Living with rheumatoid arthritis – could yoga help? (plain language summary)

In my other life, I work with pharmaceutical companies to better understand the experience of those living with chronic conditions (or as I like to call it, I help pharma be better) – given my immunology background, autoimmune conditions have been a particular focus.

You probably know at least one if not multiple people with autoimmune disease, whether that’s type 1 diabetes, Crohn’s disease or rheumatoid arthritis (also called RA). All of these are conditions where the immune system has gotten ‘confused’ about what is self and what is non-self, and starts attacking the body, for instance the pancreas (diabetes), the gut (Crohn’s disease) or the joints (RA). You may, yourself, be living with one of these conditions (especially if you are a woman, as we are more prone to developing them). You may have pursued lifestyle changes like diet and exercise to help you better manage your condition, either alone or in conjunction with medication. You may have noticed it helped, or not.

What about yoga then?

There is quite a bit of research on yoga as a support tool in autoimmune conditions (remember that yoga can help to balance the immune system, which is malfunctioning in autoimmune conditions, so it’s a reasonable hypothesis).

This particular study looked at whether yoga can help those living with RA in conjunction with their standard medication.

Spoiler: Yoga could be a good idea here

What did they do?

The researchers asked 33 study participants with RA to take part in a yoga intervention, which involved physical postures (asana), breathing work (pranayama), meditation (dyana), relaxation (savasana) and some group discussion and advice. This intervention lasted 2 hours, five times a week(!) for an eight-week period, during which time the participants continued taking their medication as normal. The other 33 study participants just took their medication and acted as the control comparison.

If you are a yoga teacher or a dedicated yogi, you may be interested to see the precise make-up of this yoga intervention – hilariously (or embarrassingly?) I had to look up quite a few of the poses (eg did you know that child’s pose with the arms in front is called shashankasana? No, me neither!).

Come on, tell us the results already!

Overall, 8 weeks of this (rather intense) yoga schedule led to improvements across all the metrics the researchers evaluated:

  • Inflammation went down: Yoga participants had significantly lower levels of molecules that drive inflammation (pro-inflammatory cytokines like IL-6), and also lower levels than those who did not take part in the yoga programme
  • Disease improved: Yoga participants showed reduced disease activity and generally reported feeling better physically, mentally and socially, both compared to before the programme started and compared with those who did not take part in the programme

What this means is that the yoga programme helped to dampen the inflammation that drives disease activity (likely by acting on the stress response), and as a result participants generally felt better across the board. BUT this doesn’t mean that medication is redundant – remember that all participants continued taking their medication as normal. Instead, think of yoga as a great complement to regular treatment.

The usual caveats apply

  • Although the study was designed to make sure that they could show if the results are statistically significant, I would still consider this fairly small and hard to generalise
  • The control group just took their medication – a way better control would have been to have them go to a group session or visit with a specialist, to account for human contact as a way to help improve inflammation and disease activity (presumably this would have been too expensive, and as we know there is no money in yoga research sadly)
  • The intervention was, let’s be fair, completely unrealistic in the real world. I would like to consider myself a fairly dedicated yogi with a full-time job, and I definitely do not practice for 2 hours five times a week. They really should have created a programme that would be sustainable in the long-run (eg 1 hour, three times a week)

Do you live with an autoimmune condition? Have you found that yoga helps? Please share your story!

As part of my ongoing research on the yoga–immune connection, I would love to hear your story on how yoga has helped (or not) in any condition that involved inflammation.

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