What is yoga and how does it work?

Yoga is an ancient and complex practice, rooted in Indian philosophy. It began as a spiritual practice but has become popular as a way of promoting physical and mental well-being.

Although classical yoga also includes other elements, yoga as practiced in the United States typically emphasizes physical postures (asanas), breathing techniques (pranayama), and meditation (dyana). Popular yoga styles such as iyengar, bikram, and hatha yoga focus on these elements.

Yoga and two practices of Chinese origin—tai chi and qi gong—are sometimes called “meditative movement” practices. All three practices include both meditative elements and physical ones.

 

What are the health benefits of yoga?

Research suggests that yoga may:

  • Help improve general wellness by relieving stress, supporting good health habits, and improving mental/emotional health, sleep, and balance
  • Relieve low-back pain and neck pain
  • Relieve menopause symptoms
  • Help people manage anxiety or depressive symptoms associated with difficult life situations (but yoga has not been shown to help manage anxiety disorders, clinical depression, or posttraumatic stress disorder [PTSD])
  • Help people quit smoking
  • Help people who are overweight or obese lose weight
  • Help people with chronic diseases manage their symptoms and improve their quality of life.

Although there’s been a lot of research on the health effects of yoga, many studies have included only small numbers of people and haven’t been of high quality. Therefore, in most instances, we can only say that yoga has shown promise for particular health uses, not that it’s been proven to help.

 

What does research show about yoga for wellness?

Studies have suggested possible benefits of yoga for several aspects of wellness, including stress management, mental/emotional health, promoting healthy eating/activity habits, sleep, and balance.

  • Stress management. Of 17 studies (involving 1,070 total participants) of yoga for stress management included in a recent review, 12 showed improvements in physical or psychological measures related to stress.
  • Mental/emotional health. In a recent review of 14 studies (involving 1,084 total participants) that assessed the effects of yoga on positive aspects of mental health, 10 studies found evidence of benefits, such as improvements in resilience or general mental well-being.
  • Promoting healthy eating/activity habits. A 2018 survey of young adults (involving 1,820 participants) showed that practicing yoga regularly was associated with better eating and physical activity habits. In interviews, people who took the survey said they thought yoga supported healthier habits through greater mindfulness, motivation to participate in other forms of activity and eat healthier, and the influence of a health-minded yoga community.
  • Sleep. Yoga has been shown to be helpful for sleep in several studies of cancer patients and older adults and in individual studies in other population groups, including people with arthritis, pregnant women, and women with menopause symptoms.
  • Balance. Of 15 studies (688 total participants) looking at the effect of yoga on balance in healthy people, 11 showed improvements in at least one outcome related to balance.

 

Can yoga help with pain management?

Research has been done on yoga for several conditions that involve pain. Studies of yoga for low-back pain and neck pain have had promising results, and yoga is among the options that the American College of Physicians recommends for first-line treatment of chronic low-back pain. Very little research has been done on yoga for headaches, arthritis, or fibromyalgia, so it’s uncertain whether it can help to relieve pain from these conditions.

Is yoga a good way to lose weight?

There’s evidence that yoga may help people lose weight. In 2013, an NCCIH-supported review looked at 17 yoga-based weight control programs and found that most of them led to gradual, moderate reductions in weight. The programs with the best results included at least some of these elements:

  • 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)
  • A larger number of elements of yoga
  • Home practice.

Another review, in 2016, looked at 10 studies of yoga in overweight or obese individuals and found that practicing yoga was associated with reduced body mass index (BMI; a measure of body fat based on height and weight).

 

 

Can yoga help you quit smoking?

There’s evidence that yoga may help people stop smoking. A 2014 report evaluated 10 studies (484 participants) in which yoga-based interventions were tested as an aid to smoking cessation. In most of the studies, yoga was associated with reduced cravings and a reduction in the number of cigarettes smoked.

 

 

How does yoga affect mental health?

There’s evidence that yoga may be helpful for anxiety associated with various life situations, such as medical conditions or stressful educational programs, and for depressive symptoms. However, yoga hasn’t been shown to help in managing diagnosed mental health conditions such as anxiety disorder, depression, or PTSD.

Can yoga help with menopause symptoms?

Yoga seems to be at least as effective as other types of exercise in relieving menopause symptoms. A 2018 evaluation of 13 studies (more than 1,300 participants) of yoga for menopause symptoms found that yoga reduced physical symptoms, such as hot flashes, as well as psychological symptoms.

 

Is yoga helpful for people with chronic diseases?

There’s promising evidence that yoga may help people with some chronic diseases manage their symptoms and improve their quality of life. Thus, it could be a helpful addition to treatment programs.

  • Cancer
    • In a 2018 evaluation of 138 studies on the use of yoga in patients with various types of cancer (10,660 total participants), most of the studies found that yoga improved patients’ physical and psychological symptoms and quality of life.
    • Many yoga studies have focused on breast cancer patients and survivors. A 2017 review of 24 studies in women with breast cancer (more than 2,100 total participants) found moderate-quality evidence that yoga helped reduce fatigue and sleep disturbances and improved health-related quality of life. The effects of yoga were similar to those of other types of exercise and better than those of educational programs.
  • Multiple sclerosis. A 2014 review of 7 studies (involving 670 participants) found evidence that yoga had short-term benefits on fatigue and mood in people with multiple sclerosis, but it didn’t affect muscle function, cognitive function, or quality of life. The effects of yoga on fatigue were similar to those of other kinds of exercise.
  • Chronic obstructive pulmonary disease (COPD). A 2018 analysis of 10 studies (502 total participants) found evidence that yoga can improve physical ability (such as being able to walk a defined distance in a defined time), lung function, and quality of life in people with COPD.
  • Asthma
    • A 2016 review of 15 studies of yoga for asthma (involving 1,048 total participants) concluded that yoga probably leads to small improvements in quality of life and symptoms.
    • Complementary health approaches such as yoga should never be used as a substitute for medical treatment for asthma.

 

What are the risks of yoga?

Yoga is generally considered a safe form of physical activity for healthy people when performed properly, under the guidance of a qualified instructor. However, as with other forms of physical activity, injuries can occur. The most common injuries are sprains and strains. Serious injuries are rare. The risk of injury associated with yoga is lower than that for higher impact physical activities.

Older people may need to be particularly cautious when practicing yoga. The rate of yoga-related injuries treated in emergency departments is higher in people age 65 and older than in younger adults.

To reduce your chances of getting hurt while doing yoga:

  • Practice yoga under the guidance of a qualified instructor.
  • If you’re new to yoga, avoid extreme practices such as headstands, shoulder stands, the lotus position, and forceful breathing.
  • Be aware that bikram yoga (“hot yoga”) has special risks related to overheating and dehydration.
  • Pregnant women, older adults, and people with health conditions should talk with their health care providers and the yoga instructor about their individual needs. They may need to avoid or modify some yoga poses and practices.

 

Why do Americans practice yoga?

National survey data from 2012 showed that 94 percent of adults who practiced yoga did it for wellness-related reasons, while 17.5 percent did it to treat a specific health condition. The numbers add up to more than 100 percent because some people reported doing both.

The majority of adults who practiced yoga said that it helped in these wellness-related ways:

  • 86 percent said it reduced stress
  • 67 percent said it helped them feel better emotionally
  • 63 percent said it motivated them to exercise more regularly
  • 59 percent said it improved sleep
  • 82 percent said it improved overall health and made them feel better.

Smaller numbers of people reported other benefits:

  • 43 percent said yoga motivated them to eat healthier
  • 39 percent said yoga eased coping with health problems
  • 25 percent of people who currently smoke cigarettes said yoga motivated them to cut back or stop smoking cigarettes
  • 12 percent of people who currently drink alcohol said yoga motivated them to cut back or stop drinking alcohol.

 

Do different groups of people have different experiences with yoga?

Much of the research on yoga in the United States has been conducted in populations similar to those among whom yoga is most popular—that is, predominantly female, non-Hispanic white, well-educated people with relatively high incomes. Other people—particularly members of minority groups and those with lower incomes—have been underrepresented in yoga studies.

Different groups of people may have different yoga-related experiences.

  • Differences related to age. In one survey, middle-aged people were more likely to be motivated to practice yoga to increase muscle strength or lose weight, while older adults were more likely to be motivated by age-related chronic health issues. As mentioned earlier, older people may also be more likely to need treatment for yoga-related injuries.
  • Differences related to education. National survey data indicate that “lack of knowledge” is more commonly reported as a reason for not practicing yoga among people with lower educational attainment than those with greater education, both in the general population and among people with low-back pain.
  • Differences related to sex. A study found evidence for differences between men and women in the effects of specific yoga poses on muscles. And a study in veterans found preliminary evidence that women might benefit more than men from yoga interventions for chronic back pain.

 

Research Funded by the National Center for Complementary and Integrative Health (NCCIH)

NCCIH-sponsored studies are investigating the effects of yoga on a variety of conditions including:

  • Generalized anxiety disorder
  • Sleep disturbance and fatigue in cancer patients receiving chemotherapy
  • Depression in adolescents
  • Chronic pain in veterans.

 

More To Consider

  • Don’t use yoga to postpone seeing a health care provider about a medical problem.
  • Ask about the training and experience of the yoga instructor you’re considering.
  • Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed  decisions.

 

Key References

  • Black LI, Barnes PM, Clarke TC, Stussman BJ, Nahin RL. Use of yoga, meditation, and chiropractors among U.S. children aged 4–17 years. NCHS Data Brief, no 324. Hyattsville, MD: National Center for Health Statistics. 2018.
  • Clarke TC, Barnes PM, Black LI, Stussman BJ, Nahin RL. Use of yoga, meditation, and chiropractors among U.S. adults aged 18 and older. NCHS Data Brief, no 325. Hyattsville, MD: National Center for Health Statistics. 2018.
  • Cramer H, Anheyer D, Lauche R, et al. A systematic review of yoga for major depressive disorder. Journal of Affective Disorders. 2017;213:70-77.
  • Cramer H, Krucoff C, Dobos G. Adverse events associated with yoga: a systematic review of published case reports and case series. PloS One. 2013;8(10):e75515.
  • Cramer H, Lauche R, Anheyer D, et al. Yoga for anxiety: a systematic review and meta-analysis of randomized controlled trials. Depression and Anxiety. 2018;35(9):830-843.
  • Cramer H, Lauche R, Klose P, et al. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database of Systematic Reviews. 2017;(1):CD010802. Accessed at www.cochranelibrary.com on June 7, 2018.
  • 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.
  • Cramer H, Ward L, Saper R, et al. The safety of yoga: a systematic review and meta-analysis of randomized controlled trials. American Journal of Epidemiology. 2015;182(4):281-293.
  • Domingues RB. Modern postural yoga as a mental health promoting tool: a systematic review. Complementary Therapies in Clinical Practice. 2018;31:248-255.
  • Li Y, Li S, Jiang J, et al. Effects of yoga on patients with chronic nonspecific neck pain. A PRISMA systematic review and meta-analysis. Medicine. 2019;98(8):e14649.
  • Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine. 2017;166(7):514-530.
  • Rioux JG, Ritenbaugh C. Narrative review of yoga intervention clinical trials including weight-related outcomes. Alternative Therapies in Health and Medicine. 2013;19(3):32-46.
  • Skelly AC, Chou R, Dettori JR, et al. Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review. Comparative Effectiveness Review no. 209. Rockville, MD: Agency for Healthcare Research and Quality; 2018. AHRQ publication no. 18-EHC013-EF.
  • Swain TA, McGwin G. Yoga-related injuries in the United States from 2001 to 2014. Orthopaedic Journal of Sports Medicine. 2016;4(11):2325967116671703.

Acknowledgments

NCCIH thanks Inna Belfer, M.D., Ph.D., and David Shurtleff, Ph.D., NCCIH, for their review of the 2018 update of this publication.

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.

Last Updated: May 2019
Source: https://www.nccih.nih.gov/health/yoga-what-you-need-to-know