Yoga for Children and Adolescents
The American Academy of Pediatrics (AAP) recommends yoga as a safe and potentially effective therapy for children and adolescents coping with emotional, mental, physical, and behavioral health conditions. Yoga can help children learn to self-regulate, focus on the task at hand, and handle problems peacefully. Yoga may also improve balance, relieve tension, and increase strength when practiced regularly. Because some yoga poses are harder than others, the AAP cautions that even children who are flexible and in good shape should start slowly.
What Does the Research Show?
- In a 2019 study, 5-year-old kindergartners doing yoga twice a week in school in place of standard physical education showed less inattention and hyperactivity and completed a task faster than 5-year-olds doing physical education or no exercise.
- A 2016 review found that school-based yoga programs seem to help improve adolescents’ health.
- A 2015 systematic review of 16 studies (including 6 randomized controlled trials, 2 nonrandomized preintervention-postintervention control-group designs, 7 uncontrolled preintervention-postintervention studies, and 1 case study) for yoga interventions addressing anxiety among children and adolescents concluded that nearly all studies included in the review indicated reduced anxiety following a yoga intervention. However, the reviewers noted that because of the wide variety of study populations, limitations in some study designs, and variable outcome measures, further research is needed to enhance the ability to generalize and apply yoga to reduce anxiety.
Yoga for Older Adults
Yoga’s popularity among older Americans is growing. National survey data show that 6.7 percent of U.S. adults age 65 and over practiced yoga in 2017, as compared to 3.3 percent in 2012, 2.0 percent in 2007, and 1.3 percent in 2002.
Older adults who practice yoga should put safety first. It’s a good idea to start with an appropriate yoga class—such as one called gentle yoga or seniors yoga—to get individualized advice and learn correct form. Chair yoga is an even gentler option for seniors with limited mobility. And it’s important for older people with medical issues to talk to both their health care providers and the yoga teacher before starting yoga.
What Does the Research Show?
- A 2015 study funded by NCCIH compared 14 experienced yoga practitioners to 14 physically active control participants of similar ages. In the control group, the amount of gray matter was lower in older participants than younger ones. In the yoga practitioners, there was no relationship between gray matter and age. Among the yoga practitioners, the volume of certain brain regions increased with the number of years of yoga experience and weekly amount of yoga practice.
Yoga for Health and Well-Being
Only a small amount of research has investigated yoga for general well-being, such as improving sleep and reducing stress, and the findings have not been completely consistent. Nevertheless, some preliminary research results suggest that yoga may have several different types of benefits for general well-being.
What Does the Research Show?
- Stress Management. Some research indicates that practicing yoga can lead to improvements in physical or psychological aspects of stress.
- Balance. Several studies that looked at the effect of yoga on balance in healthy people found evidence of improvements.
- Positive Mental Health. Some but not all studies that looked at the effects of yoga on positive aspects of mental health found evidence of benefits, such as better resilience or general mental well-being.
- Health Habits. A survey of young adults showed that practicing yoga regularly was associated with better eating and physical activity habits, such as more servings of fruits and vegetables, fewer servings of sugar-sweetened beverages, and more hours of moderate-to-vigorous activity. But it wasn’t clear from this study whether yoga motivates people to practice better health habits or whether people with healthier habits are more likely to do yoga. In another study, however, in which previously inactive people were randomly assigned to participate or not participate in 10 weeks of yoga classes, those who participated in yoga increased their total physical activity.
- Quitting Smoking. Programs that include yoga have been evaluated to see whether they help people quit smoking. In most studies of this type, yoga reduced cigarette cravings and the number of cigarettes smoked. Findings suggest that yoga may be a helpful addition to smoking cessation programs.
- Weight Control. In studies of yoga in people who were overweight or obese, practicing yoga has been associated with a reduction in body mass index. An NCCIH-supported comparison of different yoga-based programs for weight control showed that the most helpful programs had longer and more frequent yoga sessions, a longer duration of the overall program, a yoga-based dietary component, a residential component (such as a full weekend to start the program), inclusion of a larger number of elements of yoga, and home practice.
Yoga for Pain Conditions
Yoga may help relieve low-back pain and neck pain, but it has not been shown to be helpful for some other painful conditions such as headache, arthritis, fibromyalgia, or carpal tunnel syndrome.
- Fibromyalgia. Recent systematic reviews and randomized clinical trials provide encouraging evidence that some mind and body practices such as yoga may help relieve some fibromyalgia symptoms.
- In 2017, the European League Against Rheumatism (EULAR) evaluated non-pharmacologic therapies, including complementary health approaches, and issued revised recommendations for the management of fibromyalgia. The strength of these recommendation is “based on the balance between desirable and undesirable effects (considering values and preferences), confidence in the magnitude of effects, and resource use. A strong recommendation implies that, if presented with the evidence, all or almost all informed persons would make the recommendation for or against the therapy, while a weak recommendation would imply that most people would, although a substantial minority would not.” Based on the evaluation of acupuncture, meditative movement practices (e.g., tai chi, qi gong, and yoga), and mindfulness-based stress reduction, the recommendation for each was weak for use of the therapy.
- A 2015 Cochrane review of 61 trials involving 4,234 predominantly female participants with fibromyalgia concluded that the effectiveness of biofeedback, mindfulness, movement therapies (e.g., yoga), and relaxation techniques remains unclear as the quality of evidence was low or very low.
- Low-back pain. For patients with chronic low-back pain, recent evidence-based clinical practice guidelines from the American College of Physicians gave a strong recommendation based on moderate-quality evidence that clinicians and patients should initially select nonpharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, or mindfulness-based stress reduction. The guidelines also strongly recommend, based on low-quality evidence, several mind and body approaches, including yoga.
- A 2018 report by the Agency for Healthcare Research and Quality evaluated 8 trials of yoga for low-back pain (involving 1,466 total participants) and found that yoga improved pain and function both in the short term (1 to 6 months) and intermediate term (6 to 12 months). The effects of yoga were similar to those of exercise.
- A 2017 Cochrane review of 12 trials involving 1,080 participants found low- to moderate-certainty evidence that yoga compared to non-exercise controls results in small to moderate improvements in back-related function at 3 and 6 months. Yoga may also be slightly more effective for pain at 3 and 6 months, however the effect size did not meet predefined levels of minimum clinical importance.
- Neck pain. There is some limited evidence that yoga may provide short-term improvements for neck pain.
- A 2017 review of 3 studies (involving 188 total participants) found that yoga had short-term benefits for both the intensity of neck pain and disability related to neck pain.
- Headache. Only a few studies have been conducted on yoga for headaches, so there aren’t enough data to determine if yoga has beneficial effects for this pain condition.
- A 2015 attempt to review the research on this topic found only one study with 72 participants that could be evaluated. That study had favorable results, with decreases in headache intensity and frequency.
- Arthritis. Results from clinical trials suggest that some mind and body practices, including yoga, may be beneficial additions to conventional treatment plans for patients with arthritis, but some studies indicate that these practices may do more to improve other aspects of patients’ health than to relieve pain.
- A 2018 meta-analysis of 13 clinical trials involving 1557 patients with knee osteoarthritis and rheumatoid arthritis found that regular yoga training may be useful in reducing knee arthritic symptoms, promoting physical function, and general wellbeing in arthritic patients.
- A 2017 review of two studies found some beneficial effect on pain, but due to the high risk of bias in both studies, the reviewers gave a weak recommendation for yoga in rheumatoid arthritis. Yoga incorporates several elements of exercise that may be beneficial for arthritis, including activities that may help improve strength and flexibility.
Yoga for People With Chronic Diseases
- Cancer. Quite a few studies have been done on yoga for people with cancer, especially on women with breast cancer. These studies have produced some evidence that yoga can help improve quality of life and reduce fatigue and sleep disturbances. Other forms of exercise may have similar benefits.
- Multiple Sclerosis. A small amount of research in people with multiple sclerosis found that yoga has short-term benefits on fatigue and mood, but it doesn’t affect muscle function, reasoning ability, or quality of life. The effects of yoga on fatigue are similar to those of other kinds of exercise.
- Chronic Obstructive Pulmonary Disease (COPD). Studies in people with COPD have shown that yoga may improve physical ability (such as the capacity to walk a certain distance in a specific length of time), lung function, and quality of life.
- Asthma. Studies of yoga in people with asthma have shown that it probably leads to small improvements in symptoms and quality of life.
Yoga for Other Conditions
- Anxiety or Depression. Yoga may be helpful for anxiety or depressive symptoms associated with difficult life situations. However, the research on yoga for anxiety disorders, clinical depression, or posttraumatic stress disorder (PTSD), although mildly positive, is still very preliminary.
- Cardiovascular Risk Factors. Stress and a sedentary lifestyle increase people’s risk of cardiovascular disease. Because yoga involves physical activity and may help reduce stress, it might help reduce the risk of cardiovascular disease. However, not much research has been done on this topic. Some studies have suggested that yoga may improve some risk factors, such as blood pressure and cholesterol levels, but the findings aren’t definitive.
- Diabetes. Some research has suggested that participating in yoga programs is associated with better blood sugar control in people with type 2 diabetes, at least on a short-term basis.
- Irritable Bowel Syndrome (IBS). Some research has suggested that yoga may help to decrease IBS symptoms and severity, but the findings aren’t strong enough for definite conclusions to be reached.
- Menopause Symptoms. Growing research indicates that yoga may help to reduce some menopause symptoms, and it’s at least as effective for menopause symptoms as other types of exercise.
- Sleep Problems. Some research has indicated that practicing yoga may improve sleep in a variety of groups of people, including people with cancer, older adults, people with arthritis, pregnant women, and women with menopause symptoms.
Yoga is generally considered a safe form of physical activity for healthy people when it’s done properly, under the guidance of a qualified instructor. But it’s possible to get hurt practicing yoga—just as when participating in other physical activities.
The most common injuries associated with yoga are sprains and strains. Serious injuries are rare. The risk of injury associated with yoga is lower than that for higher impact sports activities.
Older adults, women who are pregnant, and those who have health conditions should discuss their needs with their health care providers and yoga instructor. They may need to modify or avoid some yoga poses and practices.
- Agarwal RP, Maroko-Afek A. Yoga into cancer care: a review of the evidence-based research. International Journal of Yoga. 2018;11(1):3-29.
- American Academy of Pediatrics. Permission To Unplug: The Health Benefits of Yoga for Kids. Healthychildren.org website. https://www.healthychildren.org/English/healthy-living/emotionalwellness/Pages/Permission-to-Unplug-The-Health-Benefits-of-Yogafor-Kids.aspx
- American College of Obstetricians and Gynecologists. Committee opinion no. 650: physical activity and exercise during pregnancy and the postpartum period. Obstetrics & Gynecology. 2015;126(6):e135-142.
- Babbar S, Shyken J. Yoga in pregnancy. Clinical Obstetrics and Gynecology. 2016;59(3):600-612.
- Black LI, Barnes PM, Clarke TC, Stussman BJ, Nahin RL. Use of yoga, meditation, and chiropractors among U.S. children aged 4–17 years. NCHS Data Brief, no 324. Hyattsville, MD: National Center for Health Statistics. 2018.
- Bridges L, Sharma M. The efficacy of yoga as a form of treatment for depression. Journal of Evidence-Based Complementary and Alternative Medicine. 2017;22(4):1017-1028.
- Chugh-Gupta N, Baldassarre FG, Vrkljan BH. A systematic review of yoga for state anxiety: Considerations for occupational therapy. Canadian Journal of Occupational Therapy. 2013;80(3):150-170.
- Clarke TC, Barnes PM, Black LI, Stussman BJ, Nahin RL. Use of yoga, meditation, and chiropractors among U.S. adults aged 18 and older. NCHS Data Brief, no 325. Hyattsville, MD: National Center for Health Statistics. 2018.
- Cramer H, Anheyer D, Lauche R, et al. A systematic review of yoga for major depressive disorder. Journal of Affective Disorders. 2017;213:70-77.
- Cramer H, Anheyer D, Saha FJ, et al. Yoga for posttraumatic stress disorder – a systematic review and meta-analysis. BMC Psychiatry. 2018;18:72.
- Cramer H, Krucoff C, Dobos G. Adverse events associated with yoga: a systematic review of published case reports and case series. PloS One. 2013;8(10):e75515.
- Cramer H, Lauche R, Anheyer D, et al. Yoga for anxiety: a systematic review and meta-analysis of randomized controlled trials. Depression and Anxiety. 2018;35(9):830-843.
- Cramer H, Lauche R, Azizi H, et al. Yoga for multiple sclerosis: a systematic review and meta-analysis. PLoS One. 2014;9(11):e112414.
- Cramer H, Lauche R, Klose P, et al. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database of Systematic Reviews. 2017;(1):CD010802.
- Cramer H, Lauche R, Langhorst J, et al. Yoga for rheumatic diseases: a systematic review. Rheumatology. 2013;52(11):2025-2030.
- Cramer H, Ostermann T, Dobos G. Injuries and other adverse events associated with yoga practice: a systematic review of epidemiological studies. Journal of Science and Medicine in Sport. 2018;21(2):147-154.
- Cramer H, Peng W, Lauche R. Yoga for menopausal symptoms—a systematic review and meta-analysis. Maturitas. 2018;109:13-25.
- Cramer H, Ward L, Saper R, et al. The safety of yoga: a systematic review and meta-analysis of randomized controlled trials. American Journal of Epidemiology. 2015;182(4):281-293.
- Dai C-L, Sharma M. Between inhale and exhale: yoga as an intervention in smoking cessation. Journal of Evidence-Based Complementary & Alternative Medicine. 2014;19(2):144-149.
- Domingues RB. Modern postural yoga as a mental health promoting tool: a systematic review. Complementary Therapies in Clinical Practice. 2018;31:248-255.
- Hartley L, Dyakova M, Holmes J, et al. Yoga for the primary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews. 2014;(5):CD010072.
- Kelley GA, Kelley KS. Meditative movement therapies and healthrelated quality-of-life in adults: a systematic review of meta-analyses. PloS One. 2015;10(6):e0129181.
- Kim S-D. Effects of yoga exercises for headaches: a systematic review of randomized controlled trials. Journal of Physical Therapy Science. 2015;27(7):2377-2380.
- Li C, Liu Y, Ji Y, et al. Efficacy of yoga training in chronic obstructive pulmonary disease patients: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2018;30:33-37.
- Li Y, Li S, Jiang J, et al. Effects of yoga on patients with chronic nonspecific neck pain. A PRISMA systematic review and meta-analysis. Medicine. 2019;98(8):e14649.
- Lipton L. Using yoga to treat disease: an evidence-based review. Journal of the American Academy of Physician Assistants. 2008;21(2):34-36, 38, 41.
- Mooventhan A, Nivethitha L. Evidence based effects of yoga practice on various health related problems of elderly people: a review. Journal of Bodywork & Movement Therapies. 2017;21(4):1028-1032.
- Ng Q-X, Venkatanarayanan N, Loke W, et al. A meta-analysis of the effectiveness of yoga-based interventions for maternal depression during pregnancy. Complementary Therapies in Clinical Practice. 2019;34:8-12.
- Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine. 2017;166(7):514-530.
- Rioux JG, Ritenbaugh C. Narrative review of yoga intervention clinical trials including weight-related outcomes. Alternative Therapies in Health and Medicine. 2013;19(3):32-46.
- Schumann D, Anheyer D, Lauche R, et al. Effect of yoga in the therapy of irritable bowel syndrome: a systematic review. Clinical Gastroenterology and Hepatology. 2016;14(12):1720-1731.
- Sharma M. Yoga as an alternative and complementary approach for stress management: a systematic review. Journal of Evidence-Based Complementary and Alternative Medicine. 2014;19(1):59-67.
- Skelly AC, Chou R, Dettori JR, et al. Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review. Comparative Effectiveness Review no. 209. Rockville, MD: Agency for Healthcare Research and Quality; 2018. AHRQ publication no. 18-EHC013-EF.
- Stussman BJ, Black LI, Barnes PM, Clarke TC, Nahin RL. Wellness-related use of common complementary health approaches among adults: United States, 2012. National health statistics reports; no 85. Hyattsville, MD: National Center for Health Statistics. 2015.
- Swain TA, McGwin G. Yoga-related injuries in the United States from 2001 to 2014. Orthopaedic Journal of Sports Medicine. 2016;4(11):2325967116671703.
- Thind H, Lantini R, Balletto BL, et al. The effects of yoga among adults with type 2 diabetes: a systematic review and meta-analysis. Preventive Medicine. 2017;105:116-126.
- U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. Washington, D.C.: U.S. Department of Health and Human Services; 2018. Accessed on October 17, 2019. https://health.gov/paguidelines/second-edition/pdf/Physical_Activity_ Guidelines_2nd_edition.pdf
- Villemure C, Čeko M, Cotton VA, Bushnell MC. Neuroprotective effects of yoga practice: age-, experience-, and frequency-dependent plasticity. Frontiers in Human Neuroscience. 2015;9:281.
- Watts AW, Rydell SA, Eisenberg ME, et al. Yoga’s potential for promoting healthy eating and physical activity behaviors among young adults: a mixed-methods study. International Journal of Behavioral Nutrition and Physical Activity. 2018;15(1):42.
- Wieland LS, Skoetz N, Pilkington K, Vempati R, D'Adamo CR, Berman BM. Yoga treatment for chronic non‐specific low back pain. Cochrane Database of Systematic Reviews 2017, Issue 1. Art. No.: CD010671. DOI: 10.1002/14651858.CD010671.pub2.
- Yang ZY, Zhong HB, Mao C, et al. Yoga for asthma. Cochrane Database of Systematic Reviews. 2016;(4):CD010346.