If you have rheumatoid arthritis (RA), the last thing you probably think about doing is bending, twisting and contorting your body into all manner of positions.
Yoga for rheumatoid arthritis can be much gentler than that. Adapted movements, breathing and relaxation may help with mobility, fatigue and emotional wellbeing. Gentle Hatha or Iyengar classes can be a useful starting point when the instructor understands arthritis and adapts the practice to you.1, 2
Yoga works alongside your usual RA care. Keep taking prescribed medicines and ask your rheumatology team or physiotherapist which activities and modifications suit your joints.3, 4
Rheumatoid arthritis and yoga
Yoga is an ancient Indian practice involving exercises, breathing techniques and meditation. On the physical side, the movements can help build muscle strength, flexibility and balance; breathing and relaxation can also help you unwind. Research in people with arthritis suggests potential benefits for wellbeing, although results vary between studies.1
Rheumatoid arthritis is an autoimmune condition characterised by joint stiffness, pain and inflammation, which can also cause fatigue. Living with it can affect your mood too. Unlike osteoarthritis, which involves changes to the tissues in a joint, RA involves the immune system attacking healthy joint tissue. Treatment aims to control inflammation and protect the joints.3, 4
Those living with RA may take disease-modifying medicines as well as treatments for symptoms. Beneficial lifestyle habits, including a balanced diet, protecting your joints, getting enough rest and doing suitable regular exercise, can help you look after your health alongside treatment.3, 4
What does the research say?
A 2009 study included 26 people with RA who took part in an eight-week yoga programme, alongside 21 controls. The yoga group improved on measures of disease activity and disability, although quality of life did not significantly improve. This was a preliminary study, rather than proof of the same benefit for everyone.5
A different study assessed young women with RA who took twice-weekly Iyengar yoga classes over six weeks. Compared with a usual-care waitlist, the yoga group reported improvements in pain-related disability, mood, fatigue and acceptance of chronic pain.6
Another small study involving 16 postmenopausal women with RA, divided into yoga and control groups, explored three 75-minute sessions weekly over ten weeks. The researchers reported improvements in balance, perceived pain and depression following yoga.7
More recent trials add to this picture. A 2020 trial involving 166 people with newly diagnosed RA found that adding a 12-week yoga programme to standard medical treatment improved disease activity more than standard treatment alone.8 Another randomised trial found benefits for fatigue and mood, but no significant improvement in its primary measure of health-related quality of life or in RA disease activity.9 Taken together, these studies suggest yoga may be a useful addition to care, with benefits depending on the person and programme.
The research isn't restricted to RA. A small pilot study of weekly Iyengar yoga for knee osteoarthritis reported improvements in pain and physical function, although the change in stiffness was not statistically significant.10 Another small study of Hatha yoga three times a week for eight weeks in women with knee osteoarthritis reported reduced pain and symptoms.11 These findings relate to osteoarthritis and should not be treated as evidence for RA.
Start off slow
A beneficial thing about yoga is that you don't have to be young and bendy to begin. Some people find the relaxation helpful straight away; changes in strength, mobility or fatigue may take longer. It's important to be wary of going too hard in the beginning.
Before you start, discuss suitability with your healthcare team. Then ask your yoga teacher about anything you shouldn't attempt given your specific condition. Choose an appropriate class and check whether your instructor is experienced in teaching people with arthritis. Many positions can be modified, and props such as a chair can help with support and balance.12
It's also important to notice how your body responds. If a position hurts, stop or move into a comfortable alternative. During a flare-up, reduce the demands on painful, swollen joints and balance gentle movement with rest. Your physiotherapist can help you plan what to do on more difficult days.3, 12
Gentle yoga poses and modifications for rheumatoid arthritis
A trained instructor can help you choose a few movements that suit your symptoms. These are examples to discuss and learn with them, rather than a fixed routine for everyone. Use a stable chair without wheels, a clear space and a non-slip surface.
- Seated breathing: Sit comfortably with your feet supported and shoulders relaxed. Breathe gently into your abdomen, then breathe out without forcing or holding your breath. This can be a simple way to begin or end a session.13
- Cat-Cow, adapted to a chair: Instead of putting weight through your wrists and knees on all fours, sit with your feet flat and hands resting lightly on your thighs. Slowly alternate between a small rounding and opening of your upper back, keeping your neck comfortable. Ask your teacher to demonstrate this seated adaptation.13, 2
- Supported Side Angle: With an instructor's help, use a comfortable standing stance, gently bend one knee and rest the same-side forearm lightly on your thigh. Use a smaller bend and keep the other hand on your hip if raising the arm is uncomfortable. Ask about chair or wall support if balance is difficult.14
- Supported standing balance: Stand beside a stable chair or wall. With support as needed, gently transfer weight to one leg and only lift the other foot if you feel steady. Keep the movement small and let your instructor decide whether a seated alternative would suit you better.14
Adapt the pose to the joint. Sore wrists or knees may make floor poses uncomfortable, so a chair-based class can be a useful option. Child's Pose and Cobra, mentioned in many beginner routines, may also need adapting. Avoid forcing deep bends or stretching your neck backwards. If you have known neck involvement, joint instability or recent surgery, get individual advice before practising.14, 2
Practising yoga at home
The other big advantage of yoga is that once you've learnt suitable stretches and poses with an instructor, you can practise them at home. Start with a short, manageable session and use the adaptations you have been shown. Online videos can provide ideas, but they cannot assess your joints or replace individual guidance.2
The most effective positions and exercises largely depend on you and how your symptoms affect you. There is no single frequency proven best for everyone with RA. Build a routine you can maintain, adjusting the length and effort according to fatigue, pain and recovery.3
Supporting your joints alongside yoga
Yoga and a healthy, balanced diet can be useful parts of looking after yourself. If you have new joint symptoms or your RA is becoming harder to manage, speak to your GP or rheumatology team.3
For more information on nutritional options, explore our joint and bone supplement range, including turmeric supplements and glucosamine supplements. Our joint-care supplements guide explains the different ingredients to help you compare them. If you take RA medicines, check a new supplement with your pharmacist or rheumatology team first.3
