Yoga guide
Gentle yoga is one of the low-impact activities the NHS suggests for psoriatic arthritis (PsA), and US guidance prefers low-impact exercise such as yoga, tai chi and swimming when the arthritis is active, though that preference rests on very low-quality evidence. No trial has tested yoga in PsA: the trials are of interval and strength training, which made people fitter and stronger without making the arthritis more active. Yoga works alongside your medicines, not instead of them.
This guide covers how to adapt yoga for sore heels, hands and wrists, the spine and your skin (mats, kneeling, sweat and hot rooms), what to do in a flare and on tired days, what the evidence shows, and which of our gentle classes to follow. Medicines that lower your immunity make infections more likely, so the warning signs matter: a hot, swollen joint with a fever, or a red, painful eye, needs help the same day.
The NHS lists yoga among low-impact exercise that can help strengthen and protect your joints, and US guidance prefers low-impact exercise such as yoga, tai chi and swimming when PsA is active: a conditional recommendation on very low-quality evidence. We found no trial of yoga in PsA.
European guidance calls physical activity an integral part of standard care in inflammatory arthritis. Medicines are the main treatment and carry the inflammation; exercise adds fitness, strength and movement.
In 67 people, hard interval training raised fitness without raising disease activity or inflammation on scans, and in 41, strength training improved everyday function. A 2026 review rates all this evidence very low certainty.
About 4 in 10 people with PsA have pain where tendons attach to bone, most often at the Achilles and under the heel, and psoriasis can appear where skin is rubbed. Keep impact low while a heel is sore, use forearms, fists or a chair for sore wrists, and pad your knees and elbows.
Slow, gentle movement rather than stopping: breathing, small-range moves and supported rest on bad days, and stretching rather than strengthening a hot, swollen joint.
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A hot, swollen joint with a fever, a red, painful eye, a sudden pus-filled skin flare, and infection signs on methotrexate or a biologic all need help quickly. The full lists are below.
A long-term inflammatory arthritis that affects some people with psoriasis: pain, swelling and stiffness in one or more joints, swollen fingers or toes, nail changes and tiredness. Symptoms can be worse first thing in the morning and may improve with exercise. It belongs to the same family as ankylosing spondylitis (spondyloarthritis).
Across 266 studies, about 1 in 5 people with psoriasis had PsA (19.7%), a little more in European studies. In some people the arthritis comes before the skin.
Pain where tendons attach to bone (enthesitis) affects about 4 in 10, most often at the Achilles, under the heel and at the outer elbow. A whole finger or toe swells (dactylitis) in about a quarter, nails are affected in about 60%, and about 1 in 30 get a painful red eye (uveitis). In early PsA, the spine was involved in 27% of 409 people.
About half of people with PsA have fatigue. Heart and circulation disease is about 43% more common, and guidelines ask doctors to look out for weight, blood sugar, the heart and low mood, so yoga is best paired with walking or cycling.
Flares come and go: about 22% to 23% of people had one over a year, and there's no agreed definition. NICE says your team should consider a flare plan, including self-care such as exercises and stretching.
As low-impact movement for stiff joints and the spine, strength in standing poses, balance, slow breathing and rest, adapted for sore heels, hands and skin, alongside medicines, walking or cycling, and a physiotherapist's programme if you have one (our reading).
Medicines treat the inflammation of PsA. Exercise trials in PsA are few and small; the yoga evidence comes from ankylosing spondylitis.
PubMed found 1 record for yoga or other mind-body practices with PsA (an app study, not a trial) and none for yoga trials in psoriasis; Europe PMC found none.
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European recommendations advocate physical activity as an integral part of standard care in inflammatory arthritis, and their 2025 update adds sitting less. The NHS says to exercise regularly.
The US guideline prefers low-impact exercise, such as tai chi, yoga and swimming, to high-impact exercise such as running when PsA is active. It's a conditional recommendation on very low-quality evidence, and high-impact exercise is fine if you prefer it and have no reason not to.
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In 67 people in Norway, 11 weeks of interval training raised fitness and didn't change disease activity or pain; scans showed no extra inflammation in joints, tendon attachments or the spine. In 41 people in Brazil, strength training twice a week for 12 weeks improved everyday function.
A 2024 review found only one PsA exercise trial at low risk of bias, and a 2026 review of reviews rates the PsA findings very low certainty. Flares from exercise looked uncommon across 13 studies.
In axial spondyloarthritis, mind-body exercise (15 trials, 2 of them yoga) improved function and disease activity a little, at moderate to low certainty, and a 2026 analysis of 59 trials found yoga eased pain. A Cochrane review found exercise in general improved function by about 1.3 points out of 10. These are in ankylosing spondylitis, not PsA, but they're the nearest evidence for spinal PsA.
Observational studies link heavy, repeated load with tendon and joint changes in PsA, though they can't show cause, and a single badminton session was well tolerated in 16 people. Building load gradually is the sensible reading.
The Achilles and the underside of the heel were the commonest painful tendon sites in a cohort of 803 people. While a heel is sore, step back rather than jump, keep standing holds short, and do calf work seated or as holds. Heel or tendon pain that doesn't settle needs checking.
With sore wrists, a swollen finger or psoriasis on your palms or nails, take weight on your forearms, fists, a wedge under the palms, or a chair or wall instead of flat hands (our suggestion, as our rheumatoid arthritis yoga guide advises). The Psoriasis Association says friction can make psoriasis on the hands worse.
If a joint is hot and swollen, do the stretches only, gently, until it settles.
The spine was involved in about 1 in 4 people with early PsA. NICE's exercise advice for spondyloarthritis of the spine includes stretching, strengthening, posture, deep breathing, back bends and moving the whole spine; our yoga for ankylosing spondylitis guide has a class built that way.
Leave out weight on your head and neck, such as headstands and shoulder stands, and never push into a stiff or fused section, as our ankylosing spondylitis guide advises.
Psoriasis can appear where skin is injured or rubbed, including where shoes, clothing or jewellery rub, and pressure helps explain why plaques favour the elbows and knees: the parts that take your weight in kneeling and forearm poses.
Psoriasis in skin folds can be made worse by friction and sweating, especially in hot weather, though the NHS doesn't list heat as a general trigger. In one small study, people with psoriasis itched more while exercising.
No study has tested hot yoga in PsA or psoriasis. Given the heat and sweat, we'd choose a room at normal temperature (our suggestion).
You can't catch it or spread it, so shared studios are fine; bring your own mat for comfort and skin care.
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Our suggestions, built on the Psoriasis Association's advice on friction, sweat and skin care:
The NHS lists stress as a psoriasis trigger. In 37 people having light treatment, listening to a mindfulness recording cleared their skin faster, and in 5 of 6 small trials, guided meditation improved self-rated psoriasis. Yoga poses haven't been tested for skin; our yoga for your skin guide covers this.
Keep sore joints moving gently through their range a few times a day, lower the intensity (for example, 15-minute strolls instead of 30-minute walks), and stretch rather than strengthen hot, swollen joints until they settle. If discomfort lasts more than a couple of hours after exercise, do less next time, not nothing. Ask your team about a flare plan.
Arthritis UK's physiotherapists advise slow, gentle movement during a flare rather than stopping altogether, and avoiding intense or jarring movement. NASS suggests avoiding high-impact exercise in a flare.
Breathing, small-range moves for sore joints and supported rest: the 15-minute flare-day version of our rheumatoid arthritis class fits (our suggestion; no trial has tested yoga in flares).
In a flare, rest the inflamed joints but keep them moving gently, then build back up.
Some pain when you start is common and isn't a sign of harm if it settles. A hot, swollen joint is different: rest it from strengthening.
About half of people with PsA have fatigue. In the interval training trial, fatigue fell a little, though that could have been chance. Pace yourself and keep a gentle version for low days.
Slow breathing, 3 minutes, no holds; seated cat-cow, 6 slow rounds; seated thoracic rotation, 5 each side with 5-second holds; wrist flow, 60 seconds (our yoga for rheumatoid arthritis class). Ankle circles: "5 slow circles each way with each ankle" (the move page's dose). Tendon glides: "4 to 6 of each position, holding each for 5 seconds, up to 4 times a day" (the move page's dose).
3D demoSlow breathing (6 breaths a minute)Beginner · No equipment
3D demoCat-cowBeginner · No equipment
3D demoThoracic rotationBeginner · No equipment
3D demoAnkle CARs (controlled articular rotations)Beginner · No equipment
3D demoTendon glides (hand tendon gliding exercises)Beginner · No equipment
3D demoWrist & forearm flowBeginner · No equipmentSole stretch: "3 to 5 holds of 10 to 30 seconds, 2 to 3 times a day" (the move page's dose). Isometric calf raise hold: "5 holds of 30 to 45 seconds" (the move page's dose). Seated calf raises: 3 sets of 15; soleus stretch, only if your ankle is stiff: 2 to 3 holds of 30 seconds each side (our Achilles tendinopathy guide). Stop if heel pain gets sharper.
Rib breathing: "5 to 8 breaths at the start of every session" (the move page's dose). Sphinx, 2 holds of 3 to 5 breaths; low cobra, 5 lifts held 3 to 5 seconds; locust with your arms by your sides, 3 to 5 lifts held 3 to 5 seconds; open book, 8 each side; wall angel, 8 slow slides (our yoga for ankylosing spondylitis class).
3D demoLateral breathing (Pilates breathing)Beginner · No equipment
3D demoSphinx pose (Salamba Bhujangasana)Beginner · No equipment
3D demoLow cobra (Bhujangasana)Beginner · No equipment
3D demoLocust pose (Salabhasana)Beginner · No equipment
3D demoSide-lying open bookBeginner · No equipment
3D demoWall angelBeginner · A wallMountain pose, 5 breaths, a hand on the chair; chair pose, 3 holds of 10 to 15 seconds, a small knee bend; warrior II with a short stance, 3 breaths each side; tree pose with your heel at your ankle, 3 breaths each side; sit to stand, 8 to 10 slow reps (our yoga for rheumatoid arthritis class).
Reclining bound angle with a cushion under each thigh, 2 minutes; corpse pose with cushions under your knees and arms, 5 minutes (our yoga for rheumatoid arthritis class).
With sore wrists or fingers, a swollen finger, or psoriasis on your palms or nails: do downward dog, plank, all-fours cat-cow and sun salutations on your forearms or fists, with a wedge under your palms, or with your hands on a chair or wall (our suggestion).
With sore knees or plaques on your knees or elbows: pad well, or use seated and standing versions (our suggestion).
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With a sore heel: step back in sun salutations and shorten standing holds.
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Inflamed joints can be left less stable, so move within comfort rather than holding deep, passive stretches (as our rheumatoid arthritis yoga guide advises).
Modify or avoid exercises that round your back deeply or repeatedly, especially with a weight: sit-ups, toe touches, Pilates roll-downs and curl-ups, and extreme yoga forward folds. Bend from the hips instead. You do not need to avoid bending, twisting or lifting altogether: move smoothly and keep your upper back straight.
Twisting should be safe if you do it smoothly and comfortably. Slow down and shorten fast or forceful twists, and leave out the added weight.
For hands, feet and flare days, our rheumatoid arthritis class (mostly in a chair, with a 15-minute flare-day version); for the back and neck, our ankylosing spondylitis class. Two or 3 sessions a week, with walking or cycling for your heart, is our editorial starting point. The hand exercises come from a rheumatoid arthritis trial.
A gentle 30-minute yoga class for rheumatoid arthritis: slow breathing, hand, foot and spine moves in a chair, standing poses with a chair, then supported rest.
30 minBeginner19 movesA bench or box, Other / check instructionsTwenty-five minutes of yoga for ankylosing spondylitis: rib breathing, posture work, standing strength, face-down back bends, gentle rotation and a supported rest.
25 minBeginner18 movesA wallA 30-minute joint-friendly yoga class for arthritis: seated breathing and joint warm-ups, standing poses with a chair, gentle lying poses and a long relaxation.
30 minBeginner17 movesA bench or box, A wallThe daily stretches and strengthening moves from the SARAH hand trial and NHS hand therapy leaflets: finger bends, finger walking, wrist circles, squeezes and pinches.
15 minBeginner7 movesA dumbbell, A bench or boxA 10-minute routine for a pain flare-up: slow breathing, small gentle moves lying and sitting, a short stroll if you can, then rest. Repeat later in the day.
10 minBeginner10 movesA band, A bench or boxA 45-minute restorative yoga sequence: five fully supported poses held for 4 to 10 minutes each, with slow breathing and a long final rest.
45 minBeginner6 movesFirm cushion, A wallPlantar fascia and calf stretches, a gentle foot roll and the towel heel raise: the exercises the 2023 heel pain guideline supports.
8 minBeginner7 movesA bench or box, A massage ballYoga is mostly light activity; a walking plan builds towards the 150 minutes a week the NHS recommends.
These are the warning signs from our psoriatic arthritis, rheumatoid arthritis and ankylosing spondylitis guides, word for word. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999.
If you have psoriasis and your skin quickly turns red with white, pus-filled bumps that join together, patches on your feet turn yellow-brown and fill with pus, or red, scaly, pus-filled bumps appear on the tips of your fingers and toes, especially with a fast heartbeat, a high temperature, or feeling hot, cold or shivery.
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Infection in a joint (septic arthritis) is more likely if your immune system is weakened. Ask for an urgent GP appointment or contact NHS 111 if you have:
Get help the same day for a hot, swollen joint with a fever, or severe pain and swelling that came on suddenly in one joint.
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NICE asks for an eye assessment the same day for symptoms of eye inflammation (uveitis), such as eye pain, redness, sensitivity to light or blurred vision. The NHS says to ask for an urgent GP appointment or contact NHS 111; untreated, it can cause the loss of some or all of your vision.
Call 999 if your lips, mouth, throat or tongue suddenly swell, or you're struggling to breathe. Tell your doctor or call 111 immediately if you get:
Call 999 or go to A&E: loss of feeling or numbness around the genitals or bottom, new trouble peeing or controlling your bladder or bowels, changes in genital sensation during sex or problems with erections or orgasm, or pain, tingling, weakness or numbness in both legs. These are signs of cauda equina syndrome, which needs treating in hospital urgently. Don't drive yourself.
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Stop if exercise brings sharp pain or swelling, and check how you're doing the move before trying again with less. Stop and get help for chest pain, palpitations (your heart pounding or fluttering) or unusual breathlessness, and rest if you feel feverish or unwell.
Call 999 if:
If you feel you can't keep yourself safe, call 999 or go to A&E. For urgent mental health help, call NHS 111 and choose the mental health option, or call Samaritans free on 116 123, any time. In the US, call or text 988.
The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.
Never stop or change your psoriatic arthritis medicines because of exercise or a flare without your team (our suggestion; the NHS says medicines are the main treatment).
In the best trial, hard interval training didn't raise disease activity or inflammation on scans, and flares from exercise looked uncommon across 13 studies. The evidence is very low certainty overall, so build up gradually.
No yoga trial exists, and exercise trials didn't change disease activity or scan inflammation. Medicines treat the inflammation.
Slow, gentle movement during a flare, rather than stopping altogether, is what Arthritis UK's physiotherapists advise.
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No study has tested it, and psoriasis in skin folds can be made worse by friction and sweating.
US guidance prefers low-impact exercise including yoga, on very low-quality evidence; strength and interval training are what the PsA trials tested. A mix of all three suits most people.
It's a reasonable low-impact choice: the NHS lists yoga among exercise that can help protect your joints. No trial has tested yoga in psoriatic arthritis, so it works alongside medicines, strength work and walking, not instead of them.
Gentle, low-impact classes with props, such as hatha or chair yoga, suit most people. Our rheumatoid arthritis class, mostly in a chair with a flare-day version, suits sore hands and feet, and our ankylosing spondylitis class suits the back.
No study has tested it. Psoriasis in skin folds can be made worse by friction and sweating, so a room at normal temperature is the safer choice.
Gently: slow, small movements, breathing and supported rest rather than stopping altogether. Stretch rather than strengthen hot, swollen joints, and call your team if a flare won't settle.
There's no evidence that it does. Exercise trials in psoriatic arthritis improved fitness and function without changing disease activity or inflammation on scans; medicines treat the inflammation.
Use your forearms, fists, a wedge under your palms, or your hands on a chair or wall instead of flat hands. Rest a hot, swollen finger from weight and gripping until it settles.
Pad kneeling and forearm poses, because psoriasis can appear where skin is rubbed. Wear loose cotton, use your own mat and a towel, and shower, pat dry and moisturise afterwards.
Pain where tendons attach to bone is common in psoriatic arthritis, most often at the Achilles and under the heel. Keep impact low, do calf holds and seated raises, and skip jumping while a heel is sore; heel pain that doesn't settle needs checking.
If psoriatic arthritis affects your spine, the exercise used in ankylosing spondylitis applies: breathing, back bends that strengthen, and turning. Mind-body exercise gave small gains in function in that condition, and our ankylosing spondylitis yoga guide has a class.
About half of people with psoriatic arthritis have fatigue. Exercise may ease it a little, though the trial result was uncertain; pace your practice and keep a gentle version for low days.
Yoga poses haven't been tested for skin. Meditation helped in small trials as an addition to treatment, and stress can trigger psoriasis; our yoga for your skin guide covers it.
Urgently for a hot, swollen joint with a fever, a red, painful eye, or skin that suddenly turns red with pus-filled bumps, and tell your doctor straight away about infection signs on methotrexate or a biologic. See your team about joint swelling that keeps coming back or heel pain that won't settle.
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition such as glaucoma, high blood pressure or osteoporosis, or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.
