research studies on yoga

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Exploring the therapeutic effects of yoga and its ability to increase quality of life

Catherine woodyard.

Department of Health, Exercise Science and Recreation Management, The University of Mississippi, The Center for Health Behavior Research, 215 Turner Center, University, MS, USA

The objective of this study is to assess the findings of selected articles regarding the therapeutic effects of yoga and to provide a comprehensive review of the benefits of regular yoga practice. As participation rates in mind-body fitness programs such as yoga continue to increase, it is important for health care professionals to be informed about the nature of yoga and the evidence of its many therapeutic effects. Thus, this manuscript provides information regarding the therapeutic effects of yoga as it has been studied in various populations concerning a multitude of different ailments and conditions. Therapeutic yoga is defined as the application of yoga postures and practice to the treatment of health conditions and involves instruction in yogic practices and teachings to prevent reduce or alleviate structural, physiological, emotional and spiritual pain, suffering or limitations. Results from this study show that yogic practices enhance muscular strength and body flexibility, promote and improve respiratory and cardiovascular function, promote recovery from and treatment of addiction, reduce stress, anxiety, depression, and chronic pain, improve sleep patterns, and enhance overall well-being and quality of life.

INTRODUCTION

A 3,000 year old tradition, yoga, is now regarded in the Western world as a holistic approach to health and is classified by the National Institutes of Health as a form of Complementary and Alternative Medicine (CAM).[ 1 ] The word “yoga” comes from a Sanskrit root “yuj” which means union, or yoke, to join, and to direct and concentrate one's attention.[ 2 , 3 ] Regular practice of yoga promotes strength, endurance, flexibility and facilitates characteristics of friendliness, compassion, and greater self-control, while cultivating a sense of calmness and well-being.[ 4 , 5 ] Sustained practice also leads to important outcomes such as changes in life perspective, self-awareness and an improved sense of energy to live life fully and with genuine enjoyment.[ 6 – 8 ] The practice of yoga produces a physiological state opposite to that of the flight-or-fight stress response and with that interruption in the stress response, a sense of balance and union between the mind and body can be achieved.[ 9 ]

Yoga is a form of mind-body fitness that involves a combination of muscular activity and an internally directed mindful focus on awareness of the self, the breath, and energy.[ 4 ] Four basic principles underlie the teachings and practices of yoga's healing system.[ 6 ] The first principle is the human body is a holistic entity comprised of various interrelated dimensions inseparable from one another and the health or illness of any one dimension affects the other dimensions. The second principle is individuals and their needs are unique and therefore must be approached in a way that acknowledges this individuality and their practice must be tailored accordingly. The third principle is yoga is self-empowering; the student is his or her own healer. Yoga engages the student in the healing process; by playing an active role in their journey toward health, the healing comes from within, instead of from an outside source and a greater sense of autonomy is achieved. The fourth principle is that the quality and state of an individuals mind is crucial to healing. When the individual has a positive mind-state healing happens more quickly, whereas if the mind-state is negative, healing may be prolonged.

Yoga philosophy and practice were first described by Patanjali in the classic text, Yoga Sutras , which is widely acknowledged as the authoritative text on yoga.[ 2 , 6 ] Today, many people identify yoga only with asana, the physical practice of yoga, but asana is just one of the many tools used for healing the individual; only three of the 196 sutras mention asana and the remainder of the text discusses the other components of yoga including conscious breathing, meditation, lifestyle and diet changes, visualization and the use of sound, among many others.[ 6 ] In Yoga Sutras , Patanjali outlines an eightfold path to awareness and enlightenment called ashtanga , which literally means “eight limbs”.[ 2 , 10 ]

The eight limbs are comprised of ethical principles for living a meaningful and purposeful life; serving as a prescription for moral and ethical conduct and self-discipline, they direct attention towards one's health while acknowledging the spiritual aspects of one's nature. Any of the eight limbs may be used separately, but within yoga philosophy the physical postures and breathing exercises prepare the mind and body for meditation and spiritual development.[ 4 , 10 ] Based on Patanjali's eight limbs, many different yogic disciplines have been developed. Each has its own technique for preventing and treating disease.[ 1 ] In the Western world, the most common aspects of yoga practiced are the physical postures and breathing practices of Hatha yoga and meditation.[ 4 ] Hatha yoga enhances the capacity of the physical body through the use of a series of body postures, movements (asanas), and breathing techniques (pranayama). The breathing techniques of Hatha yoga focus on conscious prolongation of inhalation, breath retention, and exhalation. It is through the unification of the physical body, breath, and concentration, while performing the postures and movements that blockages in the energy channels of the body are cleared and the body energy system becomes more balanced. Although numerous styles of Hatha yoga exist, the majority of studies included in this manuscript utilized the Iyengar style of yoga. The Iyengar method of Hatha yoga is based on the teachings of the yoga master B.K.S. Iyengar.[ 1 ] Iyengar yoga places an emphasis on standing poses to develop strength, stability, stamina, concentration and body alignment. Props are utilized to facilitate learning and to adjust poses and instruction is given on how to use yoga to ease various ailments and stressors.

Yoga is recognized as a form of mind-body medicine that integrates an individual's physical, mental and spiritual components to improve aspects of health, particularly stress related illnesses.[ 8 ] Evidence shows that stress contributes to the etiology of heart disease, cancer, and stroke as well as other chronic conditions and diseases.[ 11 ] Due to the fact that stress is implicated in numerous diseases, it is a priority to include a focus on stress management and reduction of negative emotional states in order to reduce the burden of disease. Viewed as a holistic stress management technique, yoga is a form of CAM that produces a physiological sequence of events in the body reducing the stress response. The scientific study of yoga has increased substantially in recent years and many clinical trials have been designed to assess its therapeutic effects and benefits.

As participation rates in mind-body fitness programs such as yoga continue to increase, it is important for health care professionals to be informed about the nature of yoga and the evidence of its many therapeutic effects. Thus, this review of the literature is timely and important and provides information regarding the therapeutic effects of yoga in various populations concerning a multitude of different ailments and conditions. Therapeutic yoga is defined as the application of yoga postures and practice to the treatment of health conditions.[ 4 ] Yoga therapy involves instruction in yogic practices and teachings to prevent reduce or alleviate structural, physiological, emotional and spiritual pain, suffering or limitations. Yogic practices enhance muscular strength and body flexibility, promote and improve respiratory and cardiovascular function, promote recovery from and treatment of addiction, reduce stress, anxiety, depression, and chronic pain, improve sleep patterns, and enhance overall well-being and quality of life.[ 4 , 6 , 12 – 17 ]

In order to locate research studies and interventions that examined the therapeutic effects of yoga, databases were searched through Google Scholar via a universities web browser. Initially, the following key words were entered into the database via the advanced search option: “yoga,” and “therapeutic effects.” This search was conducted to obtain general information regarding yoga's therapeutic effects in the existing literature. Subsequently, a second search was conducted using the following key words or exact phrases, “hatha yoga,” “therapeutic effects of yoga,” “stress,” “anxiety, “depression,” “pain,” and “chronic disease.” The following criteria were used for including studies in this review: (1) the article had to be peer reviewed, (2) published between the years 1990 and 2009, (3) the intervention had to incorporate some form of yoga and/ or meditation, and (4) effects of yoga on some outcome were measured.

In order to select the articles included in this manuscript, several steps were taken. First, the title was read. If the article appeared appropriate to the examination of the therapeutic effects of yoga, it was saved to a folder. The articles describing interventions that utilized yoga as a means to achieve some health outcome were chosen for further review. Each of the articles chosen were then thoroughly read and reviewed. The articles chosen include a broad spectrum of the benefits, application, and therapeutic effects of yoga.

Mental health problems such as depression, anxiety, stress, and insomnia are among the most common reasons for individuals to seek treatment with complementary therapies such as yoga.[ 18 ] Yoga encourages one to relax, slow the breath and focus on the present, shifting the balance from the sympathetic nervous system and the flight-or-fight response to the parasympathetic system and the relaxation response.[ 5 ] The latter is calming and restorative; it lowers breathing and heart rate, decreases blood pressure, lowers cortisol levels, and increases blood flow to the intestines and vital organs.

One of the main goals of yoga is to achieve tranquility of the mind and create a sense of well-being, feelings of relaxation, improved self-confidence, improved efficiency, increased attentiveness, lowered irritability, and an optimistic outlook on life.[ 9 ] The practice of yoga generates balanced energy which is vital to the function of the immune system.[ 9 ] Yoga leads to an inhibition of the posterior or sympathetic area of the hypothalamus. This inhibition optimizes the body's sympathetic responses to stressful stimuli and restores autonomic regulatory reflex mechanisms associated with stress. Yogic practices inhibit the areas responsible for fear, aggressiveness and rage, and stimulate the rewarding pleasure centers in the median forebrain and other areas leading to a state of bliss and pleasure. This inhibition results in lower anxiety, heart rate, respiratory rate, blood pressure, and cardiac output in students practicing yoga and meditation.[ 6 , 13 , 19 , 20 ]

Consistent yoga practice improves depression and can lead to significant increases in serotonin levels coupled with decreases in the levels of monamine oxidase, an enzyme that breaks down neurotransmitters and cortisol.[ 5 ] A range of therapeutic approaches is available for the management of depressive disorders, but many patients turn to complementary therapies due to the adverse effects of medication, lack of response or simply preference for the complementary approach. A number of studies demonstrate the potential beneficial effects of yoga interventions on depression, stress, and anxiety.[ 18 , 21 , 22 ]

Improved flexibility is one of the first and most obvious benefits of yoga.[ 5 ] With continued practice comes a gradual loosening of the muscles and connective tissues surrounding the bones and joints; this is thought to be one reason that yoga is associated with reduced aches and pains. Yoga helps to build muscle mass and/ or maintain muscle strength, which protects from conditions such as arthritis, osteoporosis and back pain.[ 6 ] During a yoga session, the joints are taken through their full range of motion, squeezing and soaking areas of cartilage not often used and bringing fresh nutrients, oxygen and blood to the area, which helps to prevent conditions like arthritis and chronic pain.[ 5 ] Without proper sustenance, neglected areas of cartilage will eventually wear out and expose the underlying bone. Numerous studies have shown that asana, meditation or a combination of the two reduced pain in people with arthritis, Carpel Tunnel syndrome, back pain and other chronic conditions.[ 5 , 6 , 17 , 23 – 25 ] Yoga also increases proprioception and improves balance.[ 5 ]

Yoga increases blood flow and levels of hemoglobin and red blood cells which allows for more oxygen to reach the body cells, enhancing their function.[ 5 ] Yoga also thins the blood which can decrease the risk of heart attack and stroke, as they are often caused by blood clots. Twisting poses wring out venous blood from internal organs and allow oxygenated blood to flow in when the twist is released. Inverted poses encourage venous blood flow from the legs and pelvis back to the heart and then pumped through the lungs where it becomes freshly oxygenated. Many studies show yoga lowers the resting heart rate, increases endurance, and can improve the maximum uptake and utilization of oxygen during exercise.[ 13 , 20 , 26 ] Consistently getting the heart rate into aerobic range lowers the risk of heart attack.[ 5 ] While not all yoga is aerobic, even yoga exercises that do not increase heart rate into the aerobic range can improve cardiovascular functioning.

While yoga is not a cure for a cancer, nor a definitive way of preventing it, yoga increases physical, emotional and spiritual wellness, and brings about a certain peace, of which many cancer patients desire.[ 27 ] Yoga, breathing exercises, and meditation can reduce stress, promote healing, and enhance quality of life for patients with cancer.[ 28 , 29 ] The growth of tumors and other cancer indicators are exacerbated by stress, thus it is especially important for people with cancer to reduce and manage stress effectively.[ 27 ] Several premises exist as rationale for applying yoga-based interventions with cancer patients. Research suggests that yoga can produce an invigorating effect on mental and physical energy that improves fitness and reduces fatigue.[ 28 ] Additionally, when practicing yoga, a fundamental emphasis is placed on accepting one's moment-to-moment experiences creating mindfulness and not forcing the body past its comfortable limits. Having this healthy sense of acceptance is especially important for individuals dealing with life-threatening illness as it decreases the stress one experiences from unpleasant symptomology. Initially, cancer patients likely benefit from the poses themselves which are designed to exercise each and every muscle, nerve and gland throughout the body.[ 27 ] The postures precisely address the tension, holding, and blockage of energy in any particular joint or organ. As this tension is released, energy flows more readily throughout the body and allows patients to experience a sense of increased well-being and strength as well as a balance of mind, body and spirit.

While stimulation is good, too much taxes the nervous system and yoga provides relief from excess stimulation and the stressors and hectic nature of modern life.[ 5 ] Restorative postures, savasana, pranayama, and meditation encourage pratyahara, a turning inward of the senses which enables downtime for the nervous system, the byproduct often being improved sleep. Pharmacological treatment of insomnia is often associated with hazardous side effects such as states of confusion, psychomotor performance deficits, nocturnal falls, dysphoric mood, impaired intellectual functioning and daytime sleepiness, especially in older adults.[ 30 ] Therefore, alternative forms of therapy for improving sleep are becoming utilized more frequently. These alternative therapeutic approaches can be generally classified into three categories: behavioral based educative methods (e.g. avoiding caffeine or other stimulants before bedtime), relaxation techniques (e.g. progressive muscular relaxation, yoga, and meditation) and formal psychotherapy. Because of its ability to increase relaxation and induce a balanced mental state, yoga has been studied to evaluate its possible effects on sleep and insomnia.[ 16 , 30 ]

In summary, stress has a negative impact on the immune system and prolonged exposure increases susceptibility to disease and leads to physical and mental health problems such as anxiety and depression.[ 9 , 19 ] Practicing yoga and meditation as a means to manage and relieve both acute and chronic stress helps individuals overcome other co-morbidities associated with diseases and leads to increased quality of life.[ 14 , 31 ] As a non-pharmacological form of treatment, yoga based interventions are an alternative option for the treatment of mood disorders. Further investigation of yoga as a therapeutic intervention in depressive disorders is needed and future studies should seek to identify which of the yoga-based interventions is most effective and what levels of severity of depression are more likely to respond to this approach.

In addition to the effects of yoga on mood disorders and stress reduction, yogic practices are shown to improve cardiorespiratory performance, psychological profile, and plasma melatonin levels and also significantly reduced systolic blood pressure, diastolic blood pressure, mean arterial pressure, and orthostatic tolerance.[ 16 , 26 ] Furthermore, yoga helps to improve the cardiovascular efficiency and homeostatic control of the body and results in improvements in autonomic balance, respiratory performance, and overall well-being. Yoga based lifestyle modifications were also shown to aid in regression of coronary lesions as well as to improve myocardial perfusion in patients with CAD.[ 32 ] Inevitably, cardiovascular parameters alter as one ages, but these age-related deteriorations in cardiovascular functions are slower in persons who practice yoga regularly as yoga practitioners had lower heart rate as well as lower systolic and diastolic blood pressure than matched controls.[ 13 ]

Numerous studies show that asana, meditation or a combination of the two can reduce pain and disability while improving flexibility and functional mobility in people with a number of conditions causing chronic pain.[ 5 , 6 , 17 , 23 – 25 ] Additionally, in some cases use of pain medication was reduced or eliminated completely. Yoga was also shown to improve gait function and reduce age-related changes in gait among a group of healthy, non-obese elders.[ 33 ]

Regarding yoga's effects for cancer patients, results show a decrease in post-chemotherapy-induced nausea frequency, nausea intensity, intensity of anticipatory nausea, and anticipatory vomiting.[ 29 ] Additionally, yoga subjects reported decreased anxiety, depression, and distressful symptoms and also showed significantly reduced toxicity scores compared to the controls. Results from another study showed patients experienced significantly lower levels of pain and fatigue, and higher levels of invigoration, acceptance and relaxation following participation in a yoga intervention.[ 28 ] Yoga, breathing exercises, and meditation can reduce stress, promote healing, increase energy, decrease adverse treatment effects, and enhance quality-of-life for patients with cancer.[ 28 , 29 ]

Yoga's ability to increase relaxation and induce a balanced mental state was studied to evaluate its effect on sleep quality and improving insomnia. Regular practice of yoga resulted in a significant decrease in the time taken to fall asleep, an increase in the total number of hours slept, and in the feeling of being rested in the morning.[ 30 ] Additionally, yoga had a positive influence on sleep patterns in individuals with lymphoma.[ 16 ] Furthermore, participation in yoga classes improved self-reported quality-of-life as well as measures of physical function among an elderly population.[ 14 ]

According to Buddhist philosophy the roots of addiction are in the mind and the practice of mindful meditation encourages addicts to accept the basic impermanence of human experience and helps them to develop a detached awareness of thoughts.[ 12 ] Yoga and meditation practices exert positive influence on addictive behaviors. Through the practice of yoga, addicts shift from self-inflicted harm and disrespect toward their bodies to more respectful, caring, and loving behaviors. Eating disorders are a specific type of addiction and yoga appears to be beneficial in improving body image disturbances and useful in the recovery from eating disorders.[ 34 ] One study found that female yoga practitioners attribute their positive feelings and sense of well-being to yoga practice and report less self-objectification, greater satisfaction with physical appearance and fewer disordered eating attitudes compared to non-yoga practitioners.[ 35 ]

The findings of the aforementioned studies examining the psychological and physical outcomes of yoga prove difficult to summarize and draw concrete conclusions due to variation in the research designs, differences in the duration and frequency of yoga classes, and differences in the specific yoga programs and populations being studied. Nonetheless, results for the included studies demonstrate many of the numerous therapeutic effects, benefits and profound healing power of yoga.

Rapidly emerging in the Western world as a discipline for integrating the mind and body into union and harmony, when adopted as a way of life, yoga improves physical, mental, intellectual and spiritual health. Yoga offers an effective method of managing and reducing stress, anxiety and depression and numerous studies demonstrate the efficacy of yoga on mood related disorders.

Currently, treatment for anxiety and depression involves mostly psychological and pharmacological interventions; however, mind-body interventions are becoming increasingly popular as a means to reduce stress in individuals. Yoga, a form of mind-body exercise, has become an increasingly widespread therapy used to maintain wellness, and alleviate a range of health problems and ailments. Yoga should be considered as a complementary therapy or alternative method for medical therapy in the treatment of stress, anxiety, depression, and other mood disorders as it has been shown to create a greater sense of well-being, increase feelings of relaxation, improve self-confidence and body image, improve efficiency, better interpersonal relationships, increase attentiveness, lower irritability, and encourage an optimistic outlook on life.

Researchers are only beginning to understand how disciplines such as yoga promote personal growth, health and well-being. By acknowledging the unity of mind, body and spirit, mind-body fitness programs (i.e. yoga) can assist people in their pursuit of peace, calmness, and greater wholeness and integration in their lives. Health care professionals, health educators and the like, need to be aware of the potential of yoga as an important component of a personal wellness plan.

While no concrete guidelines exist regarding the frequency of practice, the more you practice the more you benefit. Yoga is a personalized practice and as such, frequency and duration are personal questions with individual answers. Practice should happen with wisdom and should be modified to meet individual needs and goals. Individuals should practice as often as possible, especially in the beginning. The length of the induction phase will vary depending on an individual's initial level of fitness and health status; the more difficult yoga is for someone in the beginning the more their body needs it.

While modern medicine has the ability in many cases to heal physical diseases and alleviate psychological disorders, it is argued that a purely medical approach is far less effective in healing the emotional, intellectual, and personality layers of the human entity. The discipline of yoga offers individuals a timeless and holistic model of health and healing and although it may not result in the complete elimination of physical diseases and/ or adverse conditions from the body it offers a holistic path of healing. There exists an indisputable connection between a person's overall physical and mental health and the inner peace and well-being yoga is designed to achieve. Yoga suspends the fluctuations of the mind and by acting consciously, we live better and suffer less.

Source of Support: Nil

Conflict of Interest: None declared

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I read more than 50 scientific studies about yoga. Here's what I learned.

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I’m a yogi. I'm also a skeptic. Sometimes I wonder if the two can go together. I cringe whenever an instructor claims I'm "wringing the toxins" out of my organs with a twisting pose, for instance. Still, after eight years, I keep going back. Post-yoga, I feel calmer and more aware of my body, and this seeps into everything I do: how I work and relate to others, how I eat and sleep.

The bottom line

What we know:.

Yoga is probably just as good for your health as many other forms of exercise. But it seems particularly promising for improving lower back pain and — crucially — reducing inflammation in the body, which can actually help stave off disease. Yoga also seems to enhance "body awareness," or people's sense of what's going on inside themselves.

What we don't know:

Whether some forms of yoga are better than others, whether yoga should be prescribed to people for various health conditions, and how yoga compares with other forms of exercise for a good many specific health outcomes. There's also no good evidence behind many of the supposed health benefits of yoga, like flushing out toxins and stimulating digestion.

What this means for you:

If you like yoga, keep doing it. There's no evidence that it's particularly harmful, and it can lead to a range of heath benefits. Depending on your goal, it's important to find an appropriate style — from athletic ashtanga to gentle hatha. If you don't like yoga, no sweat: Just try another physical activity.

It's not just me. The most recent survey suggests more than 20 million Americans practice yoga, making it one of the most popular forms of exercise. Even Vladimir Putin , a devotee of "macho sports," added downward dog to his repertoire.

But is yoga really that great for health compared with other exercises? Does it really help improve our response to stress or correct bad posture, as often promised? Maybe our perceptions about yoga are biased. Or maybe, as some critics have pointed out, there are downsides to yoga. Who can forget the controversial New York Times story from 2012 suggesting that some people get seriously injured, or even die, on their yoga mats.

I wanted a more objective view on the health effects of yoga, so I turned to science, reading more than 50 studies and review articles and talking to seven of the world's leading yoga researchers. Almost immediately, I was struck by how weak the research on yoga is. Most studies were small and badly designed or plagued by self-selection bias. Making matters worse, there are so many varying styles of yoga that it's tough to say how meaningful evidence about one style is for others.

Still, what I learned is that there are a few things we can say about yoga, based on the available research. Yoga probably won't hurt you, despite what haters claim, and it appears to be just as good for your health as other similar forms of exercise.

Even more, yoga seems to help alleviate lower back pain, improve strength and flexibility, and reduce inflammation in the body — which, in turn, can help stave off chronic disease and death. Emerging research suggests yoga can increase body awareness , or attention to the sensations and things going on inside you. That's no small matter: Researchers think heightened body awareness can improve how well people take care of themselves.

Keep in mind, however, that other mind-body exercises — such as tai chi or meditation — can boost body awareness and reduce inflammation, too. That's the catch with a lot of yoga research: It still hasn't told us how much better or different yoga is for a number of health measures when compared with other forms of exercise. Finally, many of the most outlandish claims people make about yoga, like the idea that it can alleviate constipation or wring out toxins, either aren't backed by science or haven't been studied at all.

What is the state of yoga science?

(ChinaFotoPress/Getty Images)

The first randomized trial (or high-quality experiment) on yoga was published in 1975 in The Lancet . It showed that yoga was more effective than relaxation for reducing high blood pressure. But that trial only involved 34 participants, and all of them already had high blood pressure, so it is difficult to know whether the effect of the yoga would bear out in a larger trial of healthy people.

Since then, the number of yoga studies has dramatically increased, but the field is plagued by some of the same problems of that early study. Many yoga studies still involve small numbers of participants. Many lack a control group. Many don't compare yoga to activities we'd be interested in comparing it to. (Ideally, for instance, we'd want to know how yoga measures against another form of exercise or mind-body practice — not, as one study examined, comparing whether it's better for back pain than giving people a book on how to manage their back pain.) "For most conditions, the main problem is we don't have enough evidence yet"

What studies do exist are often short term. There are no long-term studies on mortality or serious disease incidence. There are few long-term studies on the potential harms yoga can wreak on the body. "For most conditions," says Holger Cramer, director of yoga research at the University of Duisburg-Essen in Essen, Germany, "the main problem is we don't have enough evidence yet."

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Studying yoga is also tricky. Researchers generally believe blinded studies are the highest quality of research, because participants involved don't know what intervention (such as a drug) they are receiving and their biases and perceptions don't color the outcomes. But you can't blind people to the fact that they're doing yoga.

Then there's the biggest question at the center of yoga research: How do you define yoga? "Yoga is many things to many people," said Karen Sherman , a researcher affiliated with the Group Health Research Institute. "What you put into a yoga intervention probably impacts what you get out."

(Soloviova Liudmyla/Shutterstock)

Lorenzo Cohen , chief of the integrative medicine section at MD Anderson Cancer Center, told me: "Many papers [on yoga] don't have enough of an in-depth description of what they mean by 'yoga.' What was the level of training of yoga therapists? How did they choose different postures or breathing exercises?"

What's more, there are so many components in a yoga class, it's tough to know what might be having an affect on health: If people report feeling better after a class, was that due to the experience of being part of a larger group? Was it the teacher's style? Was it the breathing exercises? The heat? These factors are difficult to isolate, and some of the ways yoga helps people might be hard for scientists to measure.

Still, the yoga researchers I spoke to said the quality and quantity of studies has been improving, so we may get better answers soon. "There are more researchers conducting yoga therapy studies, and when the smaller trials suggest benefit, that leads to larger, better-designed trials," said Cohen. There is also a move to study the biological outcomes of yoga — how classes affect things like hormone levels — which will lead us to a more objective picture of what yoga can do for the body.

1) Is yoga likely to hurt you?

No, probably not.

This question first came up in 2012, when the New York Times published a splashy article suggesting that yoga can wreck your body. The piece, adapted from the book The Science of Yoga: The Risks and Rewards , suggested yoga caused widespread harm to its practitioners — from ruptured disks and stroke to brain injury.

But that piece was largely based on cherry-picked anecdotes, exaggerating these horrible cases to suggest they were representative of the broader yoga experience when they simply aren't.

(Luna Vandoorne/Shutterstock)

Cramer has studied published reports of injuries and other harms from yoga for several review and told me this: "We found yoga is as safe as any other activity. It's not more dangerous than any other form of exercise." He added: "Yoga is not 100 percent safe, but nothing is 100 percent safe."

In a 2013 review of case studies , Cramer identified 76 unique incidents of adverse events from yoga. "Most adverse events affected the musculoskeletal, nervous, or visual system," he concluded. "More than half of the cases for which clinical outcomes were reported reached full recovery, 1 case did not recover at all, and 1 case died."

Most often, people got into trouble with the headstand pose, followed by shoulder stand, postures that required putting one or both feet behind the head, the lotus position, and forceful breathing. Pranayama-,  hatha-, and Bikram-style yoga practices had the most adverse events associated with them.

Based on these cases, Cramer and his co-author had this practical advice for how to stay safe in yoga: Beginners should avoid advanced postures (such as headstands), and people with chronic health conditions (such as glaucoma) should consult their doctors before diving in. "Yoga," they added, "should not be practiced while under the influence of psychoactive drugs."

As for long-term yoga harms, Cramer pointed to two studies on joint and cervical disc degeneration in people who have been doing yoga for a while. But the studies had contradictory results, "so long-term health consequences cannot be clearly derived from the available evidence," Cramer said.

I asked MD Anderson's Cohen for his take. "There can, of course, be negative consequences if done incorrectly, like any body manipulation," he said, "but if you have the right teacher this will not happen." Even if a lot of yoga over a lifetime leads to injury, it's not clear those harms outweigh the benefits, or that people would have been better off running or weightlifting all the time.

2) How does yoga compare with other forms of exercise?

(Anna Furman/Shutterstock)

The short answer is: It depends on the type of yoga. Yoga classes that involve nothing more than lying around on piles of blankets and breathing aren't likely to build your muscles. But more strenuous types of yoga like ashtanga can be surprisingly similar to other forms of vigorous exercise.

"Some studies show, depending on yoga style, that it doesn't improve fitness as much as other forms of exercise," Cramer says. "But for rigorous and intense styles [of yoga] — that can be a form of exercise. It strongly depends on what you do when you do yoga."

For example, a few high-quality studies have shown that certain types of yoga can indeed make people stronger. One small, randomized trial in the Journal of Strength and Conditioning Research — which compared eight weeks of Bikram yoga with no intervention in 32 young, healthy, adults — found that the yoga classes improved people's deadlift strength.

The Bikram classes didn't, however, improve the participants' aerobic capacity. Another before-and-after study, published in the Journal of Clinical Nursing , found that hatha yoga could improve aerobic fitness in older people . Still, it's not clear that yoga is ideal here compared with, say, running or swimming.

Considering the mixed findings, a bit of common sense is helpful: If you go to a class mainly focuses on relaxation and doesn't elevate your heart rate, you're probably not getting a good cardio workout or building muscles. If you go to a more athletic yoga class that tires  out your muscles and makes you pant, you can probably count on it helping to make you stronger. If you are panting in a yoga class, you're probably improving aerobic capacity to some extent. That said, if your main goal is building aerobic capacity, you might want to try running or swimming instead of or in addition to yoga.

Key studies:

1975: Lancet — "Randomised controlled trial of yoga and bio feedback in management of hypertension." This is the first-ever randomized trial on yoga, and it found that yoga was more effective than relaxation in reducing high blood pressure.

1985: British Medical Journal — "Yoga for bronchial asthma: a controlled study." This is the first randomized trial on yoga for asthma, and it was one of the first to show the effects of yoga on the inner organs.

1998: JAMA — "Yoga-based intervention for carpal tunnel syndrome." This was a well-regarded randomized trial that showed the benefits of yoga for carpal tunnel syndrome compared with wrist splinting and no intervention.

2005: Annals of Internal Medicine — "Comparing yoga, exercise, and a self-care book for chronic low back pain." This is the most important trial on yoga for lower back pain and the first really high-quality trial on yoga. Based on this trial, yoga had become increasingly recognized as an effective treatment for chronic lower back pain.

2013: Journal of the American College of Cardiology — "Effect of yoga on arrhythmia burden, anxiety, depression, and quality of life in paroxysmal atrial fibrillation." One of the first trials to show that yoga may have an impact on life-threatening diseases such as atrial fibrillation.

2013: Journal of Strength and Conditioning Research — "Bikram Yoga Training and Physical Fitness in Healthy Young Adults." This trial showed Bikram yoga can improve strength and flexibility but not aerobic capacity.

2014: Journal of Clinical Oncology — "Randomized, controlled trial of yoga in women with breast cancer undergoing radiotherapy." This high-quality trial demonstrated yoga can have benefits for women being treated for breast cancer.

2015: Brain, Behavior, and Immunity — "Mind-body therapies and control of inflammatory biology." A review of the evidence on yoga and other mind-body activities, and their relationship to reducing inflammation.

3) Does yoga really reduce stress and anxiety?

For all the talk of yoga lifting moods and calming people, the studies on this question are still surprisingly inconclusive.

Karen Pilkington , a research fellow at the University of Westminster, knows this research better than anybody: She sifted through the science for systematic reviews on yoga for both  anxiety and depression . (Here's another, more recent systematic review of the evidence on yoga for depression by other authors.)

"There are indications that it might be helpful," Pilkington says. "But lots of the studies are quite small, and we definitely need more and bigger studies." In other words, yoga might help with mood disorders, but we don't yet know for sure because the studies to date have generally been so badly designed. "We can't say there’s conclusive evidence that yoga works for depression and anxiety," she explained. "We’re still really exploring yoga as an idea for testing and the best ways of testing it."

One complication here: When it comes to conditions like anxiety and depression, it can be difficult to untangle whether it's the yoga that's helping or simply the act of going out, joining a group on a regular basis, and so on. Even if yoga turns out to be unequivocally beneficial for depression, other research has shown that exercise in general can alleviate depression . So, again, it's not clear that yoga is the only way to get this benefit.

As for stress reduction, there are a few randomized trials — the highest-quality evidence — that have suggested yoga is about as effective as simple relaxation programs , more helpful than no intervention , but not as effective as stretching . Pretty mixed results.

4) Does yoga have long-term health benefits?

Possibly. To be clear, there's currently no direct evidence on yoga's long-term benefits. Researchers simply haven't tracked yogis over a span of 20 years or more and followed up to see whether they get diseases at a lower rate than non-yogis.

But that's not the whole story. There are also some randomized controlled trials suggesting that yoga may improve quality of life for diabetes patients , reduce cardiovascular disease risk factors, and even help people manage high blood pressure

How can this be? One possibility is that yoga can help reduce inflammation in the body — which turns out to be surprisingly beneficial.

You can think about inflammation in two ways. There's helpful inflammation, as when your body's immune system mounts a response to bacteria in a cut. There's also harmful inflammation. When you're stressed, your body's inflammatory response can go into overdrive, hampering its ability to fight off viruses and disease. People who are inactive, obese, or eat an unhealthy diet have higher levels of harmful inflammation. And researchers have found associations between inflammation and various chronic diseases, including cancer, cardiovascular disease, and diabetes.

Yoga — like other mind-body exercises such as tai chi and meditation — seems to be particularly helpful at reducing harmful inflammation. A 2014 meta-analysis on the effects of mind-body therapies on the immune system found that yoga reduces inflammation-based blood markers. So did this 2014 randomized control trial looking at women with breast cancer and breast cancer survivors.

Michael Irwin at UCLA's medical school, one of the authors of a 2015 descriptive review on inflammation and mind-body exercises, said, "When you look at the aerobic exercise necessary to decrease inflammation, people have to maintain very vigorous levels." But not with yoga, he continued. "Even practices with minimum levels of physical activity [like Iyengar stretches] can have large effect sizes." Researchers don't yet know why, though they think the meditative components of yoga, tai chi, and meditation may have something to do with it.

In the past few years, some academics have also begun to study "body awareness" and its relationship to a number of health outcomes. Body awareness, according to this article in PLOS One , "involves an attentional focus on and awareness of internal body sensations." The idea is that in becoming more aware of your body, you might be more likely to notice when you're stressed, in pain, or tired, and perhaps less likely to abuse your body.

This 2013 study , involving 18 people with chronic neck pain who practiced Iyengar yoga once a week for nine weeks, found that participants reported increased body awareness after practicing. In this 2005 study , which compared three groups of women — 43 doing Iyengar and ashtanga yoga, 45 doing aerobic exercise, and 51 who did neither activity — the yogis reported more body awareness and body satisfaction than the other groups. These were both qualitative studies, not experimental trials, so it's difficult to know whether the yogic types are more "body aware" to begin with or whether the yoga made the difference.

"When you compare long-term yoga practitioners to people doing other forms of exercise," said Cramer, "you have better body awareness in yogis."

5) Does yoga help with lower back pain?

(My Good Images/Shutterstock)

Yes. Yoga does seem to help alleviate lower back pain, in both the short and long term. The evidence around this is some of the best yoga research we have. This meta-analysis of the evidence on yoga for back pain , from 2013, sums it up.

[There's] found strong evidence for short-term effectiveness and moderate evidence for long-term effectiveness of yoga for chronic low-back pain in the most important patient-centered outcomes. Given the low number of adverse events, yoga can be recommended as an additional therapy to patients who do not improve with education on self-care options.

That said, there are some caveats here, too. The leading researcher on this question, Karen Sherman, notes that it's still not clear whether yoga is any better than any other form of exercise for back pain. "It’s certainly a viable form of exercise, but is it better than other exercises [for back pain]? Probably not," she says. Some of the best research on lower back pain has only looked at one specific type of yoga — viniyoga.

Researchers haven't figured out why yoga helps with back pain. This Cochrane Review protocol offered a few guesses, suggesting that improved flexibility and muscle strength, as well as relaxation and body awareness, may help.

6) Does yoga improve flexibility and balance?

(Olesya Feketa/Shutterstock)

The research here is limited. But there are a few high-quality controlled trials that suggest yoga can help increase flexibility in young people , healthy seniors , and computer users . One small study on stroke patients suggested that yoga may improve balance, as did this study in healthy young adults .

7) Can yoga really stimulate digestion or wring out toxins?

Anyone who has taken a yoga class has probably been exposed to wild claims by the teacher that certain poses will do anything from wring out toxins to stimulate a particular part of the colon and alleviate constipation. But the science backing up these kinds of very specific claims was scant, so I asked one of the researchers, Cohen, about where they come from.

"[Teachers are] basing it on personal experience, on anecdote, on the lineage of practice that's been handed down," he said. "They are probably not basing it on Western-style analytic techniques that followed a control trial design. We just haven't gotten there yet with yoga research, testing particular poses or breathing techniques for particular outcomes."

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ORIGINAL RESEARCH article

Reduce stress and the risk of burnout by using yoga techniques. pilot study.

• 1 Division of Philosophy of Medicine and Bioethics, Poznan University of Medical Sciences, Poznań, Poland
• 2 Department of Occupational Therapy, Poznan University of Medical Sciences, Poznań, Poland

Introduction: This article examines the effectiveness of yoga in managing stress, with a particular focus on work-related stress. Yoga combines physical postures, breath control, and meditation, and has gained recognition for its potential to relieve stress.

Purpose: This study aimed to investigate the motivating factors behind individuals adopting yoga exercises and to assess the effects of regular yoga practice, with a particular focus on age-related differences. Additionally, we aimed to compare participants’ expectations with the actual results of their yoga practice.

Methods: To achieve this, we conducted a comprehensive survey using an online form, which was completed by 520 yoga practitioners. Participants were surveyed about their motivation, the effects they experienced, and the type of yoga they practiced.

Results: The results showed that the most common motivation for individuals practicing yoga was stress reduction. Additionally, the analysis of the effects of regular yoga practice demonstrated a significant reduction in stress levels, with experienced practitioners reporting lower stress levels compared to beginners. In conclusion, the study suggests that regular yoga practice can be an effective way to reduce stress levels.

Conclusion: Dynamic forms of yoga, which incorporate fluid movements and synchronized breathing techniques, are highly effective approaches to stress management and relief. These findings highlight the value of yoga as a tool for individuals of all ages seeking stress relief and overall well-being. Another advantage of yoga practice is its affordability and lack of negative side effects.

Introduction

In modern society, individuals are exposed to numerous stressors. In the European Region, approximately 50% of workers consider stress as a common occurrence. Occupational stress is a chronic condition that cannot be cured with a single treatment. To address this condition, it’s essential to understand its history or epidemiology. Once you have a clear understanding of the problem, you can explore various alternatives for protection, prevention, and intervention ( 1 ). Occupational stress is one of the most common work-related health problems worldwide ( 1 – 7 ). Occupational stress is a well-documented issue that poses risks to both physical and mental health. According to the World Health Organization (WHO), stress-related diseases are the leading cause of premature death in European countries. Work-related stress incurs high costs for workers, employers, and society. It is important to address this issue to promote a healthier and more productive workforce ( 8 ). Occupational stress is a significant modern health and safety challenge. The causes of occupational stress can be numerous, ranging from the fear of losing one’s job, to job burnout, lack of support, and mobbing. Whatever the cause, occupational stress not only significantly reduces the quality of life ( 9 , 10 ) and leads to various diseases and disorders ( 10 , 11 ), including cancer ( 12 – 14 ). An association between occupational stress and sleep quality has been also documented ( 15 – 18 ) A study involving a substantial cohort of firefighters revealed a correlation between heightened occupational stress and increased global suicide risk, lifetime suicide threats, and current suicidal intent. Furthermore, these associations were found to be diminished as self-reported distress tolerance increased ( 19 ).

Occupational stress can result in types of stress: behavioral (e.g., absenteeism), physical (e.g., headaches), and psychological (e.g., depressed mood) ( 20 ). Furthermore, this stress is associated with constant staying ready (fight-or-flight response) ( 21 , 22 ). This can result in a variety of disorders, such as mental disorders (e.g., depression, anxiety, post-traumatic stress disorder), job dissatisfaction, maladaptive behavior (e.g., substance abuse), cardiovascular disease, and musculoskeletal disorders ( 23 ).

A landmark study by the World Health Organization and the International Labor Organization found that exposure to long working hours, theorized to result from increased psychosocial stress at work, is the occupational risk factor with the highest burden of disease, officially estimated to have caused the deaths of some 745,000 workers from ischaemic heart disease and stroke in 2016 ( 24 ). Work-related stress is also a problem of work-life balance, as shown by the Work, Family, and Health Study ( 25 ). Although the problem of work-related stress is not a new issue, the instability of today’s labor and employment market exacerbates it. Studies have shown that occupational stress is a cause of depression and anxiety states ( 26 , 27 ). In addition, chronic stress significantly reduces the quality and productivity of work. Above all, however, it should be remembered that physiological responses to stress can accurately reflect health ( 28 – 30 ). Stress-related disorders are a group of increasingly diagnosed diseases worldwide ( 30 – 32 ). Unfortunately, conventional pharmacotherapy treatments are not always feasible ( 33 – 35 ). Other activities that positively impact the patient’s well-being can also support conventional therapy. Physical activity, including yoga, is a frequently recommended form of welfare support. Yoga is a unique form of physical activity because of the multifaceted nature of the practice. There is evidence that yoga has mood-enhancing properties, likely related to its inhibitory effects on physiological stress and inflammation, often associated with affective disorders ( 13 , 36 , 37 ). Yoga practice has already been described as an effective and safe intervention for people with depression, anxiety disorders, or PTSD ( 38 – 40 ). These findings have provided valuable insights into the potential benefits of yoga in managing these conditions. However, despite the existing evidence, there remains a need to explore the motivations and effects of yoga practice more comprehensively. Previous research suggests that health concerns, improved wellbeing, and stress reduction are the main motivations for starting a yoga practice ( 41 – 43 ). The British study also showed that the practice of yoga is used as a form of physical activity to complement the rehabilitation process ( 42 ).

The aim of this study was to investigate the motivations and effects of yoga practice among a group of randomly selected Polish yogis. The aim was to explore the role of yoga in reducing stress and improving overall well-being by understanding the perspectives and experiences of these practitioners. Specifically, the study analyzed survey responses from individuals who practice yoga with the explicit aim of reducing stress. Our research has the potential to provide valuable insights that can guide healthcare professionals and individuals seeking alternative approaches to stress management and mental health improvement.

Materials and methods

The study was approved by the Bioethics Committee at PUMS 391/20.

Participants

Yoga practitioners from different regions of Poland took part in this study. Participants were recruited from the yoga community through popular social media platforms such as Facebook and Instagram. A wide range of yoga styles were represented among the participants. The selection of these specific social media platforms aimed to include individuals within a specific age range.

The primary criterion for participation in the study was maintaining a consistent and regular yoga practice. Individuals who did not maintain a regular practice were excluded from the analyses. Table 1 shows the basic characteristics of these respondents, including their age, level of education, and place of residence. By completing the questionnaire, respondents explicitly confirmed their informed consent to participate in the study.

Table 1 . The socio-demographic characteristics of polish yogis based on the results of a survey question and answers, including the number of respondents (N) and the corresponding percentage distribution (%).

Questionary form

The survey was created using Google Forms and distributed to participants through a link on leading yoga-focused websites. The form consisted of two parts. The first part was about the experience of practicing yoga, and the second was a metric.

The survey design allowed at most 5 min to complete. The questions sought answers to issues related to motivation to practice. In addition, the practice results were checked to see if they reflected the motivations.

The filled questionnaires were downloaded and saved in “xlsx” format. Statistical analysis and visualization of the collected data were conducted in the statistical software environment “R” (version 4.1.2), utilizing additional libraries. The xlsx files were imported into R using the “openxlsx” library ( 44 ). The number of response options given to the respective questions and the corresponding percentages were calculated. The resulting figures were displayed in tables or visualized using the ggplot2 library ( 45 ).

Analysis of multiple-answer questions

The question regarding expectations of yoga practice was in the form of a multiple-choice question. The responses were segregated into distinct age categories (<18–24, 25–30, 31–35, 36–40, 41–45, 46–50, 56–60, 61–65>) to exhibit changes in expectations according to the age of the participants. The total number of responses, percentage per response, and percentage per responders population were calculated using the “multiResponse” function from the “user-friendly science” package ( 46 ).

To identify the trend of changes in expectations toward yoga with the age of respondents, pre-calculated values of percentage per response were used and a regression curve was calculated using a linear model. In addition, beta values, which quantify how strongly changes from one age category to the subsequent one affects the percentage response to a specific expectation, and R2 values, which measure the goodness of fit to the regression line, were obtained and presented in relevant figures.

Cluster analysis

The multiple-choice questions were analyzed using the Ward hierarchical clustering method ( 47 ). Firstly, the answers were transformed into a binary matrix. Each column represented one possible answer option, and each row represented the answers given by one respondent. Next, the optimal number of clusters was determined by repeatedly calculating the sum of squared error (SSE) measurement with an increasing number of clusters. The result of dividing respondents’ answers into different clusters was presented as a heatmap, which was generated using the “Complexheatmap” package ( 48 ). Next, the selected questions were analyzed by dividing the respondents into groups obtained by assigning them to the corresponding clusters. The results with the percentage distribution were presented on bar charts.

The analysis of the relationship between motivation for practicing yoga and the effects of yoga practice.

The responses to the question about motivation for practicing yoga were grouped into subsets based on the frequency of each response. Next, in each subset, the number of responses and the percentage per response was calculated concerning the effects of yoga practice. Finally, the results were presented as a heatmap in which the percentage per response values were shown, assuming that the sum of the percentage per response equals 100 for each row (motivation).

The survey included 520 yoga practitioners. Women predominated among the respondents, accounting for 93.65% (487 people), while men accounted for 6.15% (32 people). One person declared himself non-binary without indicating his gender. Yogis were asked which style of yoga they most often practice. The vast majority of people, 41.6%, practice vinyasa yoga; 22.12% said they practice Ashtanga Yoga; however, the Iyengar method is practiced by 18.85%. 6.54 people declared the practice of spine and yin yoga by 5%. Another style than those mentioned is practiced by 5.96% of respondents. Regarding the place of practice, almost half of the respondents (49.62%) choose to practice at a yoga studio. 19.81% practice independently at home, while 16.15% use online instructors. 9.42% choose gyms. 5% of respondents began practicing during the covid-19 pandemic. We asked respondents about internship placement (the duration of their practice). Those practicing yoga for less than a year prevailed, accounting for 23.85% of the group. From 1 to 3 years, 38.27% of respondents have been practicing. Those practicing for over 10 years accounted for 12.5% of the group. The largest group, 35%, were yogis aged 36–45. Those aged 25–35 made up 31% of those surveyed. Residents of large cities with higher education predominated among those surveyed ( Table 1 ).

Correlations were calculated between respondents’ stated expectations of yoga practice and their age. Among the motivating factors, stress reduction, body stretching, and personal growth were predominant. As yogis advanced in age, the frequency of citing specific health needs as a motivation for their practice increased. On the contrary, the need to strengthen the body decreases with age. However, the inclination to seek stress reduction through yoga remained consistent across all age groups except for those over 60. Individuals in this age group, more so than younger yogis, reported practicing yoga primarily due to specific health needs ( Figure 1 ).

Figure 1 . Analysis of motivation for practicing yoga in relation to the age of respondents. (A) Percentage distribution of responses [%] regarding motivation for practicing yoga in different age categories. (B) Analysis of changes in the frequency of specific responses to the question concerning motivation for practicing yoga in different age categories. The chart displays a regression line, including the beta value (indicating the magnitude of change during the transition from one age category to another) and R2 - the degree of fit of the data to the linear regression line.

Multiple-choice question answers regarding motivation to take up yoga practice in relation to stress reduction were preliminarily analyzed and visualized using alluvial plot ( Figure 2 ). The chart depicts the number of respondents whose motivation for practicing yoga included stress reduction (T, blue color), as well as those who did not indicate stress reduction as one of the possible answers (N, red color). Approximately 50% of all participants indicated that their motivation for taking up yoga practice was stress reduction. Some of these individuals also selected the need for building strength and the need to stretch the body.

Figure 2 . Alluvial Plot depending on the response indicating motivation for taking up yoga practice as stress reduction (blue lines, T- true) and in the case when respondents indicated motivations other than stress reduction (red lines, F-false). N - number of respondents. The x-axis represents all possible answer choices regarding motivation for taking up yoga practice.

Next, a detailed analysis was conducted to investigate the motivation behind taking up yoga practice. Prior to the analysis, respondents were divided into appropriate subgroups using the Ward hierarchical clustering method. Data analysis involved the repeated calculation of the sum of squared errors (SSE) to determine the optimal clusterization. The results indicated that dividing the data into six clusters, as shown in Figure 3 , provided the most optimal clusterization. Each respondent was then assigned to their respective cluster. Respondents assigned to the first cluster mostly practiced yoga due to “other motivations” not mentioned in the analyzed question. Individuals classified into the second cluster primarily chose the responses “need for personal growth” and “spiritual needs”. The third cluster consists mainly of people practicing yoga for specific health needs. The fourth cluster was assigned to people expecting stress reduction and body stretching. Those assigned to the fifth cluster practiced stretching the body and building strength. In this cluster, yogis also declared a desire for personal growth and stress reduction. Finally, those supplementing other activities with yoga were assigned to cluster 6.

Figure 3 . Cluster analysis based on multiple-choice questions related to motivation to take up yoga practice. The number of clusters is marked according to the color scale on the right side. The results of each survey respondent are presented in rows. The green color on the heatmap indicates the selection of a specific answer by the survey respondent.

A detailed analysis of responses regarding style, age, practice duration, and yoga values among survey participants assigned to respective clusters

Style of yoga practice.

Participants whose motivation to practice yoga is mainly stress reduction (cluster 4) mainly practice the Vinyasa Yoga style. Compared to the other groups, those aiming to reduce stress also practiced Yin yoga and Spinal yoga. Those belonging to cluster 4 practiced Ashtanga yoga significantly less often (12.3%) concerning participants classified in the other clusters (20.5–27%) ( Figure 4A ).

Figure 4 . Comparison of response frequencies based on assignment to respective clusters. The percentage values of each response declaration are indicated on the x-axis, divided according to the previous assignment of yogis to their respective clusters. The color represents one of the possible answers to the given question, with their corresponding values presented in the legend. (A) Style of yoga practiced by participants classified into clusters; (B) Age of participants assigned to clusters; (B) Length of practice; (C) Significant values for yoga practitioners described according to clusters.

Age of yoga practitioners

Cluster 4 was dominated by people between 25 and 60 years of age. Yogis over 60 years of age predominated in cluster 3 in which the main motivation for undertaking yoga practice was based on specific health needs. The youngest participants in the study are most represented in cluster 6 in which they mainly see yoga as a complement to other sports ( Figure 4B ).

Length of regular yoga practice

It was noted that the motivation for stress reduction was predominantly expressed by practitioners with short-term experience (those practicing for no more than 2 years accounted for over 51% in cluster 4). Yogis with many years of training were much more likely to attribute their practice to specific health needs or other motivations ( Figure 4C ).

Value of yoga practice

We asked respondents which aspect of yoga practice they valued the most. For the vast majority, combining physical practice with spiritual elements is important. Many also value yoga as a physical activity The fewest number of people attend classes because of the spiritual aspects ( Figure 4D ).

Does the motivation for practicing yoga is reflected in the outcomes achieved outcomes?

In order to answer this question, the data from the question on motivation and the effects of yoga practice were analyzed as a two-way frequency table in Figure 5 . The percentage distribution of the individual response from the question on motivation in relation to the effects of yoga practice is presented as a heatmap. The effect of yoga practice as improving body flexibility was the most frequently selected in each group however, the motivations for undertaking yoga practice overlapped with the achieved effects of yoga practice. Those whose motivation was stress reduction most often indicated that the effect of yoga practice was stress relief (17%). Those motivated by the need to stretch the body indicated improving body flexibility as an effect of the practice.

Figure 5 . two-way frequency table heatmap showing the frequency dependence of responses to individual motivations for yoga practice in relation to the effects of yoga practice. The data in the heatmap shows the percentage distribution of responses to the motivation question.

Although the causes of occupational burnout remain unclear, in the last few decades, there has been much interest in occupational stress in health sciences ( 49 – 52 ). Research shows that professional work is increasingly becoming a cause of chronic stress, which can lead to occupational burnout and consequently to deterioration of health, quality of life and the development of such diseases and disorders as depression, PTSD, anxiety, musculoskeletal disorders, cardiovascular diseases; and the development of maladaptive behavior. Through the release of stress hormones, induction of inflammation, and suppression of immunity, chronic stress can encourage tumorigenesis and oncogenesis (tumor formation). In addition, chronic stress causes the neuroendocrine system (hypothalamus-pituitary–adrenal axis) and sympathetic nervous system to become activated, producing stress hormones that can promote tumor growth and control the tumor microenvironment ( 53 ). Chronic stress and high glucocorticoid levels alter the brain’s structure and function, particularly the hippocampus, a crucial component of the limbic system that is essential for cognitive processes like learning and remembering ( 54 ).

According to the World Health Organization (WHO), occupational burnout is a syndrome resulting from chronic work-related stress, with symptoms characterized by “feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy” 1 .

Although the ICD-11 classification does not include occupational stress, it can be classified as a 6B4Y, i.e., other specified disorders specifically related to stress. However, it should be remembered that occupational burnout is a consequence of long-term work-related stress. The most common causes of work-related stress include routine, uncomfortable working conditions, long working hours, competitive, conflicted work environment, pressure, control and lack of trust from the employer, unstable employment conditions, and mobbing. Chronic stress that causes professional burnout can have negative effects, not only at the individual level, e.g., deterioration of health and quality of work, but also at the organizational and social level ( 55 ).

Our research showed that in the group of people predisposed by age to work, the dominant factor in deciding to start yoga practice was the desire to reduce stress ( Figure 1 ). It should be noted that the upward trend of this factor appears already in the group of people aged 25–30, i.e., when most people start their first professional job. This tendency significantly intensifies in people over 30, indicating the first signs of occupational stress. This trend continues throughout the entire period of active professional work. Attention is drawn to the fact that stress reduction is no longer the key motivating goal for people entitled to retirement. It is rare for individuals with age-related pension entitlements to begin a yoga practice due to stress, which supports the thesis that work is the primary cause of stress for individuals between the ages of 25 and 60. Jarvelin-Pasanen et al. have previously suggested that the criterion of working age predisposes individuals to occupational stress ( 56 ). Our research results align with the conclusions of Shoman et al. and Maslash, who conclude that work stress is positively related to occupational burnout and reinforces the concept that occupational burnout is a response to excessive stress at work ( 51 ). Researchers dealing with the problem of occupational stress of employees in the health care system are coming to similar conclusions ( 57 – 59 ). Chen et al. have shown that burnout facilitates the relationship between occupational stress and symptoms of depression and anxiety in young nurses ( 60 ).

Yoga is one of the forms of mindfulness techniques, both in its dynamic form (focusing on movement and breathing) and in the form of relaxation techniques. The regular practice of mindfulness is, among other things, linked to the functioning of various areas of the brain, including the anterior cingulate cortex (ACC). People who meditate regularly show greater activity in the ACC area, which is responsible for self-regulation and drawing conclusions based on experience, thereby aiding optimal decision-making (has an essential role in both learning and using extended action-outcome histories to optimize voluntary choice behavior) ( 17 , 60 ).

It also comprises such stress-reducing methods as stretching techniques and social support ( 61 ). In research on the effectiveness of mindfulness interventions, Kimberly notes that online mindfulness interventions seem practical and effective in decreasing employee stress while improving resiliency, vigor, and work engagement, thereby enhancing overall employee well-being ( 62 ). Green and Kinchen came to similar conclusions, indicating that mindfulness training prevents professional burnout in nurses and helps to deal with difficult situations ( 63 ). Reduced burnout, perceived stress, and increased mindfulness were demonstrated in a study on a group participating in a four-hour mindfulness workshop ( 64 ). Cabat-Zinn observed that mindfulness-based stress reduction (MBSR) might cause brain alterations that make it easier to deal with unpleasant emotions when under stress. These modifications persisted for at least 4 months following the operation. Yoga practice does not always have to be associated with spiritual aspects, which was confirmed by our respondents ( Figure 3 ). Yoga and physical therapy help reduce perceived stress in low-income persons with chronic low back pain (cLBP), according to Berlowirtz et al. Moreover, physical exercise was more efficient than educational intervention ( 65 ). The study (a systematic review and metanalysis) by Wand et al. found that yoga interventions can help manage sleep problems in women when compared to non-active control conditions ( 60 ).

A meta-analysis by Pascoe et al. indicates that the physical practice of yoga can positively impact human well-being. As a result of the study, they also claim that yoga asanas are associated with improved regulation of the sympathetic nervous system and hypothalamic–pituitary–adrenal system in various populations ( 36 , 66 , 67 ). This study also showed that yoga significantly reduces cortisol measured in saliva during wakefulness and sleep, which is extremely important because long-term elevated cortisol levels are a predisposing factor for depression ( 68 , 69 ). Cortisol levels can be lowered with properly planned physical activity ( 70 – 72 ), whereas intense exercise raises stress hormone levels ( 36 ). In the analysis of Pascoe et al., they make no distinction in terms of styles of yoga practice. Nevertheless, every yoga practice begins with calming the breath (pranayama) and ends with relaxation. All yoga styles also include mindfulness elements in their technique, such as focusing on the breath, body scanning or other forms of mindfulness techniques.

Among all yoga styles, our respondents most often chose vinyasa yoga, and their decision was motivated by the desire to reduce stress levels. However, our respondents indicated that in yoga, they value the combination of the physical and spiritual aspects, which mindfulness techniques can establish. Significantly few people indicated that spiritual motivation is the main reason for exercise ( Figure 4 ). Vinyasa yoga is a dynamic style characterized by the diversity that allows practitioners to choose the intensity of the practice according to their needs and abilities ( 37 , 73 , 74 ). The impact of vinyasa yoga practice on reducing stress and reducing problems with falling asleep has already been shown in a study on a group of oncologists who declared an improvement in well-being after 3 months of practice ( 37 ). Notably, in clusters 4 and 5 ( Figure 3 ), the respondents to whom the desire to reduce stress through yoga practice was assigned were predominantly those with a short history of the practice allowing us to assume, as confirmed by the results of other researchers, that yoga has a positive effect on stress management role ( 67 , 75 , 76 ). Respondents who have been practicing for years are less likely to report a need for stress reduction ( Figure 4 ). Balakrishnan et al. link this to a better-developed parasympathetic nervous system in yogis. The parasympathetic predominance demonstrated in the yoga group suggests that hatha yoga practitioners may be at a lower risk of stress-related comorbidities ( 77 ). Akdeniz concludes his research with the recommendation that yoga should be started at a young age and practiced regularly, as it provides a simple solution to significant problems such as pain, anxiety, sleep and stress that negatively affect our daily lives ( 41 ).

It is worth noting that the respondents achieved the expected results through yoga practice, as presented in Figure 4 .

It should be noted that chronic stress has been widely described as a cause of many severe diseases and disorders, including cardiovascular diseases ( 78 – 82 ). The impact of physical activity on well-being and chronic stress is increasingly described in literature ( 84 – 87 ); its importance was noticed both in the group of healthy people and those struggling with diseases ( 83 – 86 ). Yoga combines physical, breathing, and mindfulness exercises and may benefit HF patients and those struggling with the affective disorder ( 33 , 87 , 88 ).

Research results have shown that yoga practice significantly reduces physiological stress and inflammation, improves well-being and sleep quality, and practice is safe, meaning it can be used not only as a prophylaxis but also as a support to conventional treatment of diseases caused by occupational stress.

Occupational stress contributes to many diseases and psycho-somatic disorders. Yoga practice can effectively neutralize occupational stress.

Yoga combines the benefits of physical activity and mindfulness, making it possible to take care of both physical and mental health. Yoga practice is an inexpensive and side-effect-free way to improve human well-being. However, research should be conducted to understand the mechanisms of the exercises.

Limitations

While acknowledging that work-related stress is a significant issue in modern society, it’s imperative to recognize the limitations of this study. Notably, despite the widespread use of the Internet and social media among working individuals, it’s crucial to bear in mind that not everyone maintains accounts on platforms like Facebook or Instagram. Additionally, a limitation arises from the underrepresentation of individuals of retirement age, who typically have minimal engagement with online resources.

Another aspect to consider is the deliberate use of a custom survey form. This choice was made due to prior research indicating the positive impact of yoga on enhancing life quality and managing stress-related effects. Our specific aim was to scrutinize the intricate correlation between various yoga practices, motivational factors, exercise effects, and the age demographics of the participants. This depth of analysis wasn’t feasible using existing standardized methods.

We acknowledge the inherent constraints associated with this survey format. Nevertheless, our objective was to design a form that could accurately align the type of yoga practice with the practitioners’ specific needs. Our intent is to tailor future assessments more precisely to better cater to the requirements of yoga practitioners.

Data availability statement

The original contributions presented in the study are included in the article/ Supplementary material , further inquiries can be directed to the corresponding author.

Ethics statement

The studies involving humans were approved by Komisja Bioetyczna przy Uniwersytecie Medycznym im. Karola Marcinkowskiego w Poznaniu ul. Bukowska 70, pok. A204 60–812 Poznań. The studies were conducted in accordance with the local legislation and institutional requirements. The ethics committee/institutional review board waived the requirement of written informed consent for participation from the participants or the participants’ legal guardians/next of kin because Participants completed the questionnaire using an online form, which made it impossible to sign the consent in person. The consent form was attached to the questionnaire, and participants were informed that completing the questionnaire meant participating in the study. In addition, participants had to confirm their consent by selecting the appropriate answer.

Author contributions

AZ: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Visualization, Writing – original draft, Writing – review & editing. MM: Formal analysis, Resources, Writing – review & editing. AB: Data curation, Writing – review & editing. MC: Data curation, Writing – review & editing.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2024.1370399/full#supplementary-material

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86. Groessl, EJ, Kaplan, RM, Rejeski, WJ, Katula, JA, Glynn, NW, King, AC, et al. Physical activity and performance impact long-term quality of life in older adults at risk for major mobility disability. Am J Prev Med . (2019) 56:141–6. doi: 10.1016/j.amepre.2018.09.006

87. Prabhu, S, Annapoorna, K, Devasia, T, Paramasivam, G, Nayak, K, Shetty, L, et al. Yoga as an adjuvant therapy in heart failure patients on optimal medical management analysed using echocardiographic parameters. Explore (NY) . (2023) 19:736–42. doi: 10.1016/j.explore.2023.02.009

88. Ludwig, DS, and Kabat-Zinn, J. Mindfulness in medicine. JAMA . (2008) 300:1350–2. doi: 10.1001/jama.300.11.1350

Keywords: yoga, stress, occupational stress, burnout, wellbeing

Citation: Zok A, Matecka M, Bienkowski A and Ciesla M (2024) Reduce stress and the risk of burnout by using yoga techniques. Pilot study. Front. Public Health . 12:1370399. doi: 10.3389/fpubh.2024.1370399

Received: 14 January 2024; Accepted: 01 March 2024; Published: 02 April 2024.

Reviewed by:

Copyright © 2024 Zok, Matecka, Bienkowski and Ciesla. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Agnieszka Zok, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

A feasibility study on yoga's mechanism of action for chronic low back pain: psychological and neurophysiological changes, including global gene expression and DNA methylation, following a yoga intervention for chronic low back pain

Affiliations.

• 1 Penn Frontotemporal Degenerative Center, Philadelphia, PA, USA.
• 2 Center for Advancement in Managing Pain, University of Connecticut School of Nursing, 231 Glenbrook Road, Storrs, CT, 06269, USA. [email protected].
• 3 Center for Advancement in Managing Pain, University of Connecticut School of Nursing, 231 Glenbrook Road, Storrs, CT, 06269, USA.
• 4 Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.
• 5 Senior Clinical Scientist, Apellis Pharmaceuticals, Boston, MA, USA.
• 6 Department of Orthopedic Surgery and Neurosurgery, UConn Health, Farmington, CT, USA.
• 7 Systems Medicine Lab, University of Florida, Gainesville, FL, USA.
• PMID: 35794661
• PMCID: PMC9260994
• DOI: 10.1186/s40814-022-01103-2

Introduction: Yoga has been shown to reduce pain and improve function in populations with chronic low back pain (cLBP), yet the underlying molecular mechanisms remain elusive. This study examined the feasibility and acceptability of a yoga research protocol, including recruitment, retention, and data collection, and investigated the preliminary effects of yoga on psychological and neurophysiological functions, including gene expression and DNA methylation profiles, in participants with cLBP.

Methods: A one-arm trial was conducted with 11 participants with cLBP who enrolled in a 12-week yoga intervention. Data on subjective pain characteristics, quantitative sensory testing, and blood for analysis of differentially expressed genes and CpG methylation was collected prior to the start of the intervention and at study completion.

Results: Based on pre-determined feasibility and acceptability criteria, the yoga intervention was found to be feasible and highly acceptable to participants. There was a reduction in pain severity, interference, and mechanical pain sensitivity post-yoga and an increase in emotion regulation and self-efficacy. No adverse reactions were reported. Differential expression analysis demonstrated that the yoga intervention induced increased expression of antisense genes, some of which serve as antisense to known pain genes. In addition, there were 33 differentially hypomethylated positions after yoga (log2 fold change ≥ 1), with enrichment of genes involved in NIK/NF-kB signaling, a major pathway that modulates immune function and inflammation.

Discussion/conclusions: The study supports the feasibility and acceptability of the proposed protocol to test a specific mechanism of action for yoga in individuals with cLBP. These results also support the notion that yoga may operate through our identified psychological and neurophysiologic pathways to influence reduced pain severity and interference.

Keywords: Chronic low back pain; Emotion regulation; Gene expression; Methylation; Yoga.

© 2022. The Author(s).

Grants and funding

• F31 NR019939/NR/NINR NIH HHS/United States

Virginia Tech researchers work to make yoga accessible to everyone

The project, a collaboration between the College of Agriculture and Life Sciences, Virginia Cooperative Extension, and the University Libraries, aims to reach historically underrepresented populations in yoga.

• Max Esterhuizen
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Therese Osborn and Mary Frazier do a yoga pose in front of a fountain in the Corporate Research Center in Blacksburg, Virginia. Photo by Max Esterhuizen for Virginia Tech.

From the downward dog to the reverse warrior, yoga’s popularity has blossomed recently, partly because of its accessibility to a wide range of people at a variety of skill levels.

With benefits ranging from physical to mental to social and spiritual, yoga offers an approach to holistic well-being. Virginia Tech researchers are working on ways to broaden its appeal even further.

“The historical underrepresentation in yoga makes this the perfect thing to study in regard to equitable translation of health evidence,” said Mary Frazier, who is pursuing her Ph.D. in the Translational Biology, Medicine, and Health Graduate Program and is the graduate student lead on the project. “So many people think yoga isn’t for them and that’s largely because of how it’s often portrayed. We want to find ways to reach the groups that don’t think yoga is for them – because it could be.”

The underrepresentation of people from rural areas in yoga practices highlights significant accessibility and awareness issues, often due to a lack of local resources and classes that could introduce and nurture an inclusive yoga culture, the researchers said.

Additionally, according to the research team, prevailing narratives around body image within the yoga community can deter many from participating, as the physical component of yoga is easier to capture ‘on screen’ (e.g., photo or video), but the imagery often lacks representation of the diversity of human bodies.

“These challenges underscore the need for a more inclusive approach to yoga, one that embraces and promotes diversity in all forms, from geographical background to body shape, ensuring that the benefits of yoga are accessible to all,” said Samantha Harden, an associate professor in the Department of Human Nutrition, Foods, and Exercise and a Virginia Cooperative Extension specialist.

To help bridge this gap, the research team made up of Harden; Frazier; Brad Frick, a master’s degree student in the School of Communication ; and Therese Osborn, an undergraduate student in public health , as well as Rachel Kaplan, Cassidy Powers, and Kayla Markley, all students in human nutrition, foods, and exercise, created a messaging survey to identify terms and tactics that resonate with the historically underrepresented groups.

The development of a survey aimed at identifying effective tactics and messaging to engage historically underrepresented groups in yoga represents a strategic approach to fostering inclusivity within the practice. Through a collaboration with University Libraries, this research project can leverage advanced data visualization tools and expertise, transforming raw survey data into compelling, easy-to-understand insights that highlight opportunities for outreach and community engagement.

“This partnership not only amplifies the survey's impact through sophisticated analysis but also ensures that the findings are accessible and actionable for stakeholders aiming to create a more inclusive yoga community,” said Harden, who is also affiliated with the Fralin Biomedical Institute.

“It’s going to be interesting to see and transform the raw survey data into insightful and meaningful visualizations," said Michael Stamper, a University Libraries data visualization designer. "Once we can see the stories within that data, we can begin to take notice of and address them.”

The research project also gave Frazier valuable experience as a graduate student.

“This project has been instrumental in advancing my Ph.D. journey, providing a solid foundation for my dissertation on the importance of inclusivity in wellness spaces and highlighting the transformative potential of yoga when it truly embraces diversity in all its forms,” Frazier said. “The research into the underrepresentation of individuals from rural areas in yoga practices has illuminated critical gaps in accessibility and awareness, underscoring the urgent need for community-based interventions and inclusive programming.”

Osborn, a sophomore, was “nervous” when she first joined the lab — it’s the same nervousness that keeps people out of studios: the unknown. She now acknowledges that the experience has equipped her with valuable skills, preparing her for the workforce.

“Dr. Harden, Frazier, Megan Pullin, and the rest of the lab have been so welcoming and encouraging,” Osborn said. “Not only has the lab allowed me to apply what I have learned in my classes, but it has also taught me new things entirely, that help me to feel prepared for the future. This project has taught me how to build a successful survey and analyze qualitative data.”  

Tom Soladay

540-232-2501

• College of Agriculture and Life Sciences
• College of Liberal Arts and Human Sciences
• Human Nutrition, Foods, and Exercise
• Public Health
• School of Communication
• Translational Biology, Medicine, and Health
• University Libraries
• Virginia Cooperative Extension
• Virginia-Maryland College of Veterinary Medicine

Related Content

Here’s how you know

• U.S. Department of Health and Human Services
• National Institutes of Health

NCCIH Clinical Digest

for health professionals

Yoga for Health: What the Science Says

Clinical Guidelines, Scientific Literature, Info for Patients:  Yoga for Health

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The American Academy of Pediatrics (AAP) recommends yoga as a safe and potentially effective therapy for children and adolescents coping with emotional, mental, physical, and behavioral health conditions. Yoga can help children learn to self-regulate, focus on the task at hand, and handle problems peacefully. Yoga may also improve balance, relieve tension, and increase strength when practiced regularly. Because some yoga poses are harder than others, the AAP cautions that even children who are flexible and in good shape should start slowly.

What Does the Research Show?

• In a  2019 study , 5-year-old kindergartners doing yoga twice a week in school in place of standard physical education showed less inattention and hyperactivity and completed a task faster than 5-year-olds doing physical education or no exercise.
• A  2016 review  found that school-based yoga programs seem to help improve adolescents’ health. 
• A  2015 systematic review  of 16 studies (including 6 randomized controlled trials, 2 nonrandomized preintervention-postintervention control-group designs, 7 uncontrolled preintervention-postintervention studies, and 1 case study) for yoga interventions addressing anxiety among children and adolescents concluded that nearly all studies included in the review indicated reduced anxiety following a yoga intervention. However, the reviewers noted that because of the wide variety of study populations, limitations in some study designs, and variable outcome measures, further research is needed to enhance the ability to generalize and apply yoga to reduce anxiety.

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Yoga’s popularity among older Americans is growing. National survey data show that 6.7 percent of U.S. adults age 65 and over practiced yoga in 2017, as compared to  3.3 percent in 2012, 2.0 percent in 2007,  and 1.3 percent in 2002.

Older adults who practice yoga should put safety first. It’s a good  idea to start with an appropriate yoga class—such as one called  gentle yoga or seniors yoga—to get individualized advice and learn correct form. Chair yoga is an even gentler option for seniors with limited mobility. And it’s important for older people with medical issues to talk to both their health care providers and the yoga  teacher before starting yoga.

• A  2015 study  funded by NCCIH compared 14 experienced yoga practitioners to 14 physically active control participants of similar ages. In the control group, the amount of gray matter was lower in older participants than younger ones. In the yoga practitioners, there was no relationship between gray matter and age. Among the yoga practitioners, the volume of certain brain regions increased with the number of years of yoga experience and weekly amount of yoga practice.

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Only a small amount of research has investigated yoga for general well-being, such as improving sleep and reducing stress, and the findings have not been completely consistent. Nevertheless, some preliminary research results suggest that yoga may have several different types of benefits for general well-being. 

• Stress Management . Some research indicates that practicing yoga can lead to improvements in physical or psychological aspects of stress. 
• Balance . Several studies that looked at the effect of yoga on balance in healthy people found evidence of improvements. 
• Positive Mental Health . Some but not all studies that looked at the effects of yoga on positive aspects of mental health found evidence of benefits, such as better resilience or general mental well-being.
• Health Habits . A survey of young adults showed that practicing yoga regularly was associated with better eating and physical activity habits, such as more servings of fruits and vegetables, fewer servings of sugar-sweetened beverages, and more hours of moderate-to-vigorous activity. But it wasn’t clear from this study whether yoga motivates people to practice better health habits or whether people with healthier habits are more likely to do yoga. In another study, however, in which previously inactive people were randomly assigned to participate or not participate in 10 weeks of yoga classes, those who participated in yoga increased their total physical activity. 
• Quitting Smoking . Programs that include yoga have been evaluated to see whether they help people quit smoking. In most studies of this type, yoga reduced cigarette cravings and the number of cigarettes smoked. Findings suggest that yoga may be a helpful addition to smoking cessation programs. 
• Weight Control . In studies of yoga in people who were overweight or obese, practicing yoga has been associated with a reduction in body mass index. An NCCIH-supported comparison of different yoga-based programs for weight control showed that the most helpful programs had longer and more frequent yoga sessions, a longer duration of the overall program, a yoga-based dietary component, a residential component (such as a full weekend to start the program), inclusion of a larger number of elements of yoga, and home practice.

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Yoga may help relieve low-back pain and neck pain, but it has not been shown to be helpful for some other painful conditions such as headache, arthritis, fibromyalgia, or carpal tunnel syndrome.

• In 2017, the European League Against Rheumatism (EULAR) evaluated non-pharmacologic therapies, including complementary health approaches, and issued  revised recommendations  for the management of fibromyalgia. The strength of these recommendation is “based on the balance between desirable and undesirable effects (considering values and preferences), confidence in the magnitude of effects, and resource use. A strong recommendation implies that, if presented with the evidence, all or almost all informed persons would make the recommendation for or against the therapy, while a weak recommendation would imply that most people would, although a substantial minority would not.” Based on the evaluation of acupuncture, meditative movement practices (e.g., tai chi, qi gong, and yoga), and mindfulness-based stress reduction, the recommendation for each was weak for use of the therapy.
• A  2015 Cochrane review  of 61 trials involving 4,234 predominantly female participants with fibromyalgia concluded that the effectiveness of biofeedback, mindfulness, movement therapies (e.g., yoga), and relaxation techniques remains unclear as the quality of evidence was low or very low.
• A  2018 report  by the Agency for Healthcare Research and Quality evaluated 8 trials of yoga for low-back pain (involving 1,466 total participants) and found that yoga improved pain and function both in the short term (1 to 6 months) and intermediate term (6 to 12 months). The effects of yoga were similar to those of exercise. 
• A  2017 Cochrane review  of 12 trials involving 1,080 participants found low- to moderate-certainty evidence that yoga compared to non-exercise controls results in small to moderate improvements in back-related function at 3 and 6 months. Yoga may also be slightly more effective for pain at 3 and 6 months, however the effect size did not meet predefined levels of minimum clinical importance.
• A  2017 review  of 3 studies (involving 188 total participants) found that yoga had short-term benefits for both the intensity of neck pain and disability related to neck pain.
• A  2015 attempt  to review the research on this topic found only one study with 72 participants that could be evaluated. That study had favorable results, with decreases in headache intensity and frequency.
• A  2018 meta-analysis  of 13 clinical trials involving 1557 patients with knee osteoarthritis and rheumatoid arthritis found that regular yoga training may be useful in reducing knee arthritic symptoms, promoting physical function, and general wellbeing in arthritic patients.
• A  2017 review  of two studies found some beneficial effect on pain, but due to the high risk of bias in both studies, the reviewers gave a weak recommendation for yoga in rheumatoid arthritis. Yoga incorporates several elements of exercise that may be beneficial for arthritis, including activities that may help improve strength and flexibility.

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• Cancer . Quite a few studies have been done on yoga for people with cancer, especially on women with breast cancer. These studies have produced some evidence that yoga can help improve quality of life and reduce fatigue and sleep disturbances. Other forms of exercise may have similar benefits. 
• Multiple Sclerosis . A small amount of research in people with multiple sclerosis found that yoga has short-term benefits on fatigue and mood, but it doesn’t affect muscle function, reasoning ability, or quality of life. The effects of yoga on fatigue are similar to those of other kinds of exercise. 
• Chronic Obstructive Pulmonary Disease (COPD) . Studies in people with COPD have shown that yoga may improve physical ability (such as the capacity to walk a certain distance in a specific length of time), lung function, and quality of life. 
• Asthma . Studies of yoga in people with asthma have shown that it probably leads to small improvements in symptoms and quality of life.

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• Anxiety or Depression . Yoga may be helpful for anxiety or depressive symptoms associated with difficult life situations. However, the research on yoga for anxiety disorders, clinical depression, or posttraumatic stress disorder (PTSD), although mildly positive, is still very preliminary. 
• Cardiovascular Risk Factors . Stress and a sedentary lifestyle increase people’s risk of cardiovascular disease. Because yoga involves physical activity and may help reduce stress, it might help reduce the risk of cardiovascular disease. However, not much research has been done on this topic. Some studies have suggested that yoga may improve some risk factors, such as blood pressure and cholesterol levels, but the findings aren’t definitive. 
• Diabetes . Some research has suggested that participating in yoga programs is associated with better blood sugar control in people with type 2 diabetes, at least on a short-term basis. 
• Irritable Bowel Syndrome (IBS) . Some research has suggested that yoga may help to decrease IBS symptoms and severity, but the findings aren’t strong enough for definite conclusions to be reached. 
• Menopause Symptoms . Growing research indicates that yoga may help to reduce some menopause symptoms, and it’s at least as effective for menopause symptoms as other types of exercise. 
• Sleep Problems . Some research has indicated that practicing yoga may improve sleep in a variety of groups of people, including people with cancer, older adults, people with arthritis, pregnant women, and women with menopause symptoms.

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Yoga is generally considered a safe form of physical activity for healthy people when it’s done properly, under the guidance of a qualified instructor. But it’s possible to get hurt practicing yoga—just as when participating in other physical activities.

The most common injuries associated with yoga are sprains and strains. Serious injuries are rare. The risk of injury associated with yoga is lower than that for higher impact sports activities.

Older adults, women who are pregnant, and those who have health conditions should discuss their needs with their health care providers and yoga instructor. They may need to modify or avoid some yoga poses and practices.

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• Cramer H, Lauche R, Langhorst J, et al.  Yoga for rheumatic diseases: a systematic review .  Rheumatology . 2013;52(11):2025-2030. 
• Cramer H, Ostermann T, Dobos G.  Injuries and other adverse events associated with yoga practice: a systematic review of epidemiological studies .  Journal of Science and Medicine in Sport . 2018;21(2):147-154. 
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• Thind H, Lantini R, Balletto BL, et al.  The effects of yoga among adults with type 2 diabetes: a systematic review and meta-analysis .  Preventive Medicine . 2017;105:116-126. 
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NCCIH Clinical Digest is a service of the National Center for Complementary and Integrative Health, NIH, DHHS. NCCIH Clinical Digest, a monthly e-newsletter, offers evidence-based information on complementary health approaches, including scientific literature searches, summaries of NCCIH-funded research, fact sheets for patients, and more.

The National Center for Complementary and Integrative Health is dedicated to exploring complementary health products and practices in the context of rigorous science, training complementary health researchers, and disseminating authoritative information to the public and professionals. For additional information, call NCCIH’s Clearinghouse toll-free at 1-888-644-6226, or visit the NCCIH website at nccih.nih.gov . NCCIH is 1 of 27 institutes and centers at the National Institutes of Health, the Federal focal point for medical research in the United States.

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See how mindfulness helps you live in the moment.

If you've heard of or read about mindfulness meditation — also known as mindfulness — you might be curious about how to practice it. Find out how to do mindfulness exercises and how they might benefit you.

What is mindfulness?

Mindfulness is a type of meditation in which you focus on being intensely aware of what you're sensing and feeling in the moment, without interpretation or judgment. Practicing mindfulness involves breathing methods, guided imagery, and other practices to relax the body and mind and help reduce stress.

Spending too much time planning, problem-solving, daydreaming, or thinking negative or random thoughts can be draining. It can also make you more likely to experience stress, anxiety and symptoms of depression. Practicing mindfulness exercises can help you direct your attention away from this kind of thinking and engage with the world around you.

What are the benefits of meditation?

Meditation has been studied in many clinical trials. The overall evidence supports the effectiveness of meditation for various conditions, including:

• High blood pressure (hypertension)

Preliminary research indicates that meditation can also help people with asthma and fibromyalgia.

Meditation can help you experience thoughts and emotions with greater balance and acceptance. Meditation also has been shown to:

• Improve attention
• Decrease job burnout
• Improve sleep
• Improve diabetes control

What are some examples of mindfulness exercises?

There are many simple ways to practice mindfulness. Some examples include:

• Pay attention. It's hard to slow down and notice things in a busy world. Try to take the time to experience your environment with all of your senses — touch, sound, sight, smell and taste. For example, when you eat a favorite food, take the time to smell, taste and truly enjoy it.
• Live in the moment. Try to intentionally bring an open, accepting and discerning attention to everything you do. Find joy in simple pleasures.
• Accept yourself. Treat yourself the way you would treat a good friend.
• Focus on your breathing. When you have negative thoughts, try to sit down, take a deep breath and close your eyes. Focus on your breath as it moves in and out of your body. Sitting and breathing for even just a minute can help.

You can also try more structured mindfulness exercises, such as:

• Body scan meditation. Lie on your back with your legs extended and arms at your sides, palms facing up. Focus your attention slowly and deliberately on each part of your body, in order, from toe to head or head to toe. Be aware of any sensations, emotions or thoughts associated with each part of your body.
• Sitting meditation. Sit comfortably with your back straight, feet flat on the floor and hands in your lap. Breathing through your nose, focus on your breath moving in and out of your body. If physical sensations or thoughts interrupt your meditation, note the experience and then return your focus to your breath.
• Walking meditation. Find a quiet place 10 to 20 feet in length, and begin to walk slowly. Focus on the experience of walking, being aware of the sensations of standing and the subtle movements that keep your balance. When you reach the end of your path, turn and continue walking, maintaining awareness of your sensations.

When and how often should I practice mindfulness exercises?

It depends on what kind of mindfulness exercise you plan to do.

Simple mindfulness exercises can be practiced anywhere and anytime. Research indicates that engaging your senses outdoors is especially beneficial.

For more structured mindfulness exercises, such as body scan meditation or sitting meditation, you'll need to set aside time when you can be in a quiet place without distractions or interruptions. You might choose to practice this type of exercise early in the morning before you begin your daily routine.

Aim to practice mindfulness every day for about six months. Over time, you might find that mindfulness becomes effortless. Think of it as a commitment to reconnecting with and nurturing yourself.

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• Bystritsky A. Complementary and alternative treatments for anxiety symptoms and disorders: Physical, cognitive, and spiritual interventions. https://uptodate.com/contents/search. Accessed June 14, 2018.
• Seaward BL. Meditation and mindfulness. In: Managing Stress: Principles and Strategies for Health and Well-being. 9th ed. Burlington, Mass.: Jones & Bartlett Learning; 2018.
• Shapiro SL, et al. The Art and Science of Mindfulness: Integrating Mindfulness into Psychology and the Helping Professions. 2nd ed. Washington, D.C.: American Psychological Association; 2017.
• Lymeus F, et al. Building mindfulness bottom-up: Meditation in natural settings supports open monitoring and attention restoration. Consciousness and Cognition. 2018;59:40.
• Blanck P, et al. Effects of mindfulness exercises as stand-alone interventions on symptoms of anxiety and depression: Systematic review and meta-analysis. Behaviour Research and Therapy. 2018;102:25.
• AskMayoExpert. Meditation. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
• Khoury B, et al. Mindfulness-based stress reduction for healthy individuals: A meta-analysis. Journal of Psychosomatic Research. 2015;78:519.
• Practice mindfulness and relaxation. Springboard Beyond Cancer. https://survivorship.cancer.gov/springboard/stress-mood/practice-mindfulness. Accessed June 14, 2018.

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Study Says Venting Isn't Actually the Best Way to Reduce Anger—Here's What to Do Instead

As cathartic as it may seem, activities that relax you are said to be better anger management tools than venting about your problems to a loved one.

J Studios/Getty Images

Venting to a loved one has often been the go-to for many people after a particularly trying day. We tend to seek out our most trusted confidants to express our frustration and offer us a sense of emotional release. However, a new study found in the Clinical Psychology Review found that venting is not actually the best way to reduce anger.

The study examined 154 other studies with over 10,000 participants, and the results showed that arousal-decreasing activities, such as meditation and breathing exercises, were more effective at managing anger than arousal-increasing activities, such as venting or even physical exercises like running.

Arousal-Decreasing Activities to Try

When anger rises, it may be difficult to find your inner calm. Add some of these arousal-decreasing activities to your mental toolbox, and give them a try next time you're feeling furious.

Count to 10

The study says simply counting to a given number like 10 or 100 may be beneficial, as it can "reduce anger because it provides time for the arousal to dissipate." Try counting before responding next time you're in a heated discussion.

Start a meditation practice at home with a structured and prompted practice to follow along. There are many free meditation apps you can download for guided meditation exercises that you can listen to while you’re out on a walk or resting on the couch.

Practice Mindfulness

Mindfulness allows us to pay closer attention to our feelings and sensations around us to help us feel more grounded. There are many easy mindfulness activities to try, such as journaling, listening to music, or taking a warm bath.

Yoga has many health benefits thanks to the mind-body connection you form while practicing, which includes improving balance, reducing stress, and helping to manage your emotions. Try a class at your local yoga studio, or practice at home with various yoga poses for stress relief and full-body stretches .

Try Breathing Exercises

Breathwork plays an important role in yoga, but it's not the only time to focus on your breathing. There are several breathing techniques you can try anywhere, anytime to help you unwind and feel calmer, such as box breathing or the 4-7-8 breathing method .

Engage in Progressive Muscle Relaxation

Progressive muscle relaxation can reduce stress by contracting certain muscles in a cadence to create tension, then releasing them. For example, try lying down in a comfortable spot and squeeze your calves for a few seconds, then release. After that, squeeze your thigh muscles for a few seconds, and release. Slowly work your way up your body, focusing on one muscle group at a time until you reach your head.

J.M. Lohr, B.O. Olatunji, R.F. Baumeister, B.J. Bushman

The psychology of anger venting and empirically supported alternatives that do no harm

The scientific review of mental health practice: Objective investigations of controversial and unorthodox claims in clinical psychology, psychiatry, and social work, Vol. 5(1), Prometheus Books, Amherst, NY (2007), pp. 53-64

Toussaint L, Nguyen QA, Roettger C, et al. Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation .  Evid Based Complement Alternat Med . 2021;2021:5924040. doi:10.1155/2021/5924040

Related Articles

Hot Yoga Can Reduce Depression by 50%, New Study Says—The Easy Way to Start

Posted: November 2, 2023 | Last updated: November 2, 2023

When you're deep in the throes of depression, working out is probably the last thing you want to do. However, it's no secret that if you can dig deep and find the motivation, getting regular exercise can significantly improve your mental health. In fact, new research shows that hot yoga is especially beneficial.

A study published earlier this month in the Journal of Clinical Psychology found that joining weekly hot yoga classes for just eight weeks could significantly reduce depressive symptoms. Read on to find out how hot yoga could transform your mental health and why it comes with such unique benefits.

RELATED: Silent Walking Is the Latest Wellness Trend Everyone's Talking About .

Hot yoga can significantly reduce depression, a new study says.

The study gathered 80 participants with moderate-to-severe depression and split them into two groups. The first was asked to attend hot yoga classes twice weekly for eight weeks, while the control group was put on a "waitlist" for the classes.

RELATED: 7 Effective Ways to Control Your Anxiety, According to Therapists .

Hot yoga helps build resilience and self-esteem.

With the thermostat turned up to sauna-like levels , hot yoga challenges you to overcome both physical challenges and feats of mental endurance. Some experts believe that this is a key reason why it can improve depressive symptoms.

"The challenging environment of hot yoga, where individuals may face discomfort and adversity, can help build mental resilience," explains Ryan Sultan , MD, a board-certified psychiatrist , therapist, and professor at Columbia University. "Overcoming physical and mental obstacles in hot yoga classes can empower individuals to cope with the challenges they encounter in their daily lives, including those related to depression." Bayu Prihandito , an RYT 200-certified yoga instructor, life coach, and the founder of Life Architekture , agrees that by overcoming these physical and mental challenges, many people will notice a boost to their "self-esteem, confidence, and sense of accomplishment." He adds that the intense focus required in hot yoga can act as a form of meditation, ultimately helping to ground people in the present.

There are also physiological benefits to adding heat to your yoga practice.

Raising the room's temperature while you do yoga may also help reduce depressive symptoms by providing certain physiological benefits.

RELATED: 15 Life-Changing Habits to Add to Your Wellness Routine .

A holistic approach to treatment is best, experts say.

Hot yoga won't singularly "cure" your depression, but it can be used as part of a broader, more holistic plan to improve your mental health.

"Remember that hot yoga can be a valuable addition to your mental health treatment plan, but it should not be considered a standalone solution for depression. It is most effective when used in conjunction with other therapeutic approaches, such as medication and psychotherapy, for a comprehensive treatment strategy," advises Sultan.

Safety is key.

If you're considering adding hot yoga to your self-care routine, it's important to consult with your team of healthcare professionals before getting started. This should include both your general practitioner, who can help you assess safety given any pre-existing medical conditions you may have, as well as your psychiatrist or therapist.

For more wellness tips sent directly to your inbox, sign up for our daily newsletter .

Read the original article on Best Life .

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Developing ash-free high-strength spherical carbon catalyst supports

• Domestic Catalysts
• Published: 28 June 2013
• Volume 5 , pages 156–163, ( 2013 )

Cite this article

• V. V. Gur’yanov 1 ,
• V. M. Mukhin 1 &
• A. A. Kurilkin 1  

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The possibility of using furfurol for the production of ash-free high-strength active carbons with spheroidal particles as adsorbents and catalyst supports is substantiated. A single-stage process that incorporates the resinification of furfurol, the molding of a spherical product, and its hardening while allowing the process cycle time and the cost of equipment to be reduced is developed. Derivatographic, X-ray diffraction, mercury porometric, and adsorption studies of the carbonization of the molded spherical product are performed to characterize the development of the primary and porous structures of carbon residues. Ash-free active carbons with spheroidal particles, a full volume of sorbing micro- and mesopores (up to 1.50 cm 3 /g), and a uniquely high mechanical strength (its abrasion rate is three orders of magnitude lower than that of industrial active carbons) are obtained via the vapor-gas activation of a carbonized product. The obtained active carbons are superior to all known foreign and domestic analogues and are promising for the production of catalysts that operate under severe regimes, i.e., in moving and fluidized beds.

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Original Russian Text © V.V. Gur’yanov, V.M. Mukhin, A.A. Kurilkin, 2013, published in Kataliz v Promyshlennosti.

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Gur’yanov, V.V., Mukhin, V.M. & Kurilkin, A.A. Developing ash-free high-strength spherical carbon catalyst supports. Catal. Ind. 5 , 156–163 (2013). https://doi.org/10.1134/S2070050413020062

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Received : 08 December 2011

Published : 28 June 2013

Issue Date : April 2013

DOI : https://doi.org/10.1134/S2070050413020062

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I was born and raised in a working-class city, Elektrostal, Moscow region. I received a higher education in television in Moscow. I studied to be a documentary photographer. My vision of the aesthetics of the frame was significantly influenced by the aesthetics of my city – the endless forests and swamps of the Moscow region with endless factories, typical architecture and a meagre color palette. In this harsh world, people live and work, raise children, grow geranium, throw parties and live trouble, run a ski cross. They are the main characters of my photo projects.

I study a person in a variety of circumstances. We blog with friends with stories of such people. We are citizen journalists. In my works, I touch upon the topics of homelessness, people’s attitude to their bodies, sexual objectification, women’s work, alienation and living conditions of different people. The opportunity to communicate with my characters gives me a sense of belonging and modernity of life.

My photos create the effect of presence, invisible observation of people. I don’t interfere with what’s going on, I’m taking the place of an outside observer. I’m a participant in exhibitions in Rome (Loosenart Gallery), Collaborated with the Russian Geographical Community.

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