Yoga as therapy is the use ofyoga as exercise, consisting mainly of postures calledasanas, as a gentle form ofexercise and relaxation applied specifically with the intention of improving health. This form ofyoga is widely practised in classes, and may involvemeditation, imagery,breath work (pranayama) and calmingmusic as well as postural yoga.[1]
At least three types of health claims have been made for yoga:magical claims for medievalhaṭha yoga, including the power of healing; unsupported claims of benefits toorgan systems from the practice of asanas; and more or less well supported claims of specific medical and psychological benefits from studies of differing sizes using a wide variety of methodologies.
Systematic reviews have found beneficial effects of yoga onlow back pain[2] anddepression,[3] but despite much investigation, little or no evidence of benefit for specific medical conditions.[3][4] The study oftrauma-sensitive yoga has been hampered by weak methodology.[5]
Yoga classes used as therapy usually consist ofasanas (postures used for stretching),pranayama (breathing exercises), and relaxation insavasana (lying down).[7] The physical asanas of modern yoga are related to medievalhaṭha yoga tradition, but they were not widely practiced in India before the early 20th century.[8]
The number ofschools and styles of yoga in the Western world has grown rapidly from the late 20th century. By 2012, there were at least 19 widespread styles fromAshtanga Vinyasa Yoga toViniyoga. These emphasise different aspects includingaerobic exercise, precision in the asanas, and spirituality in the haṭha yoga tradition.[6][9] These aspects can be illustrated by schools with distinctive styles.Bikram Yoga has an aerobic exercise style with rooms heated to 105 °F (41 °C) and a fixed sequence of 2 breathing exercises and 26 asanas performed in every session.Iyengar Yoga emphasises correct alignment in the postures, working slowly, if necessary with props, and ending with relaxation.Sivananda Yoga focuses more on spiritual practice, with 12 basic poses, chanting inSanskrit, pranayama breathing exercises,meditation, and relaxation in each class, and importance is placed on avegetarian diet.[6][9]
At least three different types of claims of therapeutic benefit have been made for yoga from medieval times onwards, not counting the more general claims of good health made throughout this period: magical powers, biomedical claims for marketing purposes, and specific medical claims. Neither of the first two are supported by reliable evidence. The medical claims are supported by evidence of varying quality, from case studies to controlled trials and ultimately systematic review of multiple trials.[10][11]
Medieval authors asserted thatHaṭha yoga brought physical (as well as spiritual) benefits, and provided magical powers, including of healing. TheHatha Yoga Pradipika (HYP) states that asanas in general, described as the first auxiliary of haṭha yoga, give "steadiness, good health, and lightness of limb." (HYP 1.17)[10] Specific asanas, it claims, bring additional benefits; for example,Matsyendrasana awakensKundalini and helps to preventsemen from being shed involuntarily; (HYP 1.27)Paschimottanasana "stokes up the digestive fire, slims the belly and gives good health"; (HYP 1.29)Shavasana "takes away fatigue and relaxes the mind"; (HYP 1.32) whilePadmasana "destroys all diseases" (HYP 1.47).[12] These claims lie within a tradition across all forms of yoga that practitioners can gainsupernatural powers.[13]Hemachandra'sYogashastra (1.8–9) lists the magical powers, which include healing and the destruction of poisons.[14]
Twentieth century advocates of some schools of yoga, such asB. K. S. Iyengar, have for various reasons made claims for the effects of yoga on specific organs, without citing any evidence.The yoga scholarSuzanne Newcombe argues that this was one of several visions of yoga as in some sense therapeutic, ranging from medical to a more popular offer of health and well-being.[15]The yoga scholarAndrea Jain describes these claims of Iyengar's in terms of "elaborating and fortifying his yoga brand"[16] and "mass-marketing",[16] calling Iyengar's 1966 bookLight on Yoga "arguably the most significant event in the process of elaborating the brand."[16] The yoga teacher Bernie Gourley notes that the book neither describescontraindications systematically, nor provides evidence for the claimed benefits.[17] Jain suggests that "Its biomedical dialect was attractive to many."[16] For example, in the book, Iyengar claims that the asanas of theEka Pada Sirsasana cycle[18]
...tone up the muscular, nervous and circulatory systems of the entire body. The spine receives a rich supply of blood, which increases the nervous energy in thechakras (the various nerve plexuses situated in the spine), theflywheels in the human body machine. These poses develop the chest and make the breathing fuller and the body firmer; they stop nervous trembling of the body and prevent the diseases which cause it; they also help to eliminate toxins by supplying pure blood to every part of the body and bringing the congested blood back to the heart and lungs for purification.[18]
The history of such claims was reviewed byWilliam J. Broad in his 2012 bookThe Science of Yoga. Broad argues that while the health claims for yoga began asHindu nationalist posturing, it turns out that there is ironically[11] "a wealth of real benefits".[11]
TheInternational Association of Yoga Therapists offers a definition of yoga therapy that can encompass a wide range of activities and practices, calling it "the process of empowering individuals to progress toward improved health and well-being through the application of the teachings and practices of Yoga".[19]
The history of remedial yoga goes back to the pioneers ofyoga as exercise,Krishnamacharya and Iyengar. Iyengar was sickly as a child, and yoga with his brother-in-law Krishnamacharya improved his health; it had also helped his daughterGeeta, so his response to his students' health issues, in Newcombe's view, "was an intense and personal one."[20] In effect Iyengar was treating "remedial yoga" as analogous toHenrik Ling's medical gymnastics.[20] As early as 1940, Iyengar was using yoga as a therapy for common conditions such as sinus problems, backache, and fatigue.[21] Iyengar was willing to push people through pain "to [show] them new possibilities."[22] In the 1960s, he trained a few people such as Diana Clifton andSilva Mehta to deliver this remedial yoga; particular asanas were used for different conditions, and non-remedial Iyengar Yoga teachers were taught to inform students that ordinary classes were not suitable for "serious health issues".[23] Mehta taught a remedial yoga class in the Iyengar Yoga Institute inMaida Vale from its opening in 1984.[24] She contributed "Remedial Programs" for conditions such asarthritis,backache,knee cartilage problems,pregnancy,sciatica,scoliosis andvaricose veins in the Mehtas' 1990 bookYoga the Iyengar Way.[25] However, Iyengar was deferential to Western medicine and its assessments, so in Newcombe's view Iyengar Yoga is "positioned as complementary to standard medical treatment rather than as an alternative".[26]
Newcombe argues that in Britain, yoga "largely avoided overt conflict with the medical profession by simultaneouslyprofessionalising with educational qualifications and deferring to medical expertise."[27] AfterRichard Hittleman'sYoga for Health series onITV from 1971 to 1974,[28] the series producer Howard Kent founded acharity, the Yoga for Health Foundation, for "Research into the therapeutic benefits to be obtained by the practice of yoga";[29] residential courses began in 1978 atIckwell Bury in Bedfordshire.[30] The Foundation stated that yoga was not a therapy or cure but had "therapeutic benefits", whether physical, mental, or emotional, and it worked especially with "the physically handicapped".[31] Newcombe notes that a third organisation, the Yoga Biomedical Trust, was founded inCambridge in 1983 by a biologist, Robin Monro, to research complementary therapies. He found it difficult to obtainresearch funding, and in the 1990s moved to London, focusing on training yoga teachers in yoga as therapy and providing yoga as individualised therapy, using pranayama, relaxation and asanas.[32]
From the point of view ofsports medicine, asanas function as active stretches, helping to protectmuscles frominjury; these need to be performed equally on both sides, the stronger side first if used forphysical rehabilitation.[33]
Much of the research on the therapeutic use of yoga has been in the form of preliminary studies orclinical trials of low methodological quality, including small sample sizes, inadequatecontrol and blinding, lack ofrandomization, and high risk ofbias.[34][4] Further research is needed to quantify the benefits and to clarify the mechanisms involved.[35]
For example, a 2010 literature review on the use of yoga fordepression stated, "although the results from these trials are encouraging, they should be viewed as very preliminary because the trials, as a group, suffered from substantial methodological limitations."[4] A 2015systematic review on the effect of yoga on mood and the brain recommended that future clinical trials should apply more methodological rigour.[3]
The practice of asanas has been claimed to improve flexibility, strength, and balance; to alleviate stress and anxiety, and to reduce the symptoms oflower back pain, without necessarily demonstrating the precise mechanisms involved.[37] A review of five studies noted that three psychological mechanisms (positive affect,mindfulness,self-compassion) and four biological mechanisms (posteriorhypothalamus,interleukin-6,C-reactive protein andcortisol) that might act on stress had been examined empirically, whereas many other potential mechanisms remain to be studied; four of the mechanisms (positive affect, self-compassion, inhibition of the posterior hypothalamus and salivary cortisol) were found to mediate yoga's effect onstress.[36]
Back pain is one reason people take up yoga, and since at least the 1960s some practitioners have claimed that it relieved their symptoms.[38]
Yoga results in clinically unimportant improvements in pain and back-specific function; improvements in back-specific function are similar to those obtained from other forms of therapeutic exercise, such as physical therapy.[39]
Yoga can form a useful component of treatment forPTSD, though its effect is no different from other forms of physical exercise.[40]
A 2012 survey of yoga in Australia notes that there is "good evidence"[41] that yoga and its associatedhealthy lifestyle—oftenvegetarian, usuallynon-smoking, preferringorganic food,drinking less or no alcohol–are beneficial forcardiovascular health, but that there was "little apparent uptake of yoga to address [existing] cardiovascular conditions and risk factors".[35] Yoga was cited by respondents as a cause of these lifestyle changes. The survey notes that the relative importance of the various factors had not been assessed.[35]
There is little reliable evidence that yoga is beneficial for specific medical conditions, and an increasing amount of evidence that it is not.[42][43][44][45][46] For instance it offers no benefit inADHD.[34]
| Condition | Study | Date | Findings |
|---|---|---|---|
| rheumatic diseases | Systematic review | 2013 | Weak support in terms of pain and disability, no evidence on safety[42] |
| epilepsy ormenopause-related symptoms | Systematic review | 2015 | No evidence of benefit[43][44] |
| Cancer | American Cancer Society's opinion | 2019 | Can improve strength and balance; is "unlikely to cause harm", does not "interfere with cancer treatment";[47] "cannot cure cancer";[45] may improvequality of life in cancer survivors, as in arandomised controlled trial of women who had hadbreast cancer. Measured outcomes included fatigue, depression, and sleep quality.[45][48] |
| Dementia | Systematic review | 2015 | "Promising" evidence that exercise helps withactivities of daily living; no evidence of benefit to cognition, neuropsychiatric symptoms, or depression; yoga was not distinguished from other forms of exercise.[46] |
| Attention deficit hyperactivity disorder | Systematic review | 2010 | No effect, measured by teacher rating on the ADHD overall scale.[34] |
| Female urinary incompetence | Systematic review | 2019 | Insufficient evidence[49] |
| Irritable bowel syndrome | Systematic reviews | 2024, 2025 | Weak studies[50][51] |
Although relatively safe, yoga is not a risk-free form of exercise. Sensible precautions can usefully be taken, such as avoiding advanced moves by beginners, not combining practice with psychoactive drug use, and avoiding competitiveness.[52]
A small percentage of yoga practitioners each year suffer physical injuries analogous tosports injuries.[53] The practice of yoga has been cited as a cause of hyperextension or rotation of the neck, which may be a precipitating factor incervical artery dissection.[54]
While not every branch or school of yoga includes meditation in its technical repertoire, most do.
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