That’s certainly been the case for Julia Chayko, a writer and actor in Vancouver, British Columbia, who was diagnosed with RA 12 years ago. A former dancer, Julia understands the importance of keeping the body moving, and she has found that doing yoga several times a week allows her to maintain flexibility and strength. It also calms her mind and facilitates inner peace. “Yoga is great for escaping the crazy world for a little while. It’s just time for me,” Julia says. Julia finds she especially enjoys taking classes online, something offered by more yoga studios since the COVID-19 pandemic emerged. “Because I’m not in a class with other people, I feel comfortable taking rests anytime I want to,” she says. She also listens to her body, modifying poses that feel uncomfortable on a day when her joints might flare. “If my wrists are not having any of it, I might go on my elbows. And maybe instead of a 45- or 30-minute class I’ll choose to do one that’s 15,” she says. One of the things Julia especially likes about yoga is the variety of styles that fall under the label. “There are so many different types — it really is, pardon the pun, flexible,” she says.

Studies Show Yoga Helps Certain Aspects of RA

Several studies have documented the benefits of yoga specifically for people with RA. For example, in a study published in March 2019 in the journal Restorative Neurology and Neuroscience, people with the disease who practiced a significant amount of yoga in addition to taking medication decreased their inflammatory markers and had less depression after two months than a control group who simply continued their meds. RELATED: The Basics on Hatha Yoga, Ashtanga Yoga, Kundalini Yoga, Yin Yoga, and Yoga Nidra A review of research on people with RA published in Current Rheumatology Reports similarly concluded that yoga reduced depression, along with anxiety, and made people feel better. Another review, published in 2020 in the journal Frontiers in Medicine, included information from 10 clinical trials involving more than 800 people with RA. It found that yoga helped with physical function, disease activity, and grip strength, although no effects were found for pain or swollen joint count.

How a Regular Yoga Practice May Help People With RA

Yoga poses “also promote the circulation of fluids inside the joints, facilitate ease of motion, and it even help you sleep better” — all important to people with rheumatoid arthritis, says Loren Fishman, MD, a rehabilitation medicine physician in Manhattan and the author of numerous books about yoga and health, including Yoga for Arthritis and Yoga for Back Pain. Benefits especially come when you pay attention to your breath and you don’t rush the poses, according to the online arthritis community CreakyJoints, where Julia is a member. To ease yourself into your day or to help you sleep, you can even practice a couple of poses in bed in the morning or at night, the website suggests.   RELATED: Physical Activity Is Essential for Managing Rheumatoid Arthritis

What Is Yoga, Exactly?

Yoga is a term used to describe a variety of movement styles. Some types of yoga are mellow, others vigorous. What they all have in common is their focus on stretching and opening various parts of the body, and an inward, mental component that facilitates relaxation. Along with the physical movements, breathing is an important aspect of yoga, says Eddie Stern, a yoga teacher in New York City and the author of One Simple Thing: A New Look at the Science of Yoga and How It Can Transform Your Life. Slowing down and lengthening your breathing helps soothe the nervous system, “so you walk out of a class feeling a little calmer,” he says. Yoga can also regulate the vagus nerve, a part of the body that modulates the stress response, Stern says.

Find an Appropriate Yoga Teacher

Some people try to do yoga on their own, such as by using a DVD or a streaming service. But if you are new to yoga, it’s important to have a teacher standing in front of you who can offer you feedback, corrections, and suggested modifications, Stern says. “It is difficult for a video or the internet to help you adjust or correct something,” he says. In fact, a study of yoga injuries published in July 2019 in BMC Complementary and Alternative Medicine that surveyed 1,700 yoga practitioners in Germany found that people who did yoga on their own were some of the most likely to be injured. The growth of live online classes has helped in this regard, Stern says. “With the advent of Zoom classes, there is a lot of wonderful help where you can get live feedback.”

Seek a Yoga Teacher With Experience

You’ll want to find an instructor with a lot of experience, ideally one who has worked with people with your health condition. The most committed instructors can be found on the registry of the Yoga Alliance, where teachers bear the designations RYT 200 or 500, designating how many hours of instruction and teaching experience they have (higher numbers mean they have gone through more rigorous training and have taught for more years). A subgroup of instructors who have demonstrated knowledge in helping people with medical challenges are certified by the International Association of Yoga Therapists. You can see if there’s a teacher near you on their website. “An experienced teacher will know how to help you modify poses, and, equally important, won’t hold you back from doing what you are able to do,” says Leslie Kazadi, a longtime certified yoga therapist in Santa Monica, California. Consider taking a private session or two, ideally with a yoga therapist, so you can learn adjustments to poses that work for you before you enter a class. As with any fitness program, it’s best to consult with your doctor before you begin. Be careful not to push yourself too hard or overdo it. Signs that you’re reducing the benefits of yoga — and maybe even creating problems — include having labored breath during practice and feeling pain (not simply muscle-stretching soreness) during a class or after.

Yoga Style Is Largely a Personal Preference

People are different in terms of the types of yoga they most enjoy, Stern says. An Iyengar class, where the instructor talks a lot, for instance, might not be a fit if you have a quiet, more introspective personality. Similarly, if you’re athletic, a more mellow restorative-style class may frustrate you. In some respects, any type of class you choose can yield benefits. A review article that examined more than 300 studies of yoga programs for health conditions, which was published in Complementary Therapies in Medicine in April 2016, concluded that the vast majority of practitioners got positive benefits regardless of the style of yoga they preferred. Still, some schools of yoga are inherently gentler or better suited for people with RA.

The Best Types of Yoga for People With Rheumatoid Arthritis

Experts say that people with rheumatoid arthritis should especially seek out these yoga styles.

  1. Iyengar — Named for the late Indian guru B.K.S. Iyengar, this method emphasizes precision and alignment in each posture, along with breath work. It’s not uncommon for an Iyengar instructor to shift your foot half an inch to put your hips in the proper place, which prevents you from putting excess pressure on the joints. Poses are typically held for a few minutes, and classes include props — blankets, straps, and blocks — to get you into poses you can’t otherwise hold. “The support of the props is especially helpful for people with limited mobility, and the better you do the poses, the safer and more therapeutic they become,” Dr. Fishman says, noting that this is the style of yoga he practices. Find an Iyengar instructor on the group’s website; click on United States, then select your state.
  2. Hatha — Hatha technically refers to all forms of yoga involving postures, but the term has come to mean slower-moving classes where you hold each pose for at least a few breaths. Separate breathing practices, known as pranayama, and a brief period of meditation are also typically included in these classes. Some of the better known schools of hatha include Sivananda yoga and integral yoga. Because the pace tends to be slower, you have time to figure out how to modify poses that bother your joints. And the deep relaxation period that ends each class is great for releasing stress.
  3. Restorative — This practice is all about relaxation. Poses are held for five minutes or more, and bolsters and blankets ensure each pose is comfortable for you — allowing you to get into a mental and physical space of deep rest. Because you can sink into the postures and release tension with this method, it’s a type especially preferred by people with arthritis, according to CreakyJoints. Don’t confuse restorative yoga with yin yoga, another practice that holds poses for a long time but that aims to push the joints to their limit to improve mobility; these stretches can be too intense for people with RA, Kazadi cautions.

Yoga Styles You May Want to Avoid

  1. Bikram and hot yoga — The Indian guru Bikram Choudhury developed this precise style, in which 26 specific yoga postures are done in a room maintained at 105 degrees F and 40 percent humidity. While the heat is said to facilitate stretching, it’s also fatiguing, something people with RA don’t need more of, Fishman says. What’s more, the exact regimen of Bikram poses doesn’t allow for much adaptation, and some of the poses put particular stress on the joints. Classes advertised more generically as hot yoga may be held at slightly lower temperatures, around 85 degrees, but sometimes incorporate faster-paced sequences, which could also be overly taxing for those with RA. Nonetheless, some people with RA do find the heat relaxing for the joints, as long as they don’t over do it. Julia Chayko enjoyed Bikram for several years before settling into more gentle hatha classes.
  2. Vinyasa — Exercise enthusiasts are often drawn to vinyasa classes, which include a variety of class styles in which poses are linked in a dynamic, flowing practice that is more aerobic than other yoga types. Rather than hold a lunge, for example, you might immediately move into a twist, then a plank, then a push-up. While in theory a class of flowing movements can be fine for someone with RA, the quick pace doesn’t allow much time to alter poses that put pressure on the wrists or ankles. An exception is the small number of specialty vinyasa classes that are geared for people with joint pain; in these classes participants often use chairs.
  3. Power yoga — This fitness-based style of yoga aims to develop strength and flexibility. Power yoga is a vigorous style that typically includes poses that are more demanding than other types of yoga. Perhaps because of its difficulty, the German study singled out power yoga as the style practitioners are most likely to be injured doing.