Yoga carries a higher than expected risk of wrist, elbow and shoulder pain, possibly due to poses like downward facing dog, new research suggests.
But it’s not all bad news. The same study adds to the growing evidence that yoga can help manage lower back and neck pain.
These findings highlight the complex relationship between yoga and musculoskeletal pain, second most common cause of disability worldwide.
Our findings are not only important for people who practice yoga or plan to do so, but also for yoga teachers and healthcare professionals who treat patients with musculoskeletal conditions.
What have we done?
We surveyed 354 people who had taken at least one yoga class in the past year at a yoga studio in two locations in suburban New York City. The participants were mostly women (95%) and were on average 45 years old. The studio offers courses in Vinyasa-style yoga, Iyengar yoga and prenatal yoga, among others.
Participants completed an online electronic questionnaire so that we could assess their musculoskeletal pain at baseline. We then contacted them again a year later to assess the effect of yoga on bone, joint and muscle pain in all areas of the body.
At this point, we asked about the effect of yoga on their pain (whether they thought yoga caused it, made it worse, had no effect, or improved it) and intensity of pain.
When people reported that yoga caused pain, we asked them to tell us whether they felt pain during yoga class (and in what position), within an hour of yoga class or the following day.
What did we find?
Nearly 87% of participants reported musculoskeletal pain within a year. Of those who reported pain in at least one area of the body, most (66%) said yoga improved their bone, muscle and joint pain, particularly neck and back pain.
However, 21% said yoga made their pain worse and more than 10% said yoga caused the pain particularly in the upper limbs (hand, wrist, elbow, shoulder). This may have been due to poses, like downward facing dog, that require you to put weight on that part of the body.
A large number (44%) said yoga did not affect their pain. Because participants were asked to check all areas of the body where they had pain, some participants may have reported that yoga helps in one area but causes pain in another area, so these numbers exceed 100%.
More than half of the injuries were minor, while others resulted in no yoga (39%) or pain lasting more than three months (42%). People with yoga-related musculoskeletal pain rated their pain between two and five (on a scale of zero to ten).
Although we didn’t ask how these injuries occurred, previous research suggests overuse, inadequate instruction, and poor technique. increases the risk of injury.
How does this compare to other research?
Our study, which shows that yoga causes pain in 10% of people over a year, has much higher rates of pain than other studies, which have previously reported levels of 1% and 2.4%.
One reason for our higher numbers could be that we followed participants over a year, which provides a more accurate estimate than previous studies that assessed people at one point in time.
Still, our study has good news for people who practice yoga as it supports a common belief that yoga can help with neck and back pain. Our study also confirms recent search which shows the beneficial effects of yoga for chronic low back pain.
While our research goes in part to investigating the complex relationship between yoga and pain, our sample was limited. Future research therefore needs to examine yoga-related injuries in male and younger participants, who may be more typical of those who practice yoga in urban centers.
So what is the take home message?
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People should practice yoga conscientiously and be aware of the risk of injury. They should limit time spent with weight on their arms (such as downward dog pose), especially if they have already suffered an injury.
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Yoga teachers should inform participants of the risk of injury and encourage them to leave uncomfortable or dangerous positions. They must communicate with physiotherapists to modify positions when participants recover from injury
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patients should discuss with physical therapists and physicians if they intend to practice yoga and assess potential risks, benefits, and modifications that may make yoga practice safer.
