Abstract
While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopenia. Pranayama, hatha yoga, and Bikram yoga were the most common yoga practices; headstand, shoulder stand, lotus position, and forceful breathing were the most common yoga postures and breathing techniques cited. Twenty-seven adverse events (35.5%) affected the musculoskeletal system; 14 (18.4%) the nervous system; and 9 (11.8%) the eyes. Fifteen cases (19.7%) reached full recovery; 9 cases (11.3%) partial recovery; 1 case (1.3%) no recovery; and 1 case (1.3%) died. As any other physical or mental practice, yoga should be practiced carefully under the guidance of a qualified instructor. Beginners should avoid extreme practices such as headstand, lotus position and forceful breathing. Individuals with medical preconditions should work with their physician and yoga teacher to appropriately adapt postures; patients with glaucoma should avoid inversions and patients with compromised bone should avoid forceful yoga practices.
Highlights
Yoga is rooted in Indian philosophy and has been a part of traditional Indian spiritual practice for around 3000 years [1]
Adverse events were classified as yoga-associated if they appeared in temporal connection with yoga practice and/or a causal relationship was assumed by the authors of the report
10, 2013 using the following search strategy: (Yoga[MeSH Terms] OR Yoga[Title/Abstract] OR Yogic[Title/Abstract] OR Asana[Title/ Abstract] OR Pranayama[Title/Abstract]) AND (Case Reports[Publication Type] OR Case[Title/Abstract] OR Cases[Title/Abstract] OR Adverse[Title/Abstract]). Abstracts identified during this initial literature search were screened and adverse events that were associated with yoga practice in the retrieved abstracts were included in the final search strategy
Summary
Yoga is rooted in Indian philosophy and has been a part of traditional Indian spiritual practice for around 3000 years [1]. While yoga traditionally comprises advice for ethical lifestyle and spiritual practice [1,2,3,4], it is most often associated with physical postures (asanas), breathing techniques (pranayama), and meditation (dyana) in North America and Europe [2]. These more physically-oriented yoga forms are gaining increased popularity as a therapeutic practice: in 2008, about 15% of the American adult population reported practicing yoga or being at least strongly interested in it [5]. Yoga has been recognized as medical therapy: about 14 million Americans (6.1% of the population) reported that yoga was recommended to them by a physician or other therapist [5]
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