-term benefit in back-specific disability, with no serious adverse events. Ten randomized controlled trials were analyzed, of which eight had a low risk of bias. The outcomes measured included improvements in &#8220;pain, back-specific disability, generic disability, health-related quality of life, and global improvement.&#8221; The review stated that yoga could be recommended as an additional therapy for chronic low back pain patients.<\/p>\n<h3><span id=\"Mental_disorders\" class=\"mw-headline\">Mental disorders<\/span><\/h3>\n<div class=\"hatnote navigation-not-searchable\" role=\"note\">\u00a0<a title=\"Trauma-sensitive yoga\" href=\"https:\/\/en.wikipedia.org\/wiki\/Trauma-sensitive_yoga\">Trauma-sensitive yoga<\/a><\/div>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\">\n<p><a class=\"image\" href=\"https:\/\/en.wikipedia.org\/wiki\/File:Ptsd_figure.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage aligncenter\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/3\/30\/Ptsd_figure.png\/170px-Ptsd_figure.png\" srcset=\"\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/3\/30\/Ptsd_figure.png\/255px-Ptsd_figure.png 1.5x, \/\/upload.wikimedia.org\/wikipedia\/commons\/3\/30\/Ptsd_figure.png 2x\" alt=\"\" width=\"170\" height=\"193\" data-file-width=\"292\" data-file-height=\"332\" \/><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Trauma-sensitive yoga\u00a0has been developed in the US in the hope of benefiting individuals suffering from\u00a0psychological trauma.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>Trauma-sensitive yoga has been developed by David Emerson and others at the Trauma Center at the Justice Resource Institute in Brookline, Massachusetts. The center uses yoga alongside other treatments to support recovery from traumatic episodes and enable healing from PTSD. Workers including\u00a0Bessel van der Kolk\u00a0and\u00a0Richard Miller have studied how clients can &#8220;regain comfort in their bodies, counteract rumination, and improve self-regulation through yoga.&#8221;<sup id=\"cite_ref-Nolan2016_40-0\" class=\"reference\"><\/sup><\/p>\n<p>Systematic reviews indicate that yoga offers moderate benefits in the treatment of PTSD.\u00a0A 2017 systematic review of PTSD in post-9\/11 veterans showed that participants in studies who had received mindfulness training, mind-body therapy, and yoga &#8220;reported significant improvements in\u00a0PTSD symptoms.&#8221; Another systematic review of veterans the same year also found improvement in PTSD symptoms. Other systematic reviews postulate that designing the style and instructions to the needs of the veterans leads to better results and a larger impact on PTSD symptoms.<sup id=\"cite_ref-:2_46-0\" class=\"reference\"><\/sup><\/p>\n<p>A 2013 systematic review on the use of yoga for\u00a0depression found moderate evidence of short-term benefit over &#8220;usual care&#8221; and limited evidence compared to relaxation and aerobic exercise. Only 3 of 12 randomized controlled trials had a low risk of bias. The diversity of the studies precluded analysis of long-term effects.\u00a0A 2015 systematic review on the effect of yoga on mood and the brain concluded that &#8220;yoga is associated with better regulation of the sympathetic nervous system and\u00a0hypothalamic-pituitary-adrenal system, as well as a decrease in depressive and anxious symptoms in a range of populations.&#8221;\u00a0A systematic review in 2017 found some evidence of benefit in major depressive disorder, examining outcomes primarily of improvements in remission rates and severity of depression (and secondarily of anxiety and adverse events), but considered that better\u00a0<a class=\"mw-redirect\" title=\"Randomised controlled trial\" href=\"https:\/\/en.wikipedia.org\/wiki\/Randomised_controlled_trial\">randomized controlled trials<\/a> were required.<\/p>\n<h3><span id=\"Cardiovascular_health\" class=\"mw-headline\">Cardiovascular health<\/span><\/h3>\n<p>A 2012 survey of yoga in Australia notes that there is &#8220;good evidence&#8221;\u00a0that yoga and its associated\u00a0healthy lifestyle\u2014often\u00a0vegetarian, usually\u00a0non-smoking, preferring\u00a0organic food,\u00a0drinking less or no alcohol\u2013is beneficial for cardiovascular health, but that there was &#8220;little apparent uptake of yoga to address [existing] cardiovascular conditions and risk factors.&#8221;<sup id=\"cite_ref-PenmanStevens2012_35-1\" class=\"reference\"><\/sup> Respondents cited yoga as a cause of these lifestyle changes; the survey notes that the relative importance of the various factors had not been assessed.<\/p>\n<h3><span id=\"Other_conditions\" class=\"mw-headline\">Other conditions<\/span><\/h3>\n<p>There is little reliable evidence that yoga is beneficial for specific medical conditions, and an increasing amount of evidence is not, as follows.<\/p>\n<p>A systematic review in 2013 found weak evidence for the use of yoga for\u00a0rheumatic diseases, examining outcomes of pain and disability, with no evidence of its safety.<sup id=\"cite_ref-rd_50-0\" class=\"reference\"><\/sup><\/p>\n<p>A 2015 systematic review found no evidence of benefit in the treatment of epilepsy\u00a0or\u00a0menopause-related symptoms.<sup id=\"cite_ref-Lee2009_52-0\" class=\"reference\"><\/sup><\/p>\n<p>According to the\u00a0American Cancer Society, the practice of yoga can improve strength and balance in cancer patients, is &#8220;unlikely to cause harm,&#8221; and does not &#8220;interfere with cancer treatment.&#8221;<sup id=\"cite_ref-ACS_alternatives_53-1\" class=\"reference\"><\/sup> The society notes that yoga &#8220;cannot cure cancer,&#8221; but that yoga may help to improve the quality of life\u00a0in cancer survivors, as shown in a\u00a0randomized controlled trial\u00a0of women who had had\u00a0breast cancer. Measured outcomes included fatigue, depression, and sleep quality.<sup id=\"cite_ref-ChandwaniPerkins2014_55-0\" class=\"reference\"><\/sup><\/p>\n<p>A systematic review in 2015 found &#8220;promising&#8221; evidence that exercise helps people with\u00a0dementia\u00a0perform\u00a0activitie<a title=\"Activities of daily living\" href=\"https:\/\/en.wikipedia.org\/wiki\/Activities_of_daily_living\">s of daily living<\/a> (ADLs), but no evidence that cognition, neuropsychiatric symptoms, or depression were benefited; yoga was not distinguished from other forms of exercise.<\/p>\n<p><a href=\"https:\/\/www.diabetesasia.org\/magazine\/1220-2\/\">A 2010 systematic review<\/a> showed no effect of yoga on\u00a0attention deficit hyperactivity disorder, measured by teacher rating on the ADHD overall scale.<sup id=\"cite_ref-Krisanaprakornkit2010_34-1\" class=\"reference\"><\/sup><\/p>\n<p>A systematic review in 2019 concluded that there was not enough evidence to assess the effectiveness of yoga for treating women with urinary incontinence.<\/p>\n<h2><span id=\"Safety\" class=\"mw-headline\">Safety<\/span><\/h2>\n<div class=\"hatnote navigation-not-searchable\" role=\"note\">Further information:\u00a0Science of Yoga<\/div>\n<p>Although relatively safe, yoga is not a risk-free form of exercise. Sensible precautions can usefully be taken \u2013 for example, the avoidance of advanced moves by beginners, not combining practice with psychoactive drug use, and avoiding competitiveness.<\/p>\n<p>A small percentage of yoga practitioners each year suffer physical injuries analogous to\u00a0sports injuries.\u00a0The practice of yoga has been cited as a cause of hyperextension or rotation of the neck, which may be a precipitating factor in\u00a0<a title=\"Vertebral artery dissection\" href=\"https:\/\/en.wikipedia.org\/wiki\/Vertebral_artery_dissection\">cervical artery dissection<\/a>.<\/p>\n<p>&nbsp;<\/p>\n<h3 class=\"entry-title\"><a href=\"https:\/\/www.diabetesasia.org\/magazine\/1220-2\/\">Why International Yoga Day is no cause for celebration in India<\/a><\/h3>\n","protected":false},"excerpt":{"rendered":"<p>Yoga for Anxiety and Mind Yoga as therapy uses\u00a0yoga as exercise, consisting mainly of postures&#8230;<\/p>\n","protected":false},"author":2,"featured_media":8757,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[23,180],"tags":[656,657,659,653,660,654,663,661,662,664,652,655,651,658,394],"class_list":["post-950","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lifestyle-medicine","category-meditation","tag-adverse-events","tag-aes","tag-bulimia-episodes","tag-cbt","tag-cbt-group","tag-conginitive-behaviour-therapy","tag-dr-michelle-b-riba","tag-gad","tag-generalised-affective-disorder","tag-generalized-anxiety-disorder","tag-kundalini-yoga","tag-stress-education","tag-suicide-prevention","tag-vertigo","tag-yoga"],"aioseo_notices":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/www.diabetesasia.org\/magazine\/wp-content\/uploads\/2020\/09\/maxresdefault.jpg?fit=1280%2C720&ssl=1","jetpack_sharing_enabled":true,"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/www.diabetesasia.org\/magazine\/wp-json\/wp\/v2\/posts\/950","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.diabetesasia.org\/magazine\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.diabetesasia.org\/magazine\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.diabetesasia.org\/magazine\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.diabetesasia.org\/magazine\/wp-json\/wp\/v2\/comments?post=950"}],"version-history":[{"count":3,"href":"https:\/\/www.diabetesasia.org\/magazine\/wp-json\/wp\/v2\/posts\/950\/revisions"}],"predecessor-version":[{"id":8758,"href":"https:\/\/www.diabetesasia.org\/magazine\/wp-json\/wp\/v2\/posts\/950\/revisions\/8758"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.diabetesasia.org\/magazine\/wp-json\/wp\/v2\/media\/8757"}],"wp:attachment":[{"href":"https:\/\/www.diabetesasia.org\/magazine\/wp-json\/wp\/v2\/media?parent=950"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.diabetesasia.org\/magazine\/wp-json\/wp\/v2\/categories?post=950"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.diabetesasia.org\/magazine\/wp-json\/wp\/v2\/tags?post=950"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}