Arthritis Tara Lee by KarenYeomans.com


About

Yoga can ease movement, improve posture, and align bones. A regular practice can create space and ease pain in damaged joints, and help to prevent the cartilage erosion that causes the pain of arthritis.

It can also be a good way to build muscle strength (for example hand grip) because, practised correctly, it doesn’t put too much pressure on the joints – provided you don’t overdo it when joints are flaring.

Yoga, meditation, mindfulness, and pranayama (breathing techniques), can also help you mentally deal with the pain and improve your sense of wellbeing – helping to reduce the stress and tension caused by the discomfort and pain of arthritis. This, in turn, can promote better sleep and relaxation,helping to improve all-round physical health, wellbeing and vitality.


What the clinical studies say

Yoga
  • Alleviates depression
  • Decreased HAQ disability index
  • Decreases perception of depression
  • Decreases perception of pain
  • Improved balance
  • Improvements in Rheumatoid Arthritis disease parameters
  • Improves handgrip strength
  • Improves mental health
  • Improves RA symptoms and functioning
  • Increases vitality
  • Reduces disability scores for rheumatoid factor levels
Meditation
  • Alleviates depression
  • Enhances emotional regulation
  • Improves wellbeing
  • Reduction in psychological distress
Mindfulness
  • Alleviates depression
  • Enhances emotional regulation
  • Improves wellbeing
  • Reduces psychological distress

The clinical studies

Effect of Mindfulness-Based stress reduction in rheumatoid arthritis patients
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Objective:

To assess the effect of a meditation training program, Mindfulness-Based Stress Reduction (MBSR), on depressive symptoms, psychological status, and disease activity in patients with rheumatoid arthritis (RA) through a randomized, waitlist-controlled pilot study.

Methods:

Participants were randomized to either an MBSR group, where they attended an 8-week course and 4-month maintenance program, or to a waitlist control group, where they attended all assessment visits and received MBSR free of charge after study end. Participants received usual care from their rheumatologists throughout the trial. Self-report questionnaires were used to evaluate depressive symptoms, psychological distress, well-being, and mindfulness. Evaluation of RA disease activity (by Disease Activity Score in 28 joints) included examination by a physician masked to treatment status. Adjusted means and mean changes in outcomes were estimated in mixed model repeated measures analyses.

Results:

Sixty-three participants were randomized: 31 to MBSR and 32 to control. At 2 months, there were no statistically significant differences between groups in any outcomes. At 6 months, there was significant improvement in psychological distress and well-being (P = 0.04 and P = 0.03, respectively), and marginally significant improvement in depressive symptoms and mindfulness (P = 0.08 and P = 0.09, respectively). There was a 35% reduction in psychological distress among those treated. The intervention had no impact on RA disease activity.

Conclusion:

An 8-week MBSR class was not associated with change in depressive symptoms or other outcomes at 2-month follow up. Significant improvements in psychological distress and well-being were observed following MBSR plus a 4-month program of continued reinforcement. Mindfulness meditation may complement medical disease management by improving psychological distress and strengthening well-being in patients with RA.
Citations

177
Authors

Elizabeth K. Pradhan | Mona Baumgarten | Patricia Langenberg | Barry Handwerger | Adele Kaplan Gilpin | Trish Magyari | Marc C Hochberg | Brian M/ Berman
Published

2007
Journal

Arthritis Care & Research
Volume / Issue

57:7
Author's primary institution

The University of Maryland School of Medicine, Baltimore
Comparison of cognitive behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression.
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

This research examined whether cognitive behavioral therapy and mindfulness interventions that target responses to chronic stress, pain, and depression reduce pain and improve the quality of everyday life for adults with rheumatoid arthritis (RA).

The 144 RA participants were clustered into groups of 6-10 participants and randomly assigned to 1 of 3 treatments: cognitive behavioral therapy for pain (P); mindfulness meditation and emotion regulation therapy (M); or education-only group (E), which served as an attention placebo control. The authors took a multimethod approach, employing daily diaries and laboratory assessment of pain and mitogen-stimulated levels of interleukin-6 (IL-6), a proinflammatory cytokine.

Participants receiving P showed the greatest Pre to Post improvement in self-reported pain control and reductions in the IL-6; both P and M groups showed more improvement in coping efficacy than did the E group.

The relative value of the treatments varied as a function of depression history. RA patients with recurrent depression benefited most from M across several measures, including negative and positive affect and physicians' ratings of joint tenderness, indicating that the emotion regulation aspects of that treatment were most beneficial to those with chronic depressive features. 
Citations

200
Authors

Alex J Zautra | Mary C Davis | John W Reich | Perry Nicassario | Howard Tennen | Patrick Finan | Anna Kratz | Brendt Parrish | Michael R Irwin
Published

2008
Journal

Journal of Consulting and Clinical Psychology
Volume / Issue

76:
Author's primary institution

Department of Psychology, Arizona State University, Tempe, AZ 85287-1104, USA
Improvement in hand grip strength in normal volunteers and rheumatoid arthritis patients following yoga training
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

The present study aimed at assessing the effects of a set of yoga practices on normal adults (n=37), children (n=86), and patients with rheumatoid arthritis (n=20).

An equal number of normal adults, children, and patients with rheumatoid arthritis who did not practice yoga were studied under each category, forming respective control groups. Yoga and control group subjects were assessed at baseline and after varying intervals, as follows, adults after 30 days, children after 10 days and patients after 15 days, based on the duration of the yoga program, which they attended, which was already fixed.

Hand grip strength of both hands, measured with a grip dynamometer, increased in normal adults and children, and in rheumatoid arthritis patients, following yoga, but not in the corresponding control groups, showing no re-test effect. Adult female volunteers and patients showed a greater percentage improvement than corresponding adult males. This gender-based difference was not observed in children.

Hence yoga practice improves hand grip strength in normal persons and in patients with rheumatoid arthritis, though the magnitude of improvement varies with factors such as gender and age.
Citations

105
Authors

Manoj Dash and Shirley Telles
Published

2001
Journal

Indian Journal Physiol Parmacol
Volume / Issue

45:
Author's primary institution

Swami Vivekananda Yoga Research Foundation
The benefits of yoga for rheumatoid arthritis: results of a preliminary, structured 8-week program
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

The aim of this study was to measure the effects of a bi-weekly Raj yoga program on rheumatoid arthritis (RA) disease activity. Subjects were recruited from among RA patients in Dubai, United Arab Emirates by email invitations of the RA database.

Demographic data, disease activity indices, health assessment questionnaire (HAQ), and quality of life (QOL) by SF-36 were documented at enrollment and after completion of 12 sessions of Raj yoga. A total of 47 patients were enrolled: 26 yoga and 21 controls. Baseline demographics were similar in both groups. Patients who underwent yoga had statistically significant improvements in DAS28 and HAQ, but not QOL.

Our pilot study of 12 sessions of yoga for RA was able to demonstrate statistically significant improvements in RA disease parameters. We believe that a longer duration of treatment could result in more significant improvements.
Citations

49
Authors

Humeira Badsha | Vishwas Chhabra | Cathy Leibman | Ayman Mofti | Kok Ooi Kong
Published

2009
Journal

Rheumatology International
Volume / Issue

29:12
Author's primary institution

Dubai Bone and Joint Center, Dubai, United Arab Emirates
Functional and physiological effects of yoga in women with rheumatoid arthritis: a pilot study.
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

CONTEXT:

Stress, both psychological and physiological, has been implicated as having a role in the onset and exacerbations of rheumatoid arthritis (RA).

OBJECTIVE:

This study investigated whether neuroendocrine and physical function in women with RA can be altered through a yoga intervention.

DESIGN:

Exercise intervention.

SETTING:

University research conducted at a medical clinic.

PARTICIPANTS:

Sixteen independently living, postmenopausal women with an RA classification of I, II, or III according to the American College of Rheumatology functional classification system served as either participants or controls.

INTERVENTION:

The study group participated in three 75-minute yoga classes a week over a 10-week period.

MAIN OUTCOME MEASURES:

At baseline and on completion of the 10-week intervention, diurnal cortisol patterns and resting heart rate were measured. Balance was measured using the Berg Balance Test. Participants completed the Health Assessment Questionnaire (HIQ), a visual analog pain scale, and the Beck Depression Inventory.

RESULTS:

Yoga resulted in a significantly decreased HAQ disability index, decreased perception of pain and depression, and improved balance. Yoga did not result in a significant change in awakening or diurnal cortisol patterns (P =.12).
Citations

47
Authors

Bosch PR | Traustadottir T | Howard P | Matt KS
Published

2009
Journal

Alternative Therapies in Health and Medicine
Volume / Issue

15:24-31
Author's primary institution

Department of Physical Therapy, A.T. Still University, USA
Iyengar yoga for young adults with rheumatoid arthritis: results from a mixed-methods pilot study
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Context:

Rheumatoid arthritis (RA) is a chronic disease that often impacts patient's quality of life. For young people with RA, there is a need for rehabilitative approaches that have been shown to be safe and to lead to improved functioning. Objectives: This pilot study investigated the feasibility of a single-arm, group-administered, six-week, biweekly Iyengar yoga (IY) program for eight young adults with RA.

Methods:

IY is known for its use of props, therapeutic sequences designed for patient populations, emphasis on alignment, and a rigorous teacher training. Treatment outcomes were evaluated using a mixed-methods approach that combined quantitative results from standardized questionnaires and qualitative interviews with participants.

Results:

Initial attrition was 37% (n = 3) after the first week because of scheduling conflicts and a prior non-RA related injury. However, the remaining participants (n = 5) completed between 75% and 100% of treatment sessions (mean = 95%). No adverse events were reported. The quantitative results indicated significant improvements in pain, pain disability, depression, mental health, vitality, and self-efficacy. Interviews demonstrated improvement in RA symptoms and functioning but uncertainty about whether the intervention affected pain.

Conclusion:

These preliminary findings indicate that IY is a feasible complementary approach for young people with RA, although larger clinical trials are needed to demonstrate safety and efficacy.
Citations

32
Authors

Subhadra Evans | Mona Moieni | Rebecca Taub | Saskia K. Subramanian | Jenni C.I. Tsao | Beth Sternlieb | Lonnie K Zeltzer
Published

2009
Journal

Journal of Pain and Sympton Management
Volume / Issue

39:5
Author's primary institution

David Geffen School of Medicine, University of California, Los Angeles, USA
Effect of one week of yoga on function and severity in rheumatoid arthritis
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Background:

Previous studies have shown that yoga practice improved the hand grip strength in patients with rheumatoid arthritis (RA).

Findings:

Sixty-four participants with RA (group average age ± S.D., 46.5 ± 9.6 years; 47 females) were assessed at the beginning and end of a one week yoga program. The Stanford Health Assessment Questionnaire (HAQ), hand grip strength, rheumatoid factor, and C-reactive protein levels were assessed on the first and last day and compared using a t-test for paired data. All participants showed reduced disability scores of the HAQ and rheumatoid factor levels, with an increase in bilateral hand grip strength in male participants alone.

Conclusions:

This single group study indicated that a brief intensive yoga program was beneficial in RA, with decreased disability, better functionality and changes in the rheumatoid factor levels suggesting improvement.
Citations

17
Authors

Shirley Telles | Kalkuni V Naveen | Vaishali Gaur | Acharya Balkrishna
Published

2011
Journal

BMC Research Notes 2011
Volume / Issue

4:118
Author's primary institution

Patanjali Research Foundation, Patanjali Yogpeeth, Haridwar, India
The Suitability of Yoga as a Potential Therapeutic Intervention for Rheumatoid Arthritis: A Focus Group approach
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Objectives:

The aim of this study was to explore the views of patients with rheumatoid arthritis (RA) regarding the suitability of yoga as a potential therapeutic intervention in the management of RA.

Methods:

Twenty-two participants with RA were recruited from outpatient clinics at a regional hospital in New Zealand and divided into four focus groups. Heterogeneity between groups in terms of age, gender, duration of RA and functional ability provided opinions from a cross-section of RA patients. Transcripts were analysed using thematic analysis, with four themes predominating.

Result:

Firstly, participants described their experience of symptoms related to their RA in three independent but linked categories of physical, mental and social well-being. Secondly, participants perceived the management of their RA to be prescriptive, medicalized and failing to address their wider health concerns. Thirdly, participants perceived yoga as a safe, adaptable therapy that may allow self-management of their RA. However, there was some concern that functional limitations may inhibit ability to practise the physical aspects of yoga. Fourthly, requirements for a yoga intervention that would be feasible for people with RA were presented by participants.

Conclusions:

Patients with RA perceive a disparity between their personal experience of living with RA and their current medical management. Yoga is perceived as a potential therapy to address this disparity. Based on opinions expressed by participants, future research regarding a yoga intervention as an adjunctive therapy for managing RA should meet patients’ views on feasibility and test outcome measures reflecting the domains of physical, mental and social well-being.
Citations

5
Authors

Lesley Ward | Gareth J Treharne | Simon Stebbings
Published

2011
Journal

Muskoskeletal Care
Volume / Issue

9:4
Author's primary institution

School of Physiotherapy, Department of Psychology, University of Otago
Effects of yoga interventions on pain and pain-associated disability: a meta-analysis
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

We searched databases for controlled clinical studies, and performed a meta-analysis on the effectiveness of yoga interventions on pain and associated disability.
Five randomized studies reported single-blinding and had a higher methodological quality; 7 studies were randomized but not blinded and had moderate quality; and 4 nonrandomized studies had low quality. In 6 studies, yoga was used to treat patients with back pain; in 2 studies to treat rheumatoid arthritis; in 2 studies to treat patients with headache/migraine; and 6 studies enrolled individuals for other indications.

All studies reported positive effects in favor of the yoga interventions. With respect to pain, a random effect meta-analysis estimated the overall treatment effect at SMD = −.74 (CI: −.97; −.52, P < .0001), and an overall treatment effect at SMD = −.79 (CI: −1.02; −.56, P < .0001) for pain-related disability.

Despite some limitations, there is evidence that yoga may be useful for several pain-associated disorders.

Moreover, there are hints that even short-term interventions might be effective. Nevertheless, large-scale further studies have to identify which patients may benefit from the respective interventions.
Citations

91
Authors

Arndt Büssing
Published

2011
Journal

The Journal of pain
Volume / Issue

13 : 1
Author's primary institution

Center for Integrative Medicine, Faculty of Medicine, University of Witten/Herdecke, Herdecke, Germany
Yoga for rheumatic diseases: a systematic review
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Objective

To evaluate the quality of evidence and the strength of recommendation for yoga as an ancillary intervention in rheumatic diseases.

Methods

Medline/PubMed, Scopus, the Cochrane Library and IndMED were searched through February 2013. Randomized controlled trials (RCTs) comparing yoga with control interventions in patients with rheumatic diseases were included. Two authors independently assessed the risk of bias using the Cochrane Back Review Group risk of bias tool. The quality of evidence and the strength of the recommendation for or against yoga were graded according to the GRADE recommendations.

Results

Eight RCTs with a total of 559 subjects were included; two RCTs had a low risk of bias. In two RCTs on FM syndrome, there was very low evidence for effects on pain and low evidence for effects on disability. In three RCTs on OA, there was very low evidence for effects on pain and disability. Based on two RCTs, very low evidence was found for effects on pain in RA. No evidence for effects on pain was found in one RCT on CTS. No RCT explicitly reported safety data.

Conclusion

Based on the results of this review, only weak recommendations can be made for the ancillary use of yoga in the management of FM syndrome, OA and RA at this point.
Citations

14
Authors

Holger Cramer PHD, Romy Lauche, Jost Langhorst, Gustav Dobos
Published

2013
Journal

Rheumatology
Volume / Issue

52 : 11
Author's primary institution

Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
Yoga as an alternative and complementary approach for arthritis: a systematic review
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

In the United States, approximately 21% of the adults suffer from arthritis. Yoga offers one possible way of managing arthritis. The purpose of this study was to look at studies from 2010 to June 2013 and examine whether yoga can be an efficacious approach for managing arthritis.

A systematic search from Medline, Cumulative Index to Nursing and Allied Health, and Alt HealthWatch databases was conducted for quantitative articles involving all schools of yoga. A total of 9 articles met the inclusion criteria. Five of these were from the United States and 4 from India. Of the 9 studies, 6 demonstrated positive changes in psychological or physiological outcomes related to arthritis.

Despite the limitations not all studies using randomized controlled design, having smaller sample sizes, having different outcomes, having nonstandardized yoga intervention, not using behavioral theory, and having varying lengths, yoga appears to be a promising modality for arthritis.
Citations

1
Authors

Manoj Sharma
Published

2013
Journal

Journal of Evidence-Based Complementary & Alternative Medicine
Volume / Issue

19 : 1
Author's primary institution

University of Cincinnati, Ohio, USA
Yoga for functional ability, pain and psychosocial outcomes in musculoskeletal conditions: a systematic review and meta-analysis
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Objectives

Musculoskeletal conditions (MSCs) are the leading cause of disability and chronic pain in the developed world, impacting both functional ability and psychosocial health. The current review investigates the effectiveness of yoga on primary outcomes of functional ability, pain and psychosocial outcomes across a range of MSCs.

Methods

A comprehensive search of 20 databases was conducted for full-text, randomized controlled trials of yoga in clinically diagnosed MSCs.

Result

Seventeen studies met the inclusion criteria, involving 1,626 participants with low back pain (LBP), osteoarthritis (OA), rheumatoid arthritis (RA), kyphosis or fibromyalgia. Studies were quality rated, and analysed for the effect of yoga on primary outcomes, immediately post-intervention. Twelve studies were rated as good quality. Yoga interventions resulted in a clinically significant improvement in functional outcomes in mild-to-moderate LBP and fibromyalgia, and showed a trend to improvement in kyphosis. Yoga significantly improved pain in OA, RA and mild-to-severe LBP. Psychosocial outcomes were significantly improved in mild-to-moderate LBP and OA. Meta-analysis of good-quality studies showed a moderate treatment effect for yoga of −0.64 (95%CI −0.89 to −0.39) for functional outcomes and −0.61 (95%CI −0.97 to −0.26) for pain outcomes.

Conclusions

Evidence suggests that yoga is an acceptable and safe intervention, which may result in clinically relevant improvements in pain and functional outcomes associated with a range of MSCs. Future analysis of outcomes which take into account the amount of yoga received by participants may provide insight into any putative duration or dosage effects of yoga interventions for MSCs
Citations

22
Authors

Lesley Ward, Simon Stebbings, Daniel Gherkin, G David Baxter
Published

2013
Journal

Muskoskeletal Care
Volume / Issue

11 : 4
Author's primary institution

Centre for Physiotherapy Research
Effects of an integrated approach of hatha yoga therapy on functional disability, pain, and flexibility in osteoarthritis of the knee joint: a randomized controlled study
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Objectives:

The study objectives were to evaluate the efficacy of integrating hatha yoga therapy with therapeutic exercises for osteoarthritis (OA) of the knee joints.

Design:

This was a prospective, randomized, active controlled trial. Two hundred and fifty (250) participants who had OA knees and who were between 35 and 80 years (yoga 59.56±9.54) and (control 59.42±10.66) from the outpatient department of Ebnezar Orthopedic Center, Bengaluru, were randomly assigned to receive hatha yoga therapy or therapeutic exercises after transcutaneous electrical stimulation and ultrasound treatment (20 minutes per day). Both of the groups practiced supervised interventions (40 minutes per day) for 3 months. One hundred and eighteen (118) (yoga) and 117 (control) subjects were available for the final analysis.

Results:

There were significant differences within (Wilcoxon's, p<0.001) and between the groups (Mann–Whitney U, p<0.001) on all the variables, with better improvements in the yoga than the control groups. Walking pain in the yoga (37.3%, 64.9%) and control (24.9%, 42%), knee disability in the yoga (59.7%, 83%) and control (32.7%, 53.6%), range of knee flexion in yoga (12.7%, 26.5% right, 13.5%, 28% left) and control (6.9%, 13.3% right, 5.6%, 11.5% left), joint tenderness in yoga (52.3%, 86.1%) and control (28%, 57.1%), swelling in yoga (55.4%, 85.9%) and control (32.1%, 60%), crepitus in yoga (44.0%, 79.9%) and control (27.0%, 47.8%) and walking time in yoga (26.6%, 52.8%) and control (9.3%, 21.6%), all improved more in the yoga than the control groups on the 15th and 90th day, respectively.

Conclusions:

An integrated approach of hatha yoga therapy is better than therapeutic exercises as an adjunct to transcutaneous electrical stimulation and ultrasound treatment in improving walking pain, range of knee flexion, walking time, tenderness, swelling, crepitus, and knee disability in patients with OA knees.
Citations

23
Authors

John Ebnezar, Raghuram Nagarathna, Bali Yogitha, Hongasandra Ramarao Nagendra
Published

2012
Journal

The Journal of Alternative and Complementary Medicine
Volume / Issue

18 : 5
Author's primary institution

Ebnezar Orthopedic Centre. Parimala Specialty Hospital, Bangalore, India
A pilot study of yoga as self-care for arthritis in minority communities
Practice
  • Yoga
  • Meditation
  • Mindfulness
Abstract

Background:

While arthritis is the most common cause of disability, non-Hispanic blacks and Hispanics experience worse arthritis impact despite having the same or lower prevalence of arthritis compared to non-Hispanic whites. People with arthritis who exercise regularly have less pain, more energy, and improved sleep, yet arthritis is one of the most common reasons for limiting physical activity. Mind-body interventions, such as yoga, that teach stress management along with physical activity may be well suited for investigation in both osteoarthritis and rheumatoid arthritis. Yoga users are predominantly white, female, and college educated. There are few studies that examine yoga in minority populations; none address arthritis. This paper presents a study protocol examining the feasibility and acceptability of providing yoga to an urban, minority population with arthritis.

Methods/design:

In this ongoing pilot study, a convenience sample of 20 minority adults diagnosed with either osteoarthritis or rheumatoid arthritis undergo an 8-week program of yoga classes. It is believed that by attending yoga classes designed for patients with arthritis, with racially concordant instructors; acceptability of yoga as an adjunct to standard arthritis treatment and self-care will be enhanced. Self-care is defined as adopting behaviors that improve physical and mental well-being. This concept is quantified through collecting patient-reported outcome measures related to spiritual growth, health responsibility, interpersonal relations, and stress management. Additional measures collected during this study include: physical function, anxiety/depression, fatigue, sleep disturbance, social roles, and pain; as well as baseline demographic and clinical data. Field notes, quantitative and qualitative data regarding feasibility and acceptability are also collected. Acceptability is determined by response/retention rates, positive qualitative data, and continuing yoga practice after three months.

Discussion:

There are a number of challenges in recruiting and retaining participants from a community clinic serving minority populations. Adopting behaviors that improve well-being and quality of life include those that integrate mental health (mind) and physical health (body). Few studies have examined offering integrative modalities to this population. This pilot was undertaken to quantify measures of feasibility and acceptability that will be useful when evaluating future plans for expanding the study of yoga in urban, minority populations with arthritis.
Citations

3
Authors

Kimberly R Middleton, Michael M Ward, Steffany Haaz, Sinthujah Velummylum, Alice Fike, Ana T Acevedo, Gladys Tataw-Ayuketah, Laura Dietz, Barbara B Mitleman, Gwenyth R Wallen
Published

2013
Journal

Health and Quality of Life Outcomes
Volume / Issue

11 : 55
Author's primary institution

National Institutes of Health, Clinical Center, Nursing Department, Bethesda, MD


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