Yoga for arthritis: what it helps, how to adapt poses, and what to do in a flare

Exercise is a core treatment

NICE (the National Institute for Health and Care Excellence) recommends exercise tailored to you for everyone with osteoarthritis, and wants people to know that "exercise is not harmful to osteoarthritic joints". For rheumatoid arthritis, the American College of Rheumatology strongly recommends regular exercise, and conditionally recommends mind-body exercise such as yoga.

Sources 1, 2, 3

Knee osteoarthritis: about as good as other exercise

Reviews of yoga trials found less pain and stiffness and better function, and in 117 people yoga was as good as a strengthening programme for knee pain. The American College of Rheumatology conditionally recommends yoga for the knee, but makes no recommendation for the hip for lack of data.

Sources 4, 5, 6

Rheumatoid arthritis: modest gains

Small trials found modest improvements in disease activity and everyday function, but pain didn't clearly improve. Yoga goes alongside your medicines, never instead of them.

Sources 7, 8

Mood and sleep

Across rheumatic conditions, yoga eased low mood, anxiety and poor sleep, though not more than other exercise for low mood. In a trial of 75 inactive adults with arthritis, 8 weeks of classes improved physical health, walking and mood.

Sources 9, 10

Adapt, don't avoid

Use a chair for standing poses, pad or skip kneeling, keep weight off bent-back wrists, and hold your arms forward rather than overhead if your shoulders are sore. Most poses can be changed to suit your joints.

Source 11

In a flare, keep moving gently

Do less than usual, not nothing: gentle range-of-movement exercises and breathing, then build back up over a few days. Stop and rest if a pose makes a joint warm and swollen or causes severe pain.

Sources 12, 13

Osteoarthritis

The NHS calls exercise "one of the most important treatments for people with osteoarthritis, whatever your age or level of fitness", and NICE puts tailored exercise at the core of care. Knee and hip osteoarthritis have their own yoga guides.

Sources 14, 1

Rheumatoid arthritis

In rheumatoid arthritis the immune system attacks the lining of the joints, often starting in the small joints of the hands, wrists and feet, as our rheumatoid arthritis guide explains. When the inflammation settles, the joint capsule "can remain stretched", leaving the joint less stable, which is one reason not to force joints to the end of their range. Long-standing rheumatoid arthritis can also affect the joints at the top of the neck.

Sources 15, 16

What a trial class looked like

In a Johns Hopkins trial: questions (5 minutes), breathing (5), a gentle flowing sequence (15), poses for strength, flexibility and balance (20), relaxation (10) and a short meditation (5), twice a week for 8 weeks plus one session at home, with blocks, straps, blankets and chairs. In a Tasmanian knee trial: two 1-hour classes and one home session a week for 12 weeks, then three home sessions a week.

The effective rheumatoid arthritis programmes all had supervised group sessions, lasting a median of 8 weeks at about 68 minutes each, and some offered seated versions of standing poses and props to avoid kneeling. A chair yoga trial used 45 minutes twice a week for 8 weeks.

Sources 10, 5, 8, 17

How it should feel

NICE says joint pain may go up when you start exercising and that keeping going will still help. Our arthritis guide counts pain of 0 to 2 out of 10 as safe and up to 5 as acceptable if it has settled by the next morning. The Johns Hopkins arthritis team adds that going too far is sometimes "not felt until the next day".

Sources 1, 18

Guidelines include yoga, and put exercise firstStrong evidence

The American College of Rheumatology conditionally recommends yoga for knee osteoarthritis (tai chi is strongly recommended) and mind-body exercise for rheumatoid arthritis. EULAR (the European Alliance of Associations for Rheumatology) counts yoga as one kind of exercise and finds it "difficult to recommend one type of exercise over another". OARSI (the Osteoarthritis Research Society International) makes structured exercise a core treatment.

Sources 6, 3, 19, 20

Knee osteoarthritisEmerging evidence

Meta-analyses of 9, 8 and 14 studies found that yoga eased knee pain and stiffness and improved function, from very low to low certainty evidence with trials that varied a lot. A 2025 analysis of 92 trials (6,079 people with knee or hip osteoarthritis) ranked yoga third of five exercise types for pain, with no significant differences between them. Two small pilot trials in older adults found yoga eased knee symptoms more than waiting (36 women) and, at 8 weeks, more than aerobic and strengthening exercise (83 adults).

Sources 21, 4, 22, 23, 24, 25

As good as strengthening, in one trialEmerging evidence

In 117 adults in Tasmania, 12 weeks of yoga was as good as a strengthening programme for knee pain (a difference of about 1 point on a 100-point scale), and 7 of 27 other measures favoured yoga. Side effects possibly linked to the programmes were more common with yoga (15.5% against 6.8%), though none were serious and flare-ups of knee pain were about as common in both groups. The authors note their programme was designed for arthritis and doesn't reflect general community classes.

Source 5

Online videos alone: small, short-lived gainsEmerging evidence

In 212 adults with knee osteoarthritis, 12 weeks of unsupervised online yoga videos improved function a little but not pain when walking, and the benefits had gone by 24 weeks. Side effects were minor.

Source 26

Chair yogaEmerging evidence

In 131 older adults with hip or knee osteoarthritis who couldn't do standing exercise, chair yoga twice a week for 8 weeks reduced how much pain got in the way of life, and that lasted 3 months; pain, walking speed and tiredness improved only during the programme.

Source 17

Hip and hand osteoarthritisMixed evidence

We found no yoga trial in hip osteoarthritis on its own, and the Cochrane review of yoga for the hip or knee is still a protocol. For the hands, one small 1994 trial of weekly yoga for 8 weeks eased pain during activity and tenderness, but a 2019 meta-analysis found no clear effect.

Sources 6, 27, 28, 21

Rheumatoid arthritisEmerging evidence

Across 10 trials (840 people), yoga improved function, disease activity and grip strength but not pain, swollen or tender joints, or blood markers of inflammation. A 2025 review of 5 trials found moderate certainty for small improvements in disease activity and function, and very low certainty for pain. A 2026 review of 8 trials (651 people) found disease activity improved, but the change in function wasn't significant. The Cochrane review is still a protocol.

Sources 7, 8, 29, 30

One small new trialEmerging evidence

In 74 women with rheumatoid arthritis in remission, 8 weeks of yoga and of combined exercise both did better than usual care, and yoga eased pain more than combined exercise at 20 weeks, with a very large effect. It's one small trial, registered after it began, and the result needs confirming.

Source 31

Mood, sleep and fatigueEmerging evidence

Across rheumatic conditions, yoga eased depressive symptoms, anxiety and poor sleep, but not more than other exercise for depression, and most trials had a high or unclear risk of bias. In 26 young women with rheumatoid arthritis, 6 weeks of Iyengar yoga improved quality of life, mood and tiredness, and a review of 23 studies found better quality of life overall. The American College of Rheumatology's integrative recommendations cite low to moderate certainty evidence that mind-body approaches such as breathing and relaxation help depression, anxiety, fatigue and sleep in rheumatoid arthritis.

Sources 9, 10, 32, 3, 33

SafetyEmerging evidence

Across 94 trials, side effects were no more common with yoga than with usual care or other exercise. But many arthritis trials didn't report harms, and in one knee trial side effects possibly linked to the programme were more common with yoga than with strengthening (15.5% against 6.8%), though none were serious.

Sources 34, 5, 35

Once or twice a week, with home practice

Most trials used about an hour, once or twice a week, for 8 to 12 weeks, plus home practice; two of the rheumatoid arthritis programmes added about 40 minutes at home three times a week. Every effective rheumatoid arthritis programme included breathing and relaxation practice, not just poses.

Sources 10, 5, 8

More often may help knee painEmerging evidence

In the 14-study analysis, 4 to 7 sessions a week gave the largest effect on knee pain, and programmes of 8 weeks or more were needed for consistent benefit.

Source 22

Classes or videos

NICE suggests considering supervised exercise, which may help you keep going. In one trial, unsupervised online videos gave small gains that had gone by 24 weeks, though it didn't compare them with classes.

Sources 1, 2, 26

Our editorial starting point

A class, or our 30-minute follow-along session, once a week, and two short home sessions, alongside walking and strength exercises. Give it 8 to 12 weeks and build up gradually.

Sources 10, 22

Hands and wrists

Poses on all fours and plank put weight through bent-back wrists, and sun salutations take the wrists to about 85 degrees of bend in every round. Put a wedge under your palms, use your forearms or fists, or put your hands on a chair or wall instead. Our rheumatoid arthritis guide says to skip all-fours and kneeling moves while your wrists or knees are sore.

Sources 11, 36

Knees

Put a folded blanket under your knees when kneeling, and in tree pose keep your foot at the opposite ankle rather than pressing it against the knee. The Arthritis Foundation advises avoiding bending your knees past 90 degrees. After a knee replacement, the NHS says not to kneel on the new knee until your doctor says you can.

Sources 11, 37, 38

Hips

Sit on a chair or put blocks under your knees in cross-legged poses, and use a strap around your foot instead of folding deeply. The Johns Hopkins arthritis team advises caution with hip openers and poses that turn the hips out to the extreme. After a hip replacement, the NHS says not to cross your legs, bend the hip past 90 degrees or bend down to touch your feet while it recovers.

Sources 11, 18, 39

Your neck, with rheumatoid arthritis

Long-standing rheumatoid arthritis can affect the joints at the top of the spine, which can press on the spinal cord. It's uncommon but serious. Our rheumatoid arthritis guide's editorial advice is to leave out headstands, shoulder stands and plough, and not to force neck circles; gentle neck movement is fine unless your team says otherwise.

Source 16

Shoulders and spine

Hold your arms forward at shoulder height in chair pose if lifting them overhead hurts. Keep backbends small, with your head in line with your spine rather than dropped back.

Sources 11, 18

Balance

The Arthritis Foundation advises avoiding poses that balance on one foot, but the American College of Rheumatology conditionally recommends balance exercise for osteoarthritis. Our arthritis guides keep balance work, with a hand on a chair or counter.

Sources 37, 6

Joint replacements

Arthritis UK (formerly Versus Arthritis) suggests finding an instructor who can help you adjust movements, "especially if you have had any joint replacements". With a replaced joint, check the positions to avoid with your orthopaedic team.

Sources 40, 11

Gentle, chair, restorative or Iyengar

The Johns Hopkins arthritis team rates gentle, chair, restorative and Iyengar classes as suitable for most people with arthritis. It doesn't recommend hot yoga, because of the heat, or ashtanga, which is very strenuous, and says fast flowing vinyasa classes often move too quickly to allow changes and props.

Sources 18, 11

Find the right class

The Arthritis Foundation suggests starting in a class or with a private instructor, looking for classes designed for arthritis or gentle, beginners or seniors classes, and arriving early to tell the teacher about your arthritis.

Source 41

Relative rest, not bed rest

The National Rheumatoid Arthritis Society (NRAS) advises doing less than usual, not bed rest; ice for a hot, inflamed joint or heat for a stiff one; gentle range-of-movement exercises; then restarting your usual exercise with only a few repetitions for a few days and building back up. The NHS says rest makes inflamed joints more comfortable, but without movement joints stiffen and muscles weaken.

Sources 12, 13

What to do in a flare

Arthritis UK suggests slow, gentle movement rather than stopping altogether, and stretching rather than strengthening while joints are hot or swollen. Restorative poses, supported with props, "may be especially appropriate during flares or periods of fatigue", the Johns Hopkins team says. Breathing and relaxation suit flare days too.

Sources 42, 40, 11

When to stop

If a pose makes your joints warm and swollen, or causes severe pain, stop and rest, and if it always causes a flare, find an alternative. NICE says people with rheumatoid arthritis should have rapid access to specialist care for flares, so call your rheumatology advice line if a flare won't settle.

Sources 13, 43

Psoriatic arthritis

The NHS says "low impact exercises like swimming, walking and yoga can help strengthen and protect your joints". Our psoriatic arthritis guide covers exercise and flares.

Source 44

Axial spondyloarthritisEmerging evidence

Across 15 studies of mind-body exercise, including tai chi, yoga, Pilates and qigong, function, disease activity, pain and spinal movement improved a little, with moderate to low certainty and no serious side effects. Our ankylosing spondylitis guide has a daily routine.

Source 45

Call 999

Stop exercising and call 999 for (from our arthritis guide; in the US, call 911):

• Chest pain that feels tight or like squeezing, or spreads to your arms, neck or jaw.
• Severe difficulty breathing, or pale, blue or grey lips or skin.
• Someone who has passed out and isn't responding normally.

Get help the same day

Ask for an urgent GP appointment or get help from NHS 111 if:

• You have severe pain and swelling in just one joint that started suddenly.
• The skin around a joint is red or hot (redness can be harder to see on brown and black skin), or you have sore joints with a high temperature or feel hot, cold or shivery. A joint infection usually needs hospital treatment.
• Your pain doesn't get better with painkillers.
• You have sore joints with sore eyes or vision problems, or with pain when you pee or a rash or sores on your genitals.
• Sudden pain and swelling in a joint is getting worse, with a very high temperature, or feeling sick or unable to eat.

Sources 46, 47

With rheumatoid arthritis, get urgent advice the same day

Contact your rheumatology advice line, GP or NHS 111 the same day for:

• Pins and needles, weakness, unsteadiness, clumsy hands or loss of power, especially with neck pain: these can be signs of pressure on the spinal cord.
• A hot, swollen joint with a fever or feeling unwell, especially a replaced joint: it could be an infection.
• A flare that won't settle.

Sources 16, 43

See a GP soon

• Pain, swelling or stiffness in your joints that you can't explain and that doesn't go away in a few days.
• Morning stiffness that lasts much longer than 30 minutes, several swollen joints (often on both sides), or feeling tired, feverish or losing weight. These can be signs of an inflammatory arthritis such as rheumatoid arthritis, where early treatment matters.
• Pain, heat and swelling after exercise that last more than a few days.

Source 46

In class

"If it hurts, stop", the Johns Hopkins arthritis team says. Stop and rest if a pose makes a joint warm and swollen or causes severe pain, and ease off next time if a joint aches more the next day.

Sources 18, 13

"Yoga can cure arthritis"Mixed evidence

The benefits are modest: some easing of pain and stiffness in knee osteoarthritis, and small gains in disease activity, function and mood in rheumatoid arthritis. Nothing shows it reverses joint damage, and it doesn't replace your medicines.

Sources 4, 8, 9

"People with arthritis should avoid yoga"Strong evidence

Guidelines include it: the American College of Rheumatology conditionally recommends yoga for knee osteoarthritis and mind-body exercise for rheumatoid arthritis, and EULAR counts it as exercise. The NHS, Arthritis UK and NRAS all mention yoga as a gentle option.

Sources 6, 3, 19, 44, 40, 12

"Exercise wears out arthritic joints"Strong evidence

NICE's guideline committee wanted to reassure people "that exercise is not harmful to osteoarthritic joints", and that regular exercise over time can reduce pain and improve function.

Source 2

"No pain, no gain"Mixed evidence

"If it hurts, stop" is the Johns Hopkins arthritis team's rule for yoga. Some discomfort when you start exercising is expected and fine if it settles, but pain isn't a sign of a good session.

Sources 18, 1

"Hot yoga loosens stiff joints, so it's better for arthritis"Mixed evidence

We found no trial of hot yoga in arthritis, and the Johns Hopkins team doesn't recommend it because of the extreme heat.

Sources 18, 11

"Yoga is too gentle to make a difference"Emerging evidence

In trials, classes improved physical health and walking distance, and yoga matched a strengthening programme for knee pain. The Arthritis Foundation lists this among its yoga myths.

Sources 10, 5, 37