Yoga Works
By Elaine Lipson

New yoga devotees often talk in mystical terms about discovering a remarkable sense of well-being and health. "Yoga is opening my energy channels," they'll say, or they'll describe a sense of "being in the body." Practitioners also credit yoga for alleviating back problems, menstrual difficulties, arthritis, or chronic pain they once thought would limit their lives forever. These anecdotes are real and meaningful—but do they translate into quantifiable health improvements or the kind of credible scientific research that members of the medical community accept?

Many yoga students, trusting their own experiences, may not know or even care if the medical establishment believes in yoga as a valid therapy for specific diseases or conditions or has researched and quantified yoga's benefits. But there are practical reasons for encouraging scientific research into yoga's benefits. Insurance companies, just beginning to honor yoga and other alternative therapies as legitimate healing practices, are more likely to embrace yoga and reimburse ailing students for its costs if research documents its effectiveness.

Still, it may take some time to develop a significant body of research, especially in this country. "There's a lot of research being done, but not in the United States," says Emmanuel Brandeis, M.D., the founder of Yoga Nemo in West Hollywood, California, and a board-certified gynecologist. "The research is mostly being done in India, and the studies are being published in noted journals with a lot of credibility."

Brandeis believes that it comes down to money in the United States; funding for research tends to go into ventures more likely to result in big profits. "Compared to a drug which can be prescribed and sold worldwide, yoga just doesn't make money," Brandeis says. He's optimistic, though, that as more and more people turn to alternative and complementary medicine, this situation will change; he notes that classes at one yoga center in Los Angeles are now being covered by Blue Cross/Blue Shield. "Insurance companies are recognizing the fact that yoga is a less expensive and more efficient method of rehabilitation," he says.

With the establishment of the Office of Alternative Medicine (OAM) in 1992, and the subsequent establishment of the OAM's National Center for Complementary and Alternative Medicine (NCCAM) in 1998, government-funded research about yoga and other mind-body practices is gaining momentum in the United States.

As part of the National Institutes of Health, which calls itself one of the world's foremost biomedical research institutions, the NCCAM mandates at least some funding for research in alternative healing therapies. Though these funds don't compare to public and private funding for conventional medicine, the existence of the OAM acknowledges the growing importance of natural and traditional methods of healing, and the roles they may play in today's changing medical climate.

Scientists and medical doctors pursuing yoga-related research are focusing on its ability to help prevent, heal, or alleviate specific conditions, such as heart disease, high blood pressure, carpal tunnel syndrome, asthma, diabetes, and symptoms of menopause, and its benefits as a technique for relieving stress and coping with chronic conditions or disabilities. In fact, the NCCAM itself, identifying yoga as a therapy worth pursuing in the research arena, says that, "During the past 80 years, health professionals in India and the West have begun to investigate the therapeutic potential of yoga.

To date, thousands of research studies have been undertaken and have shown that with the practice of yoga a person can, indeed, learn to control such physiologic parameters as blood pressure, heart rate, respiratory function, metabolic rate, skin resistance, brain waves, body temperature, and many other bodily functions." Though it's difficult to find most of these studies, some current, accessible research reports significant results for challenging medical conditions:

Asthma. At the Northern Colorado Allergy Asthma Clinic in Fort Collins, a controlled clinical study of university students (19 to 52 years old) with asthma concluded that yoga techniques seem beneficial as an adjunct to the medical management of asthma, according to the 1998 published abstract. Using a set of asanas, pranayama, and meditation, the yoga group practiced three times a week for 16 weeks. Though pulmonary functions did not show a significant variance between yoga and control groups, "analysis of the data showed that the subjects in the yoga group reported a significant degree of relaxation, positive attitude, and better yoga exercise tolerance. There was also a tendency toward lesser usage of beta adrenergic inhalers."

Cardiovascular Risk Factors. A three-month residential study treating patients with yoga, meditation, and a vegetarian diet at Hanover Medical University in Germany found a substantial reduction in risk factors for heart disease (including blood pressure and cholesterol) in participants, according to an abstract published in Acta physiologica Scandinavica Supplementum in 1997.

Carpal Tunnel Syndrome. A randomized, single-blind, controlled clinical trial at the University of Pennsylvania School of Medicine in Philadelphia concluded, "In this preliminary study, a yoga-based regimen was more effective than wrist splinting or no treatment in relieving some symptoms and signs of carpal tunnel syndrome." The study, published in the Journal of the American Medical Association in 1998, also noted that "Subjects in the yoga groups had significant improvement in grip strength and pain reduction, but changes in grip strength and pain were not significant for control subjects."

Arthritis. Also at the University of Pennsylvania School of Medicine, a yoga-treated group with osteoarthritis of the hands improved significantly more than the control group in "pain during activity, tenderness, and finger range of motion." The randomized controlled clinical trial, published in the Journal of Rheumatology in 1994, concluded, "This yoga-derived program was effective in providing relief in hand osteoarthritis. Further studies are needed to compare this with other treatments and to examine long-term effects."

Researchers have also evaluated effects of yoga on healthy adults and in athletes and compared the effects of yoga to the effects of other forms of physical exercise. One study conducted at the Government Vemana Yoga Research Institute in Secunderabad, India, focused specifically on athletes practicing pranayama techniques. After two years of observation and testing, according to the report published in the Indian Journal of Medical Research in 1994, "the results...showed that the subjects who practiced pranayama could achieve higher work rates with reduced oxygen consumption...and without increase in blood lactate levels." According to Mary Pullig Schatz, M.D., author of Back Care Basics: A Doctor's Gentle Yoga Program for Back and Neck Pain Relief (Rodmell, 1995), the study results indicate that in the pranayama subjects, the body is using oxygen "more efficiently (aerobically) rather than shifting to less-efficient anaerobic (lactate-producing) metabolism."

Another clinical trial by the Yoga Research Institute in Hyderabad, India, followed the effects of intensive yoga training on physiological changes in six healthy adult females. Though the study group was small, the intensive yoga training resulted in participants' ability to exercise more comfortably, with a significantly lower heart rate, and with increased breathing efficiency, according to an abstract published in the Journal of Alternative and Complementary Medicine in 1997.
Many patients with chronic diseases that seem to elude a strict physiological diagnosis and tread the mind-body frontier also respond well to yoga. Patrick Randolph, Ph.D., director of psychological services at the Pain Center of the Texas Tech University Health Sciences Center, has studied the effects of yoga on fibromyalgia syndrome (FS), an often debilitating chronic pain condition affecting up to 6 million Americans with a wide spectrum of symptoms. According to Randolph, yoga offers FS patients a twofold benefit: The asanas help increase circulation to the limbs while the resultant relaxation addresses anxiety. "What many people report from doing yoga is that rather than being an exercise that takes energy away, it actually energizes," Randolph says.

Yoga also alleviates the extraneous mind chatter that can turn chronic pain into misery through relentless anxiety about the condition. "Patients are left with the physical sensation of pain rather than the unnecessary emotional worries that tend to get wrapped around it," Randolph adds. "And that's the real gift yoga offers FS patients. It encourages living within the limits imposed by the body. When we yoke the body and the mind together, we train ourselves to find where we truly are and to stay within that boundary."

Dr. Brandeis of Yoga Nemo echoes this prescription of yoga as an aid for patients coping with the anxiety of illness. While Brandeis cites yoga's ability to have an impact in concrete ways, by lowering blood pressure, improving circulation, lessening the need for insulin in diabetics, and improving pulmonary function in children with asthma, he also considers yoga an invaluable restorative and anxiety-reducing practice for some of the special groups he treats: menopausal women, patients with HIV/AIDS, cancer survivors, deaf children, and at-risk teenagers. He hopes in particular to see research about yoga for the ongoing treatment of those living with HIV. "If we can take the anxiety ingredient out," Brandeis says, "we can help the patients cope with illness and also get better physically."

Relieving stress and anxiety is, of course, hard to quantify except by noting physiological changes, which presents a challenge to researchers. And yoga's most ephemeral benefits, such as the opening of energy channels, are even more difficult to define and evaluate in a research setting. Dr. Brandeis believes it will take more scientists with a much greater experiential knowledge of yoga to begin measuring what might be classified as energetic changes.

"Probably in the future [research will] try to translate energetic effects into concrete medicine, but right now there aren't enough practitioners with enough knowledge to generate that kind of interest," he says. James S. Gordon, M.D., director of the Center for Mind-Body Medicine in Washington, D.C., also sees energetic changes in yoga practitioners. "Stress relief is certainly part of it, but there's much more to it than that," Gordon says. "I don't think that's the whole story." Gordon suspects that yoga asanas activate different parts of the body in ways similar to the stimulation of the body's meridians in Chinese acupuncture.

Whether yoga is studied as a method for preventing or treating disease, as a way of coping with difficult-to-treat or chronic illnesses, or as a way of altering the energy state of the body, it's important to remember that yoga is a way of living and not an isolated technique, say the experts. "While many doctors and patients demand proof that yoga really can help certain medical conditions, they risk overlooking yoga's far-reaching benefits," says Elliott S. Dacher, M.D., author of Whole Healing: A Step-b\y-Step Program to Reclaim Your Power to Heal (Plume, 1997).

"Yoga is a way to get to the source of ourselves. The challenge is not to see yoga as a treatment for disease, but as an opportunity to see something deeper in the self. To reconnect with the body is one way of artfully facing the reality of pain in our life and a means for accepting and being with our lives more deeply," he adds. As researchers build a body of studies and trials confirming what yoga practitioners know so well, then, it may still come down to being in and with our bodies in ways too profound to measure.

Elaine Lipson writes about yoga, organic foods, natural health, and textiles. Alison Ashton, a writer based in San Diego, California, contributed to this article.