This is the latest in a series of blog articles about alternative therapies for injuries and pain management.

This time, we turn to yoga, the ancient Indian mind-body practice that has become a mainstream form of exercise, stress release and pain management.

Future articles in this series will explore massage, Pilates, Reiki and other alternative treatments and pain-management techniques. You can access all articles in the Alternative Therapies Series by clicking here.

This article is presented for informational purposes only. As always, please consult with your physician and other health care providers before undertaking an exercise regimen or alternative treatment.

The following is adapted and excerpted from the National Center for Complementary and Alternative Medicine, Yoga Today and Yoga Journal.

Yoga is a mind-body practice with origins in ancient Indian philosophy. Yoga combines physical postures, or poses, with breathing techniques and meditation.

There are many different styles of yoga - Hatha, Vinyasa, Iyengar, Bikram (or hot yoga), Ashtanga and Kindalini, for example - but all are based on the same postures. These types of yoga differ in pacing, intensity and area of emphasis, such as breathing, body alignment or flow. It's not uncommon for people who've tried yoga and disliked it to discover that they love it after participating in another type of yoga class.

While some people practice yoga for physical fitness, others use it as a method of relaxing and reducing stress.

A good primer on the different types of yoga is available online. There's also an online tool designed to help you determine your yoga type.

The gentle Iyengar form of yoga, for instance, is good for people who have suffered from injuries or who have medical conditions that require special attention. As with any exercise regimen or alternative therapy, you should always consult with your physician before taking up yoga to avoid pushing your body beyond its limits and capabilities.

Origins of Yoga

Yoga in its full form combines physical postures, breathing exercises, meditation, and a distinct philosophy. Yoga is intended to increase relaxation and balance the mind, body, and the spirit.
Early written descriptions of yoga are in Sanskrit, the classical language of India. The word "yoga" comes from the Sanskrit word yuj, which means "yoke or union." It is believed that this describes the union between the mind and the body.

The first known text, The Yoga Sutras, was written more than 2,000 years ago, although yoga may have been practiced as early as 5,000 years ago. Yoga was originally developed as a method of discipline and attitudes to help people reach spiritual enlightenment. The Sutras outline eight limbs or foundations of yoga practice that serve as spiritual guidelines:

1. yama (moral behavior)
2. niyama (healthy habits)
3. asana (physical postures)
4. pranayama (breathing exercises)
5. pratyahara (sense withdrawal)
6. dharana (concentration)
7. dhyana (contemplation)
8. samadhi (higher consciousness)

The numerous schools of yoga incorporate these eight limbs in varying proportions. Hatha yoga, the most commonly practiced in the United States and Europe, emphasizes two of the eight limbs: postures (asanas) and breathing exercises (pranayama).

According to the 2007 National Health Interview Survey (NHIS), yoga is one of the most mainstream complementary and alternative therapies being used by Americans. More than 13 million adults had practiced yoga in the previous year, an increase of 3 million people since 2002. The 2007 survey also found that more than 1.5 million children practiced yoga in the previous year.

According to Yoga Journal's most recent "Yoga in America" survey, 15.8 million people in the United States now practice yoga, spending nearly $6 billion a year on classes, equipment, clothing, vacations and yoga-related books, magazines and DVDs.
 

Yoga & Health

People use yoga for a variety of health conditions including anxiety disorders or stress, asthma, high blood pressure, and depression. People also use yoga as part of a general health regimen-to achieve physical fitness and to relax.

Research suggests that yoga might:

• Improve mood and sense of well-being
• Counteract stress
• Reduce heart rate and blood pressure
• Increase lung capacity
• Improve muscle relaxation and body composition
• Help with conditions such as anxiety, depression, and insomnia
• Improve overall physical fitness, strength, and flexibility
• Positively affect levels of certain brain or blood chemicals.

There's strong anecdotal and increasing scientific evidence that yoga can have a healing impact on certain injuries while also offering pain relief. Recently, researchers at West Virginia University found that people with chronic low-back pain reduced their pain and improved their mobility through the practice of Iyengar yoga.

The researchers found that compared with a control group who received only standard medical care, the yoga group had significantly greater reductions in functional disability, pain, and depression.

Yoga is generally considered to be safe in healthy people when practiced appropriately.

However, people with certain medical conditions should not use some yoga practices. For example, people with disc disease of the spine, extremely high or low blood pressure, glaucoma, retinal detachment, fragile or atherosclerotic arteries, a risk of blood clots, ear problems, severe osteoporosis, or cervical spondylitis should avoid some inverted poses. It's important to consult with a physician and a skilled yoga practitioner before beginning yoga.

In addition, while yoga during pregnancy is safe if practiced under expert guidance, pregnant women should avoid certain poses that may be problematic.

Finding a Yoga Class

Because of its popularity and accessibility to people of different fitness levels and physical abilities, most private health clubs and YMCAs offer yoga classes. Most communities also have private yoga studios that offer classes for a small fee. Some physician's offices and hospitals also offer yoga classes.

In addition, you can find many yoga workouts online, many designed for people with certain injuries, illnesses or types of pain:

For lower back pain

Also for lower back pain

General yoga workouts

For shoulder pain

For knee pain
 

There are many training programs for yoga teachers throughout the country. These programs range from a few days to more than 2 years. Standards for teacher training and certification differ depending on the style of yoga.

There are organizations that register yoga teachers and training programs that have complied with minimum educational standards. For example, one nonprofit group requires at least 200 hours of training, with a specified number of hours in areas including techniques, teaching methodology, anatomy, physiology, and philosophy. However, there are currently no official licensing requirements for yoga teachers in the United States.

If You Are Thinking About Yoga

• Do not use yoga as a replacement for conventional care or to postpone seeing a doctor about a medical problem.
• If you have a medical condition, consult with your health care provider before starting yoga.
• Ask about the physical demands of the type of yoga in which you are interested, as well as the training and experience of the yoga teacher you are considering.
• Look for published research studies on yoga for the health condition you are interested in.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.
• If you take one yoga class and don't like it, consider trying a different style of yoga or taking a class from a different teacher. Teaching methods and yoga styles vary, and you may have to try several classes before finding the one that is right for you.
• If you experience pain while practicing yoga, stop. Don't push yourself to do any pose that causes you pain.