A new study in the Journal of Alternative and Complementary Medicine (July 2015) reports that there is surge in clinical research on yoga for certain illnesses and medical conditions. The researched examined articles published between 1967 and 2013 and found 486 articles published in 217 different peer-reviewed journals from 29 countries.
About half of clinical studies of yoga (45%) were randomized controlled trials, which are considered the highest level of clinical evidence. The top three diseases studied with yoga were mental health, cardiovascular disease, and respiratory disease (like asthma).
Clinical research of yoga, however, continues to face challenges. There are also significant limitations in funding, time, and resources. Researchers often use different types of yoga (often not specified), lengths of study, and frequency of practice. Studies also draw from a variety of yoga breathing, postures, and meditation. Standardization would help advance and clarify the role of yoga in treatment.
With one in ten Americans practicing yoga and nearly half (45%) of Americans saying that they are interested in doing yoga, now is the time to examine the healing role of yoga. More high-quality, evidence-based research will help us know how best to integrate yoga into the medical treatment of illnesses.
Chronic pain can lead to physical and mental consequences beyond the pain. Up to 50% of patients with long-term chronic pain can experience mood issues including anxiety and depression. Chronic pain can also impair concentration, attention, and memory, even after controlling for mood symptoms, which suggests that pain impacts cognition.
Chronic pain has been associated with structural changes in the brain. Structural magnetic resonance imaging studies (MRIs) of chronic pain patients have shown a decrease in gray matter in areas of the prefrontal cortex, insula, and anterior and midcingulate cortices-- areas associated with pain processing, regulation of mood, and cognition. It is unclear whether these brain differences are the cause or effect of chronic pain.
A recent review in Pain (April 2015) discusses the growing literature to support that mind-body practices like meditation and yoga can improve chronic pain and its negative impact on the body and mind. Several studies have shown that both experienced and beginner mind-body practitioners experience less pain when exposed to painful stimuli-- both during and outside of meditative states. Experienced yoga practitioners as well as short-term mindfulness practices have been shown to have increased ability to tolerate cold pain. Yoga has also been shown to improve conditions associated with chronic pain, including depression, anxiety, and fatigue.
There is also growing evidence that suggests the protective effects of yoga on the brain (both gray and white matter).
Yoga and meditation have also been associated with changes in the brain that appear to counter age-related decline in gray matter volume. Experienced yogis and meditators have more gray matter volume and cortical thickness in brain regions that are involved in pain processing, attention, autonomic control, and emotion regulation (including primary and secondary somatosensory cortices, insula, anterior and posterior cingulate cortices, superior and inferior parietal cortices, hippocampus, and medial prefrontal and orbitofrontal cortices). Yoga and meditation practitioners have also been found to have increased white matter connectivity throughout the entire brain (in contrast, chronic pain is associated with disrupted white matter connectivity). Even a short term intervention of 11 hours of meditation has been associated with white matter changes in areas associated with self-regulation (i.e., changes to the corona radiata, a white matter tract).
Chronic pain is challenging both because of the pain itself as well as the long-term impairment of mood and cognition. Yoga and meditation-- even short-term beginner practices-- can be effective non-pharmacological interventions to counter the long-term negative effects of chronic pain on the body, brain, and mind.
Bushnell MC, Case LK, Ceko M, Cotton VA, Gracely JL, Low LA, Pitcher MH, Villemure C. Effect of environment on the long-term consequences of chronic pain. Pain. 2015 Apr;156 Suppl 1:S42-9. doi: 10.1097/01.j.pain.0000460347.77341.bd.
Yoga & Pregnancy
A recent study published in Women's Health Issues found that a 10-week gentle prenatal yoga program for 34 pregnant women with depression significantly improved the severity of depression. Yoga helped improve depression severity in both observed measures as well as subjective self-report. No injuries or safety issues were reported during the program. This study adds to the existing literature that gentle prenatal yoga can help treat depression and has advantages especially for women who prefer to minimize medications during pregnancy.
Battle CL, Uebelacker LA, Magee SR, Sutton KA, Miller IW. Potential for prenatal yoga to serve as an intervention to treat depression during pregnancy. Womens Health Issues. 2015 Mar-Apr;25(2):134-41. doi: 10.1016/j.whi.2014.12.003.
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