Yoga: What You Need To Know

• Stress management. 
  • A 2020 review of 12 recent studies (672 total participants) of a variety of types of yoga for stress management in healthy adults found beneficial effects of yoga on measures of perceived stress in all the studies.
  • Of 17 older studies (1,070 total participants) of yoga for stress management included in a 2014 review, 12 studies 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, most 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 eating healthier. In addition, the yoga community itself was characterized as a social circle that encouraged connection, where healthy eating was commonplace.
• Sleep. Yoga has been shown to be helpful for sleep in several studies of cancer patients, women with sleep problems, and older adults and in individual studies of other population groups, including people with arthritis and women with menopause symptoms.
• Balance. In a 2014 review, 11 of 15 studies (688 total participants) that looked at the effect of yoga on balance in healthy people showed improvements in at least one outcome related to balance. An additional study, published in 2016, showed that both yoga and stretching-strengthening exercises were effective in improving balance (as well as strength and flexibility) in healthy, previously sedentary older adults.

• Low-back pain.
  • A 2020 report by the Agency for Healthcare Research and Quality evaluated 10 studies of yoga for low-back pain (involving 1,520 total participants) and found that yoga improved pain and function in both the short term (1 to 6 months) and intermediate term (6 to 12 months). The effects of yoga were similar to those of exercise.
  • The American College of Physicians recommends using nondrug methods for the initial treatment of chronic low-back pain. Yoga is one of several suggested nondrug approaches.
• Neck pain. A 2019 review of 10 studies (686 total participants) found that practicing yoga reduced both the intensity of neck pain and disability related to neck pain and improved range of motion in the neck.
• Headaches. A 2020 review of 6 studies (240 participants) of yoga for chronic or episodic headaches (tension-type headache or migraine) found evidence of reductions in headache frequency, headache duration, and pain intensity, with effects seen mostly in patients with tension-type headache rather than migraine. Because of the small numbers of studies and participants, as well as limitations in the quality of the studies, these results should be considered preliminary.
• Knee osteoarthritis.
  • A 2019 review of 9 studies (640 total participants) showed that yoga may be helpful for improving pain, function, and stiffness in people with osteoarthritis of the knee. However, the number of studies was small, and the research was not of high quality.
  • A 2019 guideline from the American College of Rheumatology and the Arthritis Foundation conditionally recommended yoga for patients with knee osteoarthritis based on similarities to tai chi, which has been better studied and is strongly recommended by the same guideline.

In 2013, a review supported by the National Center for Complementary and Integrative Health (NCCIH) 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 individuals who were overweight or obese and found that practicing yoga was associated with reduced body mass index (BMI; a measure of body fat based on height and weight).

• A 2019 NCCIH-funded study with 227 participants compared yoga classes with general wellness classes as additions to a conventional once-weekly counseling program. The people in the yoga group were 37 percent more likely to have quit smoking by the end of the 8-week program. However, 6 months after treatment, there was no difference between the groups in the proportion of people who were still not smoking.
• A study published in 2020 showed a reduction in cigarette cravings after a single yoga session, as compared with a wellness education session. The study participants were people who were trying to cut back or stop smoking.

• In a 2013 review of 22 studies (involving 1,728 participants) of yoga for anxiety associated with life situations, yoga seemed to be helpful in some instances but not others. In general, results were more favorable for interventions that included at least 10 yoga sessions. The studies were of medium-to-poor quality, so definite conclusions about yoga’s effectiveness couldn’t be reached.
• In a review of 23 studies (involving 1,272 participants) of people with depressive symptoms (although not necessarily diagnosed with depression), yoga was helpful in reducing symptoms in 14 of the studies.
• A 2018 review of 18 studies (1,532 participants) of people who had been diagnosed with an anxiety disorder or depression found that hatha yoga was not more effective in relieving symptoms than treatment as usual or most of the other interventions examined in the studies. However, it was more effective than psychoeducation programs at relieving symptoms of depression. Most of the studies included in the review were not of high quality.
• A 2018 evaluation of 7 studies (284 participants) of yoga for people with post-traumatic stress disorder (PTSD) found only low-quality evidence of a possible benefit.
• A 2021 study of Kundalini yoga for generalized anxiety disorder (226 participants, 155 of whom completed the study), supported by NCCIH, found that Kundalini yoga improved symptoms but was less helpful than cognitive behavioral therapy, an established first-line treatment for this condition.

• 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 women who have or have had breast cancer. A 2017 review of 24 studies of 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.
• 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.
• HIV/AIDS. A 2019 review of 7 studies (396 participants) of yoga interventions for people with HIV/AIDS found that yoga was a promising intervention for stress management.
• 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.
• Multiple sclerosis. Two recent reviews on yoga for people with multiple sclerosis had mostly negative results. One review found a significant benefit only for fatigue (comparable to the effect of other types of exercise), and the other found no benefits for any aspect of quality of life.

• Being physically active is safe and beneficial for most pregnant women. However, some precautions need to be taken.
  • If you’re pregnant, you should be evaluated by your health care provider to make sure there’s no medical reason why you shouldn’t exercise.
  • You may need to modify some activities, including yoga. For example, you shouldn’t exercise in a hot environment (as you would in a “hot yoga” class), especially during the first trimester. You also need to avoid activities (including yoga poses) that involve long periods of lying on your back. Talk with your health care provider about how to adjust your physical activity during pregnancy.
• A 2020 review of 5 recent studies (311 total participants) found evidence that yoga may have benefits for pregnant women, including reductions in stress, anxiety, and depression, as well as pain during labor. A 2012 review of earlier research had similar findings.

• A 2016 report from the American Academy of Pediatrics concluded that yoga appears to be promising as a stress management tool for children and adolescents, with very low reports of adverse effects. It also said that yoga may have positive effects on psychological functioning in children coping with emotional, mental, and behavioral health problems. The report noted, however, that studies of yoga for children have had limitations, such as small sample sizes and high dropout rates.
• A 2020 review of 27 studies (1,805 total participants) of yoga interventions in children or adolescents found reductions in anxiety or depression in 70 percent of the studies, with more promising results for anxiety. Some of the studies involved children who had or were at risk for mental health disorders, some involved children with physical illnesses, and others involved groups of children in schools. The quality of the studies was relatively weak, and the results cannot be considered conclusive.
• A 2021 review evaluated 9 studies (289 total participants) of yoga interventions for weight loss in children or adolescents who were obese or overweight. Some of the studies evaluated yoga alone; others evaluated yoga in combination with other interventions such as changes in diet. The majority of the yoga interventions had beneficial effects on weight loss and related behavior changes. The studies were small, and some did not use the most rigorous study designs.
• A 2016 review looked at 47 studies that evaluated school-based yoga programs. The evidence indicated that implementing yoga in school settings is feasible. However, most of the studies were preliminary, so definite conclusions could not be reached about whether the programs were beneficial.

• Differences related to age. In one survey, people age 40 to 54 were more likely to be motivated to practice yoga to increase muscle strength or lose weight, while those age 55 or older were more likely to be motivated by age-related chronic health issues. People age 65 and older may be more likely to need treatment for yoga-related injuries.
• Differences related to education. National survey data indicate that, both in the general population and among people with low-back pain, respondents who did not graduate from high school were more likely than those who had a high school diploma or had attended college to report “lack of knowledge” as a reason for not practicing yoga.
• Differences related to sex. A study found evidence for differences between men and women in the effects of specific yoga poses on muscles. A study in veterans found preliminary evidence that women might benefit more than men from yoga interventions for chronic back pain.
• Differences related to ethnicity. U.S. national survey data show lower participation in yoga among Hispanic adults, compared to non-Hispanic White adults (8.0 percent vs. 17.1 percent of adults in 2017). A small 2021 survey of U.S. Hispanic adults with low incomes showed that cost was the most common barrier to participation in yoga. Other perceived barriers included concern about the need for physical flexibility (especially among men and those with no prior experience with yoga), thinking that they would feel like outsiders in a yoga class (among those with no prior experience), and considering yoga boring (among young adults).