Innovative Journal Journal of Medical Biomedical and Applied Sciences 2277:4939 10 05 The role of Iyengar Yoga practice in chronic, non-malignant pain. A clinical review focused on current evidence 1 Chrysanthi Batistaki MD, MsC, PhD, Associate Professor of Anaesthesiology, 2nd Department of Anaesthesiology, Faculty of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, “Attikon” Hospital, 1Rimini str, 12452, Athens, Greece Georgios Batistakis Certified Iyengar Yoga Teacher, Athens, Greece, 2nd Department of Anaesthesiology, Faculty of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, “Attikon” Hospital, 1Rimini str, 12452, Athens, Greece Katerina Pylava Certified Iyengar Yoga Teacher, Athens, Greece, 2nd Department of Anaesthesiology, Faculty of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, “Attikon” Hospital, 1Rimini str, 12452, Athens, Greece Paraskevi Matsota Professor of Anaesthesiology, 2nd Department of Anaesthesiology, Faculty of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, “Attikon” Hospital, 1Rimini str, 12452, Athens, Greece Journal Article https://doi.org/10.15520/ijmhs.v10i03.282 Abstract Background: Chronic pain leads to severe functional disability and worsening of quality of life. The aim of this review is to assess the efficacy of Iyengar yoga on chronic non-malignant pain, in terms of pain intensity, functional status, and quality of life. Methods: Research focused on the efficacy of Iyengar yoga on non-malignant chronic pain, from 2019 and back, with studies only in English language. Results: Studies about Iyengar yoga were limited (N=17). Six studies were identified on low back pain, 3 on chronic neck pain, 2 on osteoarthritis, 2 on rheumatoid arthritis, 1 on irritable bowel syndrome and 1 on multiple sclerosis. Results were positive for low back pain, and beneficial in all other entities. Furthermore, Iyengar yoga requires an experienced certified teacher, and regular home practice. Conclusions: Iyengar yoga with could be beneficial as an adjuvant for chronic pain diseases, especially in patients with low back pain. Nambi, GopalS, Shanmugananth, Devi, Surbala, Inbasekaran, Dipika, Jagannathan, K, Khuman, Ratan, Changes in pain intensity and health related quality of life with Iyengar yoga in nonspecific chronic low back pain: A randomized controlled study, International Journal of Yoga, 2014, 7, 1, 48, 48, 0973-6131, 10.4103/0973-6131.123481, Medknow, https://dx.doi.org/10.4103/0973-6131.123481 Cohen, Steven P, Hooten, W Michael, Advances in the diagnosis and management of neck pain, BMJ, 2017, 358, j3221, j3221, 0959-8138, 1756-1833, 10.1136/bmj.j3221, BMJ, https://dx.doi.org/10.1136/bmj.j3221 Evans, Subhadra, Moieni, Mona, Taub, Rebecca, Subramanian, Saskia K., Tsao, Jennie C.I., Sternlieb, Beth, Zeltzer, Lonnie K., Iyengar Yoga for Young Adults with Rheumatoid Arthritis: Results From a Mixed-Methods Pilot Study, Journal of Pain and Symptom Management, 2010, 39, 5, 904, 913, 0885-3924, 10.1016/j.jpainsymman.2009.09.018, Elsevier BV, https://dx.doi.org/10.1016/j.jpainsymman.2009.09.018 Evans, Subhadra, Subramanian, Saskia, Sternlieb, Beth, Yoga as treatment for chronic pain conditions: A literature review, International Journal on Disability and Human Development, 2008, 7, 1, 25, 32, 2191-1231, 2191-0367, 10.1515/ijdhd.2008.7.1.25, Walter de Gruyter GmbH, https://dx.doi.org/10.1515/ijdhd.2008.7.1.25 Wieland, L S, Skoetz, N, Pilkington, K, Yoga treatment for chronic non specific low back pain. Cochrane Data base Syst Rev, Issue1. Art, 2017 Iyengar, Bks, The Tree of Yoga, Shambhala Publications, Boston, 2002 Williams, Kimberly, Abildso, Christiaan, Steinberg, Lois, Doyle, Edward, Epstein, Beverly, Smith, David, Hobbs, Gerry, Gross, Richard, Kelley, George, Cooper, Linda, Evaluation of the Effectiveness and Efficacy of Iyengar Yoga Therapy on Chronic Low Back Pain, Spine, 2009, 34, 19, 2066, 2076, 0362-2436, 10.1097/brs.0b013e3181b315cc, Ovid Technologies (Wolters Kluwer Health), https://dx.doi.org/10.1097/brs.0b013e3181b315cc Evans, Subhadra, Lung, Kirsten C., Seidman, Laura C., Sternlieb, Beth, Zeltzer, Lonnie K., Tsao, Jennie C.I., Iyengar Yoga for Adolescents and Young Adults With Irritable Bowel Syndrome, Journal of Pediatric Gastroenterology and Nutrition, 2014, 59, 2, 244, 253, 0277-2116, 10.1097/mpg.0000000000000366, Ovid Technologies (Wolters Kluwer Health), https://dx.doi.org/10.1097/mpg.0000000000000366 Hochberg, Marc C., Altman, Roy D., April, Karine Toupin, Benkhalti, Maria, Guyatt, Gordon, McGowan, Jessie, Towheed, Tanveer, Welch, Vivian, Wells, George, Tugwell, Peter, American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee, Arthritis Care & Research, 2012, 64, 4, 465, 474, 2151-464X, 10.1002/acr.21596, Wiley, https://dx.doi.org/10.1002/acr.21596 Whitehead, Alison, Gould Fogerite, Susan, Yoga Treatment for Chronic Non-Specific Low Back Pain (2017), EXPLORE, 2017, 13, 4, 281, 284, 1550-8307, 10.1016/j.explore.2017.04.018, Elsevier BV, https://dx.doi.org/10.1016/j.explore.2017.04.018 Iyengar, Bks, Light On Life, Rodale, London, 2005 Garfinkel, M S, Schumacher, H R, Husain, A, Evaluation of a yoga based regimen for treatment of osteoarthritis of the hands, J Rheumatol, 1994, 12, 2341, 2344 Kolasinski, Sharon L., Garfinkel, Marian, Tsai, Adam Gilden, Matz, Whitney, Dyke, Alison Van, Schumacher, H. Ralph, Iyengar Yoga for Treating Symptoms of Osteoarthritis of the Knees: A Pilot Study, The Journal of Alternative and Complementary Medicine, 2005, 11, 4, 689, 693, 1075-5535, 1557-7708, 10.1089/acm.2005.11.689, Mary Ann Liebert Inc, https://dx.doi.org/10.1089/acm.2005.11.689 Michalsen, Andreas, Traitteur, Hermann, Lüdtke, Rainer, Brunnhuber, Stefan, Meier, Larissa, Jeitler, Michael, Büssing, Arndt, Kessler, Christian, Yoga for Chronic Neck Pain: A Pilot Randomized Controlled Clinical Trial, The Journal of Pain, 2012, 13, 11, 1122, 1130, 1526-5900, 10.1016/j.jpain.2012.08.004, Elsevier BV, https://dx.doi.org/10.1016/j.jpain.2012.08.004 Iyengar, Bks, Yoga ; London, D K, The Path To Holistic Health, 2001 Wattamwar, R B, Nadkarni, K, Effect of conventional occupational therapy and yoga in chronic low back pain, Indian Journal of Occupational Therapy, 2013, 45, 3, 13, 20 Tilbrook, Helen E., Cox, Helen, Hewitt, Catherine E., Kang'ombe, Arthur Ricky, Chuang, Ling-Hsiang, Jayakody, Shalmini, Aplin, John D., Semlyen, Anna, Trewhela, Alison, Watt, Ian, Torgerson, David J., Yoga for Chronic Low Back Pain, Annals of Internal Medicine, 2011, 155, 9, 569, 569, 0003-4819, 10.7326/0003-4819-155-9-201111010-00003, American College of Physicians, https://dx.doi.org/10.7326/0003-4819-155-9-201111010-00003 Ulug, N, Yilmaz, O T, Kara, M, Effects of pilates and yoga in patients with chronic neck pain: a sonographic study, J Rehab Med, 2018, 50, 80, 85 Cramer, Holger, Klose, Petra, Brinkhaus, Benno, Michalsen, Andreas, Dobos, Gustav, Effects of yoga on chronic neck pain: a systematic review and meta-analysis, Clinical Rehabilitation, 2017, 31, 11, 1457, 1465, 0269-2155, 1477-0873, 10.1177/0269215517698735, SAGE Publications, https://dx.doi.org/10.1177/0269215517698735 Iyengar, Geeta, Yoga, Gem For, Women, Timeless books, 1990, Canada Oliveira, Crystian B., Maher, Chris G., Pinto, Rafael Z., Traeger, Adrian C., Lin, Chung-Wei Christine, Chenot, Jean-François, van Tulder, Maurits, Koes, Bart W., Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview, European Spine Journal, 2018, 27, 11, 2791, 2803, 0940-6719, 1432-0932, 10.1007/s00586-018-5673-2, Springer Science and Business Media LLC, https://dx.doi.org/10.1007/s00586-018-5673-2 Cramer, Holger, Lauche, Romy, Hohmann, Claudia, Langhorst, Jost, Dobos, Gustav, Yoga for Chronic Neck Pain: A 12-Month Follow-Up, Pain Medicine, 2013, 14, 4, 541, 548, 1526-2375, 1526-4637, 10.1111/pme.12053, Oxford University Press (OUP), https://dx.doi.org/10.1111/pme.12053 Oken, B. S., Kishiyama, S., Zajdel, D., Bourdette, D., Carlsen, J., Haas, M., Hugos, C., Kraemer, D. F., Lawrence, J., Mass, M., Randomized controlled trial of yoga and exercise in multiple sclerosis, Neurology, 2004, 62, 11, 2058, 2064, 0028-3878, 1526-632X, 10.1212/01.wnl.0000129534.88602.5c, Ovid Technologies (Wolters Kluwer Health), https://dx.doi.org/10.1212/01.wnl.0000129534.88602.5c Mehta, Silva, Shyam, Mira &, Yoga, Iyengar Way, D K, London, 1990 Iyengar National Association of United States (IYNAUS) Certification Committee, IYNAUS Certification Manual, 2002 Williams, K A, Petronis, J, Smith, D, Effect of Iyengar yoga therapy for chronic low back pain, Pain, 2005, 115, 107, 124 Iyengar, Bks, Light On Yoga, Thorsons, London, 2001 Cox, H, Tibrouk, H, Aplin, J, A randomised controlled trial of yoga for the treatment of chronic low back pain. Results of a pilot study, Complementary Therapies in Clinical Practie, 2010, 16, 187, 194