Inflammation, Yoga and the NHS

In September I started a physiotherapy degree at Kings College London and dived deeply into the realms of human anatomy, physiology and disease. So far it has been fascinating, overwhelming and frustrating. Fascinating because the human body is amazing and it's a privilege to be learning about it in such detail. Overwhelming because I'm not sure how I'm going to memorise everything I'm being taught. And to find out about the frustration read on!

As a yoga teacher and scientist I have a strong belief in the healing potential of yoga. I have seen it many times in the students I teach, in myself and in the growing body of scientific research into various therapeutic applications of yoga. I am always viewing the body from a yoga perspective as well as a physio perspective. I look for links between the two areas and ways yoga might help in some conditions. The more I learn, the more convinced I am that yoga could be beneficial in so many health conditions. But the greatest potential for yoga is in reducing one of the major pandemics of the western world; inflammation.

Inflammation is the single most recurrent theme in my course. Lecturers come back to it again and again when talking about things that can go wrong within the body and how to reduce inflammation when it has got out of control. Sometimes, the causes of inflammation are obvious e.g. as a result of a sprained ankle, but in other cases, such as a spontaneously occurring frozen shoulder, we simply don't know. 

We do know inflammation can affect any part of the body, muscle, nerves, connective tissue, joints etc. We know it is helpful as part of an acute healing response but extremely unhelpful if it becomes chronic, linking in to chronic pain and other issues. And we know diseases which cause inflammation in the body, stress and external irritants can all increase risk of other inflammatory conditions. However, reducing inflammation is very poorly understood, especially when it becomes chronic. Except yoga can do just that.

Yoga and meditation have been proved to reduce inflammatory blood markers in patients with cancer1, heart failure2 and chronic pain3 and in members of the general population4. These are all rigorous studies published high impact journals and are just a snapshot of the wonderful research being done into the therapeutic benefits of yoga and meditation.  But not once have they been mentioned as useful interventions in any of my lectures. A situation which I find incredibly frustrating! From a patient perspective, they are being denied drug free and enjoyable way to help treat themselves which has proven physiological and physiological benefits. For the cash strapped NHS yoga offers great potential as a cheap, safe and efficient (particularly group classes) way to reduce inflammation in patients with many different diseases.

How yoga and meditation reduce inflammation will be the topic of a future blog, but now the evidence is available I don’t understand why it is taking so long for them to be routinely offered to patients. We are gradually starting to see some patchy inclusion but it’s still very much on the whim of individual hospitals and wards. My dream is to see yoga thoroughly integrated into the NHS and for that to happen it needs to start being included in NICE guidelines. A huge break though has happened with the most recent set of NICE guidelines for lower back pain which include yoga for the first time! Hopefully this will be the first of many more inclusions for yoga but it’s important to keep up the pressure.

If you are a patient and think yoga could help especially if you are suffering from inflammatory conditions then talk to the health care professional/s (HCPs) treating you. One of the key priorities in the NHS is ‘client focused care’ e.g giving the patient as far as possible what they want. If there is increasing patient demand for yoga then more HCPs will start to listen. If you are a HCP be open minded about the benefits of yoga and maybe even have a look at some of the research out there. You might be surprised at the quality and the results! If you are a yoga teacher again why not investigate some of the research and keep you students informed. Finally if you are a researcher keep doing research the more we have the more convincing our arguments. I know from experience it can be quite difficult to get funding for this kind of research (I was tantalizingly close to doing a project on yoga for chronic pelvic pain which fell though at the last minute) but please keep trying and if anyone would like to collaborate on a project then please get in touch!!

1. J.K. Kiecolt-Glaser,. et al., “Yoga's Impact on Inflammation, Mood, and Fatigue in Breast Cancer Survivors: A Randomized Controlled Trial” Journal of Clinical Oncology, vol 32, no. 10, pp. 1040-1049, 2014. 

2. P. Pullen, et al., “Effects of yoga on inflammation and exercise capacity in patients with chronic heart failure,” Journal of Cardiac Failure, vol. 14, no. 5, pp. 407–413, 2008.

3. A. Wren, et al., “Yoga for persistent pain: New findings and directions for an ancient practice,” Pain, vol. 152, no. 3, pp. 477–480, 2011.

4. P. Kaliman, et al., “Rapid changes in histone deacetylases and inflammatory gene expression in expert meditators,” Psychoneuroendocrinology, vol. 40, pp. 96–107, 2014.