When it comes to treating various types of arthritis, studies generally focus on medications—comparing one to another, one to placebo, or monotherapies versus combination treatment regimens. But what about options past the pill bottle or injection?
Evidence on alternative therapies is not as robust as data on traditional treatment, but as these practices increase in popularity, more patients are questioning how they may benefit from these therapies. Here, DocWire highlights two popular options: yoga and tai chi.
Yoga comes in a variety of forms—some more physically challenging than others—but the central theme is on finding a connection between your body and your breath. Yoga has grown significantly more popular in the United States in recent years. In 2012, 20.4 million Americans reported practicing yoga, compared to 15.8 million in 2008, according to data collected by Sports Marketing Surveys USA on behalf of Yoga Journal. And among those who do not have a current yoga practice, 44.4% said they are interested in trying. But is yoga for everyone—particularly, those with arthritis?
— Dr Ai Lyn Tan (@DrAiLynTan) May 2, 2019
Contrary to popular belief, arthritis patients shouldn’t avoid yoga; in fact, it could very well be of great benefit. One study of sedentary rheumatoid arthritis (RA) patients found an association between yoga and improvements in physical component summary, flexibility, 6-minute walk test (6MWT), and certain psychological and health-related quality of life outcomes. These benefits were observed over an eight-week period, and most outcomes still persisted after nine months.
In another trial, RA patients were stratified into two groups: a combination therapy of disease modifying anti-rheumatic drugs (DMARDs) and yoga, or DMARDs alone. After eight weeks, the yoga group presented significantly reduced levels of several systemic inflammatory markers; disease activity score 28, erythrocyte sedimentation rate and health assessment questionnaire disability index also showed significant improvement compared to the DMARDs group.
In addition to the physical benefits, the yoga group showed reduced depressive symptoms. Other research has also found that practicing yoga could help arthritis patients improve their relationship with their pain.
Tai chi has its roots in ancient China, but like yoga has become more common in the U.S. and also focuses on a mind-body connection. A new study examined outcomes for osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA). Patients who practiced tai chi for 12 weeks had better scores in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function score, 6MWT, and Short Form (36) Health Survey for the physical and mental components.
One study observed the effects of tai chi in older patients with knee OA. For eight weeks, researchers measured area and mean velocity of center of pressure movements (CoP) on patients before and after 60 minutes of tai chi. Tai chi was associated with a significant decrease in the area of CoP in standing position, as well as the mean velocity of CoP. The researchers therefore suggested, “it might be concluded that motor control and postural stability improvements have occurred.”
A literature review evaluated existing data regarding tai chi’s impact on numerous conditions and found “excellent evidence” that tai chi could benefit fall prevention and OA, as well as “fair evidence” supporting a positive association between tai chi and osteoporosis.
It’s so important that we support, empower and enable people with rheumatic and musculoskeletal diseases to find the best forms of #physicalactivity that works for them, and most importantly, that they enjoy. Just telling people to exercise isn’t enough! #BSR19 https://t.co/S2zq3MmPs1
— Dr Simon Stones (@SimonRStones) May 2, 2019
Bottom Line: Jury Is Still Out
Many of the studies on alternative therapy options had a similar message: there is not enough existing literature to make a conclusive statement on alternative therapies for rheumatic diseases. Large, long-term, randomized clinical trials must be conducted to fully understand if—and how—options beyond the pharmacy counter can benefit patients.
Still, activities like yoga and tai chi—when performed safely—could have benefits beyond possible disease treatment. These are often group classes that give patients a chance to socialize and interact with others. Physical activity is also associated with improved mood, which could perhaps help patients cope with the symptoms of their disease.