Healthcare is in a crisis in the United States. Even with the Affordable Care Act, too many people are underinsured or without insurance. For many patients, high deductibles and copayments, make access to healthcare providers limited to annual visits or emergencies. Politicians, researchers and government agencies talk a lot about the need to shift towards preventative medicine, but insurance carriers exclude many providers from billing for preventative services. However, healthcare providers are sick of putting band-aids on chronic illnesses. They are demanding and asking for solutions that take them out of the treadmill of just writing prescriptions. They want to spend more time with patients and shift from treating the disease to treating the whole person.
Patients are also demanding more. In my practice we have seen a rise of people coming in and asking to find alternate ways to recover from a injury, to get off their pain medication, to improve their quality of life. They are asking for yoga. The great news is that the National Institutes of Health had the insight many years ago to set up a branch that funds research in integrative medicine called The National Center for Complementary and Integrative Health (NCCIH) . This investment in research has paid off, and we now have good evidence to support what many yoga practitioners have known for centuries. A regular yoga practice not only helps people feel better, but can improve health outcomes, and can even change your body at a cellular level. Once scorned as a fringe practice of weird ascetics, yoga is now practiced by more than 10 million americans and is starting to earn the respect of western health care providers.
Although the perception is changing, many people in the general public and healthcare still have a view that yoga is all about doing acrobatic postures and thus off limits to the inflexible and the injured. In fact the beauty of yoga is that the breath work, postures, meditation and philosophical practices make yoga accessible to anyone. Yoga can be practiced in a chair, in a hospital bed, at home, or in a class. A study by Holger Cramer PhD and colleagues in 2015 looked at the data from 301 randomized control trials on yoga, and found that yoga appears to be as safe as usual care and exercise. This reassured healthcare providers that yoga is a relatively safe practice to prescribe.
In 2013 Dr. Holger Cramer and colleagues analyzed the results from eight randomized control trials (the gold standard for high quality studies) looking at yoga as an intervention for treating people with low back pain, and found “strong evidence for short-term and moderate evidence for long-term reductions of low back pain and back specific disability after yoga interventions”. Considering that 80-90{2bd103ee3922297dd26721aa2b4723f52b7c1e46e10078a5bb1f7638d0cbcf8c} of the population will experience low back pain at some point in their lives, finding a treatment for low back pain is a huge priority for healthcare providers. With the surge of addiction to prescription drugs following low back injuries, yoga provides a safe, drug-free alternative.
Cancer treatment centers were some of the first groups to embrace yoga as an integral practice for their patients. A meta-analysis (a technique that combines data from multiple studies) performed in 2015 by Kuan-Yin Lin of The National Taiwan University and colleagues examined the results of ten randomized control trials and found that yoga improved quality of life outcomes (anxiety, depression, distress and stress) in patients with cancer.
One of the most exciting areas of research is looking at the changes that occur in the body over time. A study completed at McGill University in 2015 by Chantal Villemure PhD and colleagues, examined the grey matter in brains of experienced yoga practitioners, and compared their grey matter to matched controls who do an equal amount of exercise. They found the yoga practitioners did not have the same reduction in grey matter that occurs with age, that they found in the control group. They concluded that yoga may provide a neuroprotective benefit that was not found in the exercise group. This study may reveal the importance of breathing exercises, systematic relaxation, concentration exercises and meditation that are key components of a yoga program.
With the advent of functional MRI’s researchers can look inside the brain to see what is happening at the neural pathway level. A study by Boccia and colleagues in 2015 examined data from 110 functional MRI studies of the brain that examined the effects of meditation. They found that meditation activates sections of the brain that are associated with self regulation, self awareness, attention, memory formation, and executive functioning.
This is just a small selection of the studies examining the effects of yoga interventions. Yoga may be the answer to the healthcare crisis in America. It is inexpensive, can be integrated into most treatment settings, and addresses the complex biological, psychological, and social aspects of illness. The surge of yoga-based research in the headlines has woken up western healthcare providers to the benefits of using this mind-body centered practice. Hospitals are starting to hire yoga instructors and yoga therapists to work in their departments. There has been a surge of interest in offering training in yoga, to healthcare providers in medical schools, and to clinicians. For patients, the integration of yoga into treatment programs, offers a more comprehensive approach to healing. The focus is not just on the physical injury, but helps to develop strategies to manage pain, reduce stress, reduce depression and provide long term strategies for self care.
The next time you visit your healthcare provider you may walk away with a prescription for breathing, instruction in guided relaxation, a series of postures tailored to your needs, and training in meditation. We are in an exciting time in healthcare, turning old ways upside down, reducing the use of passive treatments that treat a body part and moving towards addressing the needs of the whole person.
References:
Cramer, H., Ward, L., Saper, R., Fishbein, D., Dobos, G., & Lauche, R. (2015). The Safety of Yoga: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. American Journal Of Epidemiology, 182(4), 281-293.
Cramer, H., Lauche, R., Haller, H., & Dobos, G. (2013). A systematic review and meta-analysis of yoga for low back pain. The Clinical Journal Of Pain, 29(5), 450-460.
Lin, K., Hu, Y., Chang, K., Lin, H., & Tsauo, J. (2011). Effects of yoga on psychological health, quality of life, and physical health of patients with cancer: a meta-analysis. Evidence-Based Complementary And Alternative Medicine: Ecam, 2011659876.
Villemure, C., Čeko, M., Cotton, V. A., & Bushnell, M. C. (2015). Neuroprotective effects of yoga practice: age-, experience-, and frequency-dependent plasticity. Frontiers In Human Neuroscience, 9281.
Boccia, M., Piccardi, L., & Guariglia, P. (2015). The Meditative Mind: A Comprehensive Meta-Analysis of MRI Studies. Biomed Research International, 2015419808.
Dr. Janet Carscadden is a physical therapist and yoga instructor who integrates yoga into her treatment programs. She is the owner of Evolution Physical Therapy and Yoga Studio Inc. in Burlington Vermont. Along with her colleagues at Evolution, she lectures at healthcare conferences and The University of Vermont on the integration of yoga in healthcare, and provides trainings introducing the research and benefits of yoga to healthcare providers. For more information on yoga and healthcare visit www.evolutionvt.com.

en English
X