Can yoga help relieve chronic pain?

DEAR DOCTOR K:

I’ve heard that yoga can help relieve chronic pain. What types of pain can yoga help?

DEAR READER:

People have been practicing yoga for thousands of years. This mind-body exercise combines breath control, meditation and movements to stretch and strengthen muscles. But yoga places as great an emphasis on mental fitness as on physical fitness.

Research finds that yoga may help relieve pain in people with a variety of chronic pain conditions, including arthritis, fibromyalgia, migraine headaches and low back pain.

A study published in the journal Annals of Internal Medicine looked at 313 patients with chronic low back pain. The researchers found that a weekly yoga class increased mobility more than standard medical care for the condition.

People with carpal tunnel syndrome may also benefit from yoga. In 2003, the Cochrane Collaboration published a review of 21 studies. (This international group of health authorities evaluates randomized clinical trials.) They concluded that yoga significantly reduced pain in people with the syndrome.

Other studies have found that yoga may help increase strength and flexibility. The evidence is less strong that yoga improves physical fitness or balance, but there is some suggestion that it does. Yoga may improve what are called the “executive function” aspects of thinking. There is strong evidence that yoga reduces stress and anxiety.

Interestingly, yoga appears to calm inflammation in the body and boost the immune system, as measured by the immune response to immunizations for viral diseases. It also appears to modestly lower blood pressure, though not to a greater degree than other forms of exercise.

There are several types of yoga. The most popular form practiced in the United States is hatha yoga. It is built around a series of yoga postures, called asanas. Yoga sessions typically last from 45 to 90 minutes. But you can also get some benefit from shorter sessions, done a few times a week.

A session generally begins with breathing exercises that relax the body and help free the mind of worries and distractions. Breathing deeply through the nose is a vital component of yoga. The session then proceeds through a series of seated, standing and prone asanas. You may be instructed to hold each asana for a few seconds to minutes.

But you should never push your body further than it wishes to go. And you should stop if you feel any pain. Yoga sessions typically end with meditation.

Yoga postures can be modified to accommodate your strength and experience. People with medical conditions that make doing exercises on the floor (traditional for yoga) difficult or impossible can do yoga on a chair, instead. Be sure to tell your instructor about any limiting health problems. He or she can warn you against certain positions that may aggravate your pain and help you modify the poses to prevent injury.

So there are many reasons for you to try yoga. Some of my patients with chronic pain (and other medical conditions) find that it helps them greatly.