Therapeutic yoga is defined as the application of yoga postures and practice to the treatment of health conditions. A 3,000 year old tradition, yoga, is now regarded in the Western world as a holistic approach to health and is classified by the National Institutes of Health as a form of Complementary and Alternative Medicine.  The word “yoga” comes from a Sanskrit root “yuj” which means union, or yoke, to join, and to direct and concentrate one’s attention.

Regular practice of yoga promotes strength, endurance, flexibility and facilitates characteristics of friendliness, compassion, and greater self-control, while cultivating a sense of calmness and well-being. Sustained practice also leads to important outcomes such as changes in life perspective, self-awareness and an improved sense of energy to live life fully and with genuine enjoyment. The practice of yoga produces a physiological state opposite to that of the flight-or-fight stress response and with that interruption in the stress response, a sense of balance and union between the mind and body can be achieved.

Yoga is a form of mind-body health regime that involves a combination of practices and an internally directed mindful focus on awareness of the self, the breath, and energy.

Four basic principles underlie the teachings and practices of yoga’s healing system:

1. The first principle is the human body is a holistic entity comprised of various interrelated dimensions inseparable from one another and the health or illness of any one dimension affects the other dimensions.
2. The second principle is individuals and their needs are unique and therefore must be approached in a way that acknowledges this individuality and their practice must be tailored accordingly.
3. The third principle is yoga is self empowering; the student becomes his or her own healer. Yoga engages the student in the healing process; by playing an active role in their journey toward health, the healing comes from within, instead of from an outside source and a greater sense of autonomy is achieved.
4. The fourth principle is that the quality and state of an individual’s mind is crucial to healing. When the individual has a positive mind-state healing happens more quickly, whereas if the mind-state is negative, healing may be prolonged.

Yoga philosophy and practice were first described by Patanjali in the classic text, Yoga Sutras, which is widely acknowledged as the authoritative text on yoga. Today, many people identify yoga only with asana, the physical practice of yoga, but asana is just one of the many tools used for healing the individual; only three of the 196 sutras mention asana and the remainder of the text discusses the other components of yoga including conscious breathing, meditation, lifestyle and diet changes, visualization and the use of sound, among many others.

In Yoga Sutras, Patanjali outlines an eightfold path to awareness and enlightenment called ashtanga, which literally means “eight limbs”. The eight limbs are comprised of ethical principles for living a meaningful and purposeful life; serving as a prescription for moral and ethical conduct and self-discipline, they direct attention towards one’s health while acknowledging the spiritual aspects of one’s nature. Any of the eight limbs may be used separately, but within yoga philosophy the physical postures and breathing exercises prepare the mind and body for meditation and spiritual development. Based on Patanjali’s eight limbs, many different yogic disciplines have been developed. Each has its own technique for preventing and treating disease.

In the Western world, the most common aspects of yoga practiced are the physical postures and breathing practices of Hatha yoga and meditation. Hatha yoga enhances the capacity of the physical body through the use of a series of body postures, movements (asana), and breathing techniques (pranayama). The breathing techniques of Hatha yoga focus on conscious prolongation of inhalation, breathe retention, and exhalation. It is through the unification of the physical body, breath, and concentration, while performing the postures and movements that blockages in the energy channels of the body are cleared and the body energy system becomes more balanced.

Yoga is recognized as a form of mind-body medicine that integrates an individual’s physical, mental and spiritual components to improve aspects of health, particularly stress related illnesses. It shows that stress contributes to the etiology of heart disease, cancer, and stroke as well as other chronic conditions and diseases. Due to the fact that stress is implicated in numerous diseases, it is a priority to include a focus on stress management and reduction of negative emotional states in order to reduce the burden of disease.

The scientific study of yoga has increased substantially in recent years and many clinical trials have been designed to assess its therapeutic effects and benefits. As participation rates in mind-body fitness programs such as yoga continue to increase, it is important for health care professionals to be informed about the nature of yoga and the evidence of its many therapeutic effects. Thus, this review of the literature is timely and important and provides information regarding the therapeutic effects of yoga in various populations concerning a multitude of different ailments and conditions.

Therapeutic yoga is defined as the application of yoga postures and practice to the treatment of health conditions. Yoga therapy involves instruction in yogic practices and teachings to prevent reduce or alleviate structural, physiological, emotional and spiritual pain, suffering or limitations. Yogic practices enhance muscular strength and body flexibility, promote and improve respiratory and cardiovascular function, promote recovery from and treatment of addiction, reduce stress, anxiety, depression, and chronic pain, improve sleep patterns, and enhance overall well-being and quality of life.

Mental health problems such as depression, anxiety, stress, and insomnia are among the most common reasons for individuals to seek treatment with complementary therapies such as yoga. Yoga encourages one to relax, slow the breath and focus on the present, shifting the balance from the sympathetic nervous system and the flight-or-fight response to the parasympathetic system and the relaxation response.

The latter is calming and restorative; it lowers breathing and heart rate, decreases blood pressure, lowers cortisol levels, and increases blood flow to the intestines and vital organs. One of the main goals of yoga is to achieve tranquility of the mind and create a sense of well-being, feelings of relaxation, improved self-confidence, improved efficiency, increased attentiveness, lowered irritability, and an optimistic outlook on life. The practice of yoga generates balanced energy which is vital to the function of the immune system. Yoga leads to an inhibition of the posterior or sympathetic area of the hypothalamus. This inhibition optimizes the body’s sympathetic responses to stressful stimuli and restores autonomic regulatory reflex mechanisms associated with stress. Yogic practices inhibit the areas responsible for fear, aggressiveness and rage, and stimulate the rewarding pleasure centers in the median forebrain and other areas leading to a state of bliss and pleasure. This inhibition results in lower anxiety, heart rate, respiratory rate, blood pressure, and cardiac output in students practicing yoga and meditation.

Consistent yoga practice improves depression and can lead to significant increases in serotonin levels coupled with decreases in the levels of monoamine oxidase, an enzyme that breaks down neurotransmitters and cortisol. A range of therapeutic approaches is available for the management of depressive disorders, but many patients turn to complementary therapies due to the adverse effects of medication, lack of response or simply preference for the complementary approach. A number of studies demonstrate the potential beneficial effects of yoga interventions on depression, stress, and anxiety. Improved flexibility is one of the first and most obvious benefits of yoga. With continued practice comes a gradual loosening of the muscles and connective tissues surrounding the bones and joints; this is thought to be one reason that yoga is associated with reduced aches and pains. Yoga helps to build muscle mass and/ or maintain muscle strength, which protects from conditions such as arthritis, osteoporosis and back pain. During a yoga session, the joints are taken through their full range of motion, squeezing and soaking areas of cartilage not often used and bringing fresh nutrients, oxygen and blood to the area, which helps to prevent conditions like arthritis and chronic pain. Without proper sustenance, neglected areas of cartilage will eventually wear out and expose the underlying bone. Numerous studies have shown that asana, meditation or a combination of the two reduced pain in people with arthritis, Carpel Tunnel syndrome, back pain and other chronic conditions. Yoga also increases proprioception and improves balance.

Yoga increases blood flow and levels of hemoglobin and red blood cells which allows for more oxygen to reach the body cells, enhancing their function. Yoga also thins the blood which can decrease the risk of heart attack and stroke, as they are often caused by blood clots. Twisting poses wring out venous blood from internal organs and allow oxygenated blood to flow in when the twist is released. Inverted poses encourage venous blood flow from the legs and pelvis back to the heart and then pumped through the lungs where it becomes freshly oxygenated. Many studies show yoga lowers the resting heart rate, increases endurance, and can improve the maximum uptake and utilization of oxygen during exercise. Consistently getting the heart rate into aerobic range lowers the risk of heart attack. While not all yoga is aerobic, even yoga exercises that do not increase heart rate into the aerobic range can improve cardiovascular functioning. While yoga is not a cure for a cancer, nor a definitive way of preventing it, yoga increases physical, emotional and spiritual wellness, and brings about a certain peace, of which many cancer patients desire.

Yogasanas, pranayama (breathing exercises), and meditation can reduce stress, promote healing, and enhance quality of life for patients with cancer. The growth of tumors and other cancer indicators are exacerbated by stress, thus it is especially important for people with cancer to reduce and manage stress effectively. Several premises exist as rationale for applying yoga-based interventions with cancer patients. Research suggests that yoga can produce an invigorating effect on mental and physical energy that improves fitness and reduces fatigue. Additionally, when practicing yoga, a fundamental emphasis is placed on accepting one’s moment-to-moment experiences creating mindfulness and not forcing the body past its comfortable limits. Having this healthy sense of acceptance is especially important for individuals dealing with life-threatening illness as it decreases the stress one experiences from unpleasant symptomology. Initially, cancer patients likely benefit from the poses themselves which are designed to exercise each and every muscle, nerve and gland throughout the body The postures precisely address the tension, holding, and blockage of energy in any particular joint or organ. As this tension is released, energy flows more readily throughout the body and allows patients to experience a sense of increased well-being and strength as well as a balance of mind, body and spirit.