Yoga and pain
Learn how yoga can assist in musculoskeletal pain management and how you may wish to start yoga to form part of your co-management plan
Yoga is a vast system of practices and philosophy that originate in India. The most common and well-known form of yoga is Hatha Yoga, which involves physical postures, specific breathing techniques, and relaxation exercises. Yoga is an increasingly popular form of exercise and self-care that is accessed through yoga studios, gyms, hospitals, community centres, schools and at home through online yoga classes.
Yoga and pain
Yoga can be helpful in pain management with both physical and mental benefits, but yoga is not a quick fix solution. Yoga has many of the same benefits as mindfulness practice, due to the common focus on breath, body and present moment awareness. Because yoga is also a physical practice many people find yoga more accessible than traditional meditation practices, which are undertaken in stillness.
Yoga is particularly helpful in promoting relaxation when encountering stress and agitation. Yoga traditionally serves as a ‘warm up’ of sorts for formal sitting and lying mindfulness meditation practice. Yoga can also invigorate the body to help counter depression.
Yoga is very helpful in treating some of the mechanical aspects of pain, for example when there are tight muscles which contribute to pain. However, practised incorrectly or without proper supervision yoga can also exacerbate your pain in the short term, despite the fact that research shows yoga is as safe as usual care and exercise1,2. Coming up with a helpful yoga routine requires greater care and experience when you have a persistent pain condition, especially when your nervous system is sensitized and you are prone to flare-ups.
When starting yoga it is important to start slowly and it must be practiced regularly and with awareness to be effective. Watch the video below that highlights the “do’s and don’ts” for people thinking about practicing yoga developed by the National Center for Complementary and Alternate Medicine.
What is the evidence for yoga when you have pain?
Reviews of the last 20 years of clinical trials suggest that yoga can significantly improve pain, disability and mood in people with persistent pain3,4. The effect sizes of these improvements can be considered ‘moderate’4: this means roughly equivalent to Cognitive Behaviour Therapy (CBT). Yoga is one of the therapies recommended by the American Pain Society for people with low back pain who do not improve with other self-care strategies5.
Most evidence is for the benefits of yoga in people with chronic back pain, although it can also help arthritis, headache/migraine, irritable bowel syndrome, fibromyalgia, and carpal tunnel syndrome4.
We still need more high quality studies to figure out for which pain conditions yoga is most effective, as well as what types of yoga are best suited to people in pain. So far, there is most evidence for Iyengar Yoga, Hatha Yoga and Viniyoga.
We don’t yet fully understand how yoga helps people with pain. Emerging evidence suggests that it might help us more effectively control how we think and feel, both mentally and physically. It might also work by improving muscle flexibility, promoting relaxation, reducing inflammation, increasing the release of pain relieving endorphins, improving confidence and sense of our self control and confidence.
How to choose a Yoga teacher and class?
Yoga is currently an unregulated industry. Unlike health professions, such as medicine, physiotherapy or psychology, anyone can call themselves a yoga teacher.
However, many yoga teachers are represented by Yoga Australia, a volunteer association that sets minimum standards for Yoga Teacher Training and ongoing professional development. A good place to start looking for a suitably qualified yoga teacher is the Yoga Australia website.
Given the complexity of many pain conditions pain, choosing a Level 2 (500 hours of training/5years of teaching experience) or Level 3 (10 years of training and 10 years of teaching) yoga teacher would be a good place to start.
Most experienced yoga teachers may be able to recommend a class for you and some specifically run Yoga Therapy or Restorative Yoga classes which cater to those with injuries, chronic pain, or chronic illness.
You will get the best individual advice on tailoring yoga to your pain condition by finding a yoga teacher who has studied to become a Yoga Therapist and is registered with either the International Association of Yoga Therapists or the Australasian Association of Yoga Therapists.
Can anyone do yoga?
Yes, yoga is suitable for everyone, however you just need to speak to the teacher before attendance. There are many different styles of yoga and not all classes will be suitable for you at this point in your life. If you have more specific needs then start with a private class, ideally with a Yoga Therapist.
Can I do yoga at home?
Initially it is not recommended that you commence yoga practice at home without the supervision of a yoga teacher. If you find it difficult to get to a class, many yoga teachers are able to conduct a private class in the comfort of your home or you may be able to access yoga through a community centre or hospital.
Once you have become more experienced with yoga, your teacher will be able to offer suggestions as to what practices are suitable for you at home.
Do I need to tell my health care professional I am doing yoga?
Yes! It is essential that you advise your health care professional before you commence yoga classes.
You may even wish to ask your health professional to communicate with your yoga teacher/therapist the specifics of your condition.
For more information about Yoga and pain management or to find registered yoga teachers and therapists, visit Yoga Australia., the International Association of Yoga Therapists or the Australasian Association of Yoga Therapists. Alternatively, if you need to speak to your GP or health care professional, please seek further assistance.
Cancer Council - Yoga information sheet
Better Health Channel - Yoga health benefits
Kelly McGonigal - Talks Yoga at Google
- Cramer H, Lauche R, Haller H, Dobos G. A systematic review and meta-analysis of yoga for low back pain. The Clinical journal of pain 2013; 29(5): 450-60. [PubMed]
- Cramer H, Ward L, Saper R, Fishbein D, Dobos G, Lauche R. The Safety of Yoga: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Am J Epidemiol 2015; 182(4): 281-93. [PubMed]
- Wren AA, Wright MA, Carson JW, Keefe FJ. Yoga for persistent pain: new findings and directions for an ancient practice. Pain 2011; 152(3): 477-80. [PubMed]
- Bussing A, Ostermann T, Ludtke R, Michalsen A. Effects of yoga interventions on pain and pain-associated disability: a meta-analysis. The journal of pain : official journal of the American Pain Society 2012; 13(1): 1-9. [PubMed]
- Eccleston C, Williams AC, Morley S. Psychological therapies for the management of chronic pain (excluding headache) in adults. The Cochrane database of systematic reviews 2009; (2): CD007407. [PubMed]
This module has been developed by Jean Byrne, BA, GradDipEd, DipChildbirthEd, BA(Hons), PhD and Rob Schütze, BA, BJourn, BSc(Psych)Hons, MPsych(Clinical) The information in this module is based on current best evidence research and clinical practice.