Therapeutic Yoga for the Management of Chronic Nonspecific Neck Pain: Current Evidence and Mechanisms

Abstract

Chronic nonspecific neck pain (CNNP), which is neck pain in the absence of attributable structural and neurological findings, is often challenging for medical and rehabilitation professionals to treat. Conventional treatments such as medications and physical therapy often fail to provide lasting relief, which leads patients to pursue complementary therapies such as yoga. This review discusses the evidence from nine studies, including four randomized controlled trials, which suggests that a supervised yoga program may decrease pain intensity, disability, and mood symptoms in adults with CNNP. Cervical range of motion and quality of life (both physical and mental) may also improve with yoga intervention, although this is less consistent across studies. Evidence of yoga’s superiority to other exercise-based practices such as pilates was conflicting. Adverse effects of yoga, such as exacerbation of neck pain, were relatively uncommon, minor, and often transient. This article also comprehensively reviews the pathophysiology of CNNP, therapeutic mechanisms of yoga, and limitations in the evidence (including risk-of-bias assessment). Future studies should attempt to: (1) compare the effectiveness of different lineages of yoga for individuals with CNNP, (2) determine the optimal length and duration of these yoga interventions, (3) better characterize the physical and psychological mechanisms of yoga, (4) compare yoga to other exercise- and mindfulness-based practices, (5) evaluate the effect of yoga on sleep in the CNNP population, and (6) explore the applicability/efficacy of virtual yoga instruction.

Impact of yoga asanas on flexion and relaxation phenomenon in women with chronic low back pain: Prophet model prospective study

“…38,39 The painrelieving effects of yoga may be attributed to various mechanisms, including the activation of endogenous pain modulation systems, the promotion of relaxation and stress reduction, the release of endorphins, and the improvement of body awareness and posture. 40,41 Exploring the potential mechanisms through which yoga asanas may impact the FRP and pain in chronic NSLBP is essential for understanding the therapeutic effects of yoga. Yoga combines physical postures (asanas), breathing exercises (pranayama), and mindfulness practices, creating a holistic approach to mind-body integration.…”

“…42 This integration may contribute to the observed improvements in muscle function, reduced muscle tension, and pain modulation. 40,41 The physical postures in yoga involve stretching, strengthening, and balancing the body, which can help improve muscle strength, flexibility, and coordination. 43 By targeting specific muscle groups in the back, abdomen, and pelvis, yoga asanas may enhance muscle activation, improve muscular endurance, and promote muscular relaxation during flexion movements.…”

“…Decreasing pain levels can enhance individuals' ability to engage in daily activities, improve overall well‐being, and reduce the reliance on pain medications 38,39 . The pain‐relieving effects of yoga may be attributed to various mechanisms, including the activation of endogenous pain modulation systems, the promotion of relaxation and stress reduction, the release of endorphins, and the improvement of body awareness and posture 40,41 …”

“…Yoga combines physical postures (asanas), breathing exercises (pranayama), and mindfulness practices, creating a holistic approach to mind–body integration 42 . This integration may contribute to the observed improvements in muscle function, reduced muscle tension, and pain modulation 40,41 …”

Yoga as an adjunct therapy for musculoskeletal pain and burnout in orthopedic surgery: A trainee's perspective

“…describe improved pain intensity and mood with yoga intervention among individuals with chronic neck pain, with few adverse events. [ 19 ] Similarly, multiple randomized controlled trials and systematic reviews have been conducted with yoga used as a therapeutic intervention in patients with chronic lower back pain. These studies universally report improved back pain and functional capacity from yoga therapy,[ 20 21 22 ] with one study citing improvements in symptoms of depression and anxiety in addition to treating back pain.…”