Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes painful, swollen, and stiff joints as well as fatigue, fever, loss of appetite, and weight loss. RA can also affect the heart, lungs, blood, nerves, eyes, and skin. Read on to explore whether yoga can help treat RA.
A healthy immune system defends the body against disease and infection but if the immune system malfunctions, in the case of autoimmune diseases, it mistakenly attacks healthy cells, tissues, and organs. These attacks can affect any part of the body, weakening bodily function and even turning life-threatening.
The precise cause of RA remains largely unknown however both genetic and environmental factors have been shown to contribute to its development and the prevalence of the condition ranges from 0.4% to 1.3% of the population (Lin et al 2020).
RA affects at least twice as many women as men and although it can occur at any age, the peak incidence is at the age of 50 years. Additional risk factors include having a family history of RA, smoking, obesity, gum disease and certain lung diseases.
Rheumatoid Arthritis Risk Factors
The classic presentation of RA is a symmetrical polyarthritis involving hand and foot joints. Some people present with polyarthritis of very acute onset, but a gradual and insidious onset is more common. While until the 1990s RA frequently resulted in disability, inability to work, and increased mortality, newer treatment options have made RA a more manageable condition.
A local inflammatory response causes swelling of the joint lining (synovitis), damage to articular cartilage and supporting ligaments, and potentially bony erosions.
Systemically, inflammation results in: significant fatigue; muscle loss; fat gain; increased risk of osteoporosis; significantly exacerbated cardiovascular disease risk primarily due to accelerated atherosclerosis (Metsios et al 2008, Radner et al 2017).
Rheumatoid Arthritis Hands
Can yoga help?
A Systematic Review and Meta-Analysis (deemed to be the highest quality of scientific evidence) looked at the role yoga can play in the treatment of RA (Ye et al 2020). The review included ten trials including 840 patients with RA aged 30–70 years with 86% female participants.
Half of these studies did not specify the style of yoga used. Of those which specified the styles of yoga, two used Pranayama Yoga one used Hatha Yoga, one used Vishwas–Raj Yoga and one used Patanjali’s Raj Yoga. All of these styles essentially combined asana, pranayama and meditation. The yoga group will perform yoga intervention for at least 30 consecutive minutes each time with a frequency of 2–6 times a week. The length of the supervised training programs differed between 40 days and 12 weeks.
The findings of this meta-analysis indicate that yoga may be beneficial for improving physical function, disease activity, and grip strength in patients with RA. However, the balance of evidence showed that yoga had no significant effect in improving pain, tender joints, swollen joints count, and inflammatory cytokines in patients suffering from RA. The authors noted that high-quality and large-scale randomized control trials are urgently needed in the future, and the real result may be substantially different.
Senior Yoga
A major barrier to individuals with arthritis starting an exercise program (including yoga) is the misconception that exercise, particularly weight-bearing exercise, will exacerbate joint damage and symptoms such as pain and fatigue. This fear is prevalent not only among individuals with arthritis but also among some physicians and allied health professionals (Munneke et al 2004).
Therefore, individuals with arthritis need to be reassured that physical activity is not only safe but also widely and consistently reported to reduce pain, fatigue, inflammation, and disease activity. Those with arthritis, particularly those with pain and those who are deconditioned, should gradually progress to exercise intensities and volumes that provide clinically significant health benefits.
This great infographic was produced by the American college of Sports Medicine:
Rheumatoid Arthritis Physical Activity Guidance
References:
Romão, V. C., & Fonseca, J. E. (2021). Etiology and Risk Factors for Rheumatoid Arthritis: A State-of-the-Art Review. Frontiers in medicine, 8, 689698. https://doi.org/10.3389/fmed.2021.689698
Ye, X., Chen, Z., Shen, Z., Chen, G., and Xu, X. (2020). Yoga for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Frontiers in medicine, 7, 586665.