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Yoga may be linked to more pain, injury than previously thought

Yoga caused musculoskeletal pain and exacerbated existing physical injuries, according to research recently published in the Journal of Bodywork and Movement Therapies.

“Yoga participation in experimental studies appears to be safe,” Marc Campo, PT, PhD, School of Health and Natural Sciences, Mercy College, New York, and colleagues wrote. “[But] in these studies, yoga was practiced under structured experimental conditions, with careful delivery and multiple observations. In real life, millions participate in yoga in recreational studios, where quality and standardization vary. Thus, it is important to understand the extent of risks for musculoskeletal pain associated with recreational yoga participation.”

To gather more data on yoga risks, researchers conducted a prospective cohort study involving 354 participants who took two electronic questionnaires 1 year apart. These queries assessed yoga participation habits and musculoskeletal pain in the period between surveys in nine body regions, and asked about pain from all sources, not just yoga. Participants that said they had pain were asked if the pain was caused, not caused but exacerbated, unaffected, or improved by yoga. All participants reported on frequency, duration and intensity of their pain, with frequency defined as the number of days of pain in a typical month, duration defined as the number of months in the previous year that pain was experienced, and intensity defined as the average level of pain on a typical day with pain. Campo and colleagues also noted that if pain was caused by yoga, participants were asked when they first noticed it, what pose they were in if the pain started during class, and if they were unable to participate in yoga and for how long.

Researchers found that the incidence rate of pain caused by yoga was 10.7% and that more than 33% of the incident cases resulted in lost yoga participation time and/or symptoms lasting more than 3 months. In addition, 21% of existing injuries were aggravated, but none of the risk factors at baseline — age, experience, hours of practice per week, self-rated average intensity of practice, and self-rated peak intensity of practice — increased the risk for subsequent incident cases of pain caused by yoga.

Campo and colleagues also reported that 86.7% of participants reported pain in at least one body region during the follow-up year between the surveys. The 1-year prevalence rates calculated for pain in at least body region were 65.8% for pain improved by yoga, 44.9% for pain unaffected by yoga 20.9% for pain exacerbated by yoga, and 13.3% for pain caused by yoga. In addition, new cases of pain were reported by 10.7% of participants, with most of these occurring in the upper extremities (shoulder, elbow, wrist, hand). Most of the pain was in one body region, but some had pain in two or three of these areas. On a scale of 0 to 10, with 10 being the most intense pain, participants said their pain intensity ranged from 2 to 5. Fifteen participants with incident cases reported lost yoga participation time and 16 said they had pain lasting more than 3 months.

“Pain caused by yoga might be prevented by careful performance and participants telling their yoga teachers of injuries they may have prior to participation, as well as informing their health care professionals about their yoga practice,” Evangelos Pappas, associate professor, University of Sydney, Australia, said in a press release. “These findings can be useful for clinicians and individuals to compare the risks of yoga to other exercise enabling them to make informed decisions about which types of activity are best.”

Researchers also suggested yoga participants recognize their limits, discuss yoga participation with their physical therapists and health care providers and should also disclose relevant pain or injuries to their yoga teachers. – by Janel Miller

Disclosure: Healio Family Medicine was unable to determine researchers’ relevant financial disclosures prior to publication.