Yoga for Rheumatoid Arthritis: Recommendations for Practice

By: 
Baxter Bell, MD

Most of us associate arthritis with aging. While osteoarthritis and menopausal arthritis both tend to appear as we age, rheumatoid arthritis can affect anyone of any age. This post will help clarify our understanding of rheumatoid arthritis and will provide background on the scientific research on yoga and rheumatoid arthritis. We’ll also discuss ways to accommodate rheumatoid arthritis flare-ups in your yoga practice.

What is Rheumatoid Arthritis? 

Rheumatoid arthritis is an autoimmune condition in which your body mistakes the lining of your joints (the synovial membrane) as a foreign invader and attacks it as it would a virus or bacteria. This attack creates inflammation inside the joint spaces which, over time, ultimately destroys the synovial lining, then the underlying cartilage, and finally the bone, resulting in breakdown and deformity of the joints.

This destructive process also affects the structures around the joints, weakening the joint capsules, ligaments, muscles, and tendons, which further contributes to poor function, instability, stiffness, and pain. Rheumatoid arthritis usually starts by affecting joints in the hands and feet but, over time, can involve all the major joints of the arms and legs. It accounts for about 10 percent of all arthritis cases.

Although it is still not clear what triggers the autoimmune response, it is believed genetics plays a role, and it may be that environmental factors (such as exposure to asbestos) and infections can also act as triggers. You are at higher risk of developing rheumatoid arthritis if you have a first-degree relative with it, if you are a woman, a smoker, or are overweight. 

Unlike osteoarthritis, which becomes progressively more common with age, this condition usually arises between the ages of 40-60. About 40 percent of those with rheumatoid arthritis will also experience negative effects to other body systems, such as the heart, lungs, eyes, and skin (psoriasis). 

The course of the condition is variable, with periods of flaring of symptoms alternating with periods of relative remission. The most common symptoms include joint swelling and tenderness over the joints, stiffness around affected joints, and during flares fatigue, weight loss, and possibly fever.

Western treatment aims at reducing the inflammation if possible, with powerful medications (such as steroids, anti-cancer medications such as methotrexate, and even gold!), and treating symptoms of pain, stiffness, and fatigue with a variety of other medications as well. Physical therapy to maintain joint range of motion and to keep the muscles strong is also often prescribed.  

Research on Yoga for Rheumatoid Arthritis 

There has been a decent amount of research on yoga and rheumatoid arthritis, with 21 studies cited in the recent text Principles and Practice of Yoga in Health Care by Khalsa, et al.

From their review of those studies, the authors of this book recommend that yoga be considered as an adjunct to Western treatments (as opposed to a primary form of treatment), and noted that it was beneficial in improving physical function and activity, addressing quality of life issues, symptom relief, and sleep quality (pg. 169).
 

Yoga for Rheumatoid Arthritis 

Recommendations for yoga practice for both osteoarthritis and rheumatoid arthritis include practicing both active and gentle asana sequences to build and maintain strength and flexibility, as well as using stress management tools and equanimity practices to help with pain and stress. 

However, when a yoga practitioner with rheumatoid arthritis has a flare, a regular active asana class or practice could worsen symptoms. So, for those times, you should temporarily replace your active asana practice with gentle and restorative practices. Avoid bearing weight on the affected joints. For pain and stress, shift toward calming breathing practices, such as lengthening the exhalation and alternate nostril breath. Once the flare has calmed, gradually return to a more active physical practice. 

Do you need some relief from arthritis-related pain or stiffness?  Read this article from Dr. Baxter Bell and YogaUOnline - Arthritis of the Hip Joint: Three Yoga Poses that Can Help. 

Need more tips for healthy aging? Study with Baxter Bell, MD, and YogaUOnline - Yoga for Healthy Aging: Yoga Tools to Help Keep Your Blood Pressure Balanced. 

This article originally appeared on Yoga for Healthy Aging. Reprinted with permission.

 

Baxter BellBaxter Bell, MD, is a yoga teacher and educator, physician and medical acupuncturist. These days he focuses on teaching yoga full-time, both to ordinary students of all ages and physical conditions and to the next generation of yoga teachers, to whom he teaches anatomy and yoga therapy along with his accessible, skillful style of yoga. Baxter brings a unique perspective to his teaching, combining his understanding of anatomy and medicine with his skill at instructing people from all walks of life and all levels of ability. Baxter is the co-founder and writer for the popular Yoga for Healthy Aging blog, where he shares his knowledge of medical conditions, anatomy, and yoga with practitioners and teachers across the world. In addition to being a frequent presenter at Yoga Journal Alive events and yoga conferences such as IAYT’s SYTAR, he is often quoted as an expert on yoga and health by major national news outlets such as The Washington Post and Wall Street Journal. To learn more, visit www.baxterbell.com, www.yogaforhealthyaging.blogspot.com, and his YouTube channel Baxter Bell Yoga.