Yoga guide
Yoga can help some veterans move more easily with back pain and feel calmer and safer in their body, as an addition to care, never instead of it. In trials run in the US Department of Veterans Affairs (VA), twice-weekly classes eased back pain a little, and trauma-sensitive yoga helped symptoms of post-traumatic stress disorder (PTSD) over 3 months in women veterans, though guidelines say the evidence isn't strong enough to recommend yoga as a PTSD treatment. Trauma-focused therapy is what helps most people with PTSD.
If you're struggling now, help is in the first section of this page: in the UK, 999, 111 and Samaritans on 116 123, and in England Op COURAGE; in the US, the Veterans Crisis Line (dial 988 then press 1, or text 838255).
This guide covers back pain, PTSD and what a trauma-sensitive class is like, sleep, chair yoga and yoga after injury, and ends with a free 25-minute class you can do sitting or standing at a chair, where every pose is your choice.
The NHS says a mental health emergency should be taken as seriously as a physical one, and that you will not be wasting anyone's time.
Veterans, reservists and people leaving the forces in England: Op COURAGE, the NHS mental health service for veterans. You can contact it yourself, or ask a GP or a charity to refer you.
US veterans: call 988 and press 1 for the Veterans Crisis Line, or text 838255.
US and UK guidelines recommend trauma-focused therapy first for PTSD and make no recommendation for or against yoga. The VA's own PTSD centre says yoga is shown to be safe for people with PTSD, but it's not recommended as a treatment for PTSD.
Trauma-sensitive yoga did about as well as group therapy over 3 months in 131 women veterans after military sexual trauma, but the people rating symptoms knew who had which treatment. A 16-week programme helped at the end of treatment but not 7 months later. Across trials, people rated their own symptoms as better, but clinicians' ratings didn't clearly change.
Twice-weekly classes for 12 weeks helped back pain and everyday function a little in one VA trial; weekly classes did no better than a self-care book in another. The VA and Department of Defense (DoD) back pain guideline makes no recommendation for or against yoga.
Every pose is optional, the teacher invites rather than instructs, nobody touches you without asking, and you can keep your eyes open and stay sitting or standing. Slow breathing suits most people; skip breath holds and fast breathing if they unsettle you.
No trial in veterans has made sleep its main outcome; cognitive behavioural therapy for insomnia (CBT-I) is the recommended treatment. There's no trial of chair yoga in veterans, and none in veterans with amputation or spinal cord injury, so chair and wall versions and your rehab team's advice are the way in.
In UK ex-regulars who deployed in a combat role, probable PTSD was about three times as common as in support roles, and US veterans report pain more often than non-veterans.
The 2021 Census counted 1,853,112 veterans in England and Wales, 3.8% of residents aged 16 and over. In the US there were 15.7 million veterans in 2024, 29.1% of them aged 75 or over. Many are older adults, so chair and standing-at-a-chair options matter.
In a US national survey, 65.5% of veterans reported pain in the past 3 months and 9.1% severe pain, against 56.4% and 6.4% of non-veterans. Severe pain was commoner in veterans with back pain.
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In 8,093 serving and ex-serving UK personnel, 6.2% had probable PTSD, rising to 17.1% in ex-serving regulars who had deployed in a combat role, against 5.7% in support roles. In the US, the VA says about 7 in 100 veterans will have PTSD at some point, more among women veterans, and that war zone deployment, training accidents and military sexual trauma can lead to it.
Individual trauma-focused therapy, such as cognitive processing therapy (CPT), prolonged exposure or eye movement desensitisation and reprocessing (EMDR). NICE notes that combat trauma can involve situations with no right answer, which can leave shame or guilt, and that people with PTSD may be apprehensive or ashamed and may avoid treatment.
Yoga is one of the complementary approaches the VA must make available to veterans, and the VA says 84% of its sites offer it. Its PTSD centre suggests talking with your mental health provider about how such practices might support your wellbeing during or after PTSD treatment.
In 150 veterans with chronic low back pain at a VA centre in California, two 60-minute hatha yoga classes a week for 12 weeks, with practice at home, didn't change everyday function more than waiting at 12 weeks, but did by 6 months (2.5 points on a 24-point scale). Pain eased a little more than waiting, by less than the 1 point out of 10 that most people would notice. Opioid use fell in both groups equally. Pain's interference with life, tiredness and quality of life also favoured yoga.
In 120 mostly older veterans with several health conditions, 12 weekly yoga classes, adapted with chairs, straps and blocks, were no better for pain or function than a self-care book. More of the yoga group said they felt much better (39% against 19%), but under half went to 9 or more classes.
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The VA and DoD's 2022 back pain guideline found insufficient evidence to recommend for or against yoga, after suggesting it as part of exercise in 2017. It suggests a structured exercise programme led by a clinician.
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Across 21 trials, yoga gave a small improvement in back pain and function compared with no exercise, about the same as other exercise, with more minor flare-ups than doing nothing. In 75 Gulf War veterans, yoga and pain-focused cognitive behavioural therapy (CBT) didn't differ on the main pain measures.
Yoga is one reasonable way to stay active with back pain, twice a week if you can, about as good as other exercise. It doesn't replace a physiotherapy or pain programme, and it hasn't been shown to cut painkiller use (our reading of these trials). If you'd rather try Pilates, our Pilates for veterans guide covers it.
Our yoga for PTSD guide covers trauma-sensitive yoga for everyone, the full evidence and guidelines, and breathing in more depth.
The VA and DoD recommend individual trauma-focused therapy and find insufficient evidence for or against yoga, adding that such practices might have other benefits for wellbeing and should be supported in people who want them. NICE made no yoga recommendation, noting that 46% of people dropped out of yoga in its trials. The American Psychological Association (APA) found insufficient evidence either way.
In 131 women veterans with PTSD after military sexual trauma, at two VA systems, 10 weekly 1-hour trauma-sensitive yoga groups did about as well over 3 months as 12 weekly 90-minute groups of cognitive processing therapy, and more finished (65% against 46%). But the people rating symptoms knew which group each woman was in, the therapy was given in groups rather than one to one, follow-up was only 3 months, and therapy completers kept improving while yoga levelled off.
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In 209 people with PTSD, 91% of them veterans, a 16-week yoga programme lowered PTSD symptoms more than a wellness programme at the end of treatment, but not 7 months later. Feeling better in yourself and less stigma explained the benefit best, not body awareness.
In 85 veterans, a yoga breathing programme with about twice the contact time did no worse than one-to-one therapy on a PTSD checklist for a year, but worse on depression at a year. A Kripalu yoga trial lost most of its participants and found no difference, and the largest planned trial, in 192 veterans, hasn't reported yet.
Across 20 trials, people rated their own PTSD symptoms as better straight after yoga, but the difference didn't last and clinicians' ratings didn't clearly change. Against an attention control, the effect was small and uncertain. A 2026 review of veterans found low-quality evidence that movement-based yoga may not reduce PTSD symptoms.
Across 30 trials, mind-body therapies, yoga among them, didn't beat other active treatments for PTSD or pain, while trauma-focused treatments helped both. The authors say treatment for both should include a trauma-focused therapy part.
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Trauma-sensitive yoga is built on noticing your body, invitational language, choice, no pressure, and a teacher who practises alongside you. The UK's working definition of trauma-informed practice rests on safety, trust, choice, collaboration, empowerment and cultural consideration, and says it is not itself a treatment.
From these principles, a class can offer:
Slow breathing suits most people. In a trial in 74 people with PTSD, adding fast breathing and breath holds to therapy led some to report anxiety or a feeling of being constricted, and one had a flashback during a breath hold. Skip breath holds and fast breathing such as breath of fire if they unsettle you.
Meditation and mind-body practices can bring a temporary rise in anxiety or low mood for some people, including people with no history of mental health problems. Feeling emotional in a pose is common; it isn't a sign that anything is being released, and you can stop at any time.
No trial of yoga or yoga nidra in veterans has made sleep its main outcome. In the breathing programme trial, sleep diaries improved a little with both treatments, but sleep measured on a wrist monitor didn't change. Small studies without a comparison group, including yoga nidra in women veterans, report better sleep.
The VA and DoD recommend CBT-I for chronic insomnia and find insufficient evidence for or against yoga. A gentle evening practice can sit alongside it; if lying still with your eyes closed brings up memories, sit up and keep your eyes open (our suggestion).
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Our searches found no trial of chair yoga in veterans, and no yoga study in veterans with an amputation or spinal cord injury.
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A pilot of yoga after stroke, run through a VA centre, found no difference from a waiting list. Telehealth yoga was acceptable to older rural veterans but didn't ease loneliness. In older veterans after cancer, the yoga had to be adapted a lot for each person.
The VA's yoga guidance says yoga can be used by most people, including courses for wheelchair users, and that a clinician should check first if other health issues might pose risks. Use the chair and wall versions in this guide, and ask your physiotherapist or rehab team first after an amputation, spinal cord injury, brain injury or stroke.
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Eyes open, feet on the floor. Slow breathing: "At least 5 minutes, done regularly as part of your daily routine" (the move page's dose), with no holds and counting optional. Seated march: "1 to 2 minutes as a warm-up" (the move page's dose). Breath reach: "5 breaths, exhale longer than inhale" (the move page's dose), sitting or standing.
Seated side bend: "Hold 10 to 20 seconds, 2 or 3 times each side" (the move page's dose), both sitting bones on the chair. Thoracic rotation: "6 rotations per side, moving with the breath" (the move page's dose). Cat-cow: "8 waves, slower than feels natural" (the move page's dose), seated with your hands on your knees, or on all fours if that feels right. Table slide: "10 slow repetitions, 1 to 3 times a day" (the move page's dose).
Mountain pose: "Stand for 5 to 10 slow breaths, 2 or 3 times" (the move page's dose), a hand on the chair if you like. Sit to stand, 8 slow reps from a firm chair (our desk yoga class). Chair pose, 2 holds of 3 to 5 breaths; warrior II, 5 breaths each side, as deep or as shallow as you like; tree pose, 5 breaths each side, hand on the chair (all our trauma-sensitive yoga practice).
Pelvic tilts, 8 slow tilts, and low cobra, 5 lifts with 2 breaths at the top (both our yoga for back pain class); skip low cobra if arching sends symptoms down a leg. Knees to chest: "Hold 20 to 30 seconds, 2 to 4 times" (the move page's dose). Hip windshield wipers: "10 slow passes side to side, 2 rounds" (the move page's dose). Child's pose: "Hold 1 to 3 minutes, breathing into the back ribs" (the move page's dose); skip it if folding forward with your head down feels uneasy.
Easy pose, 2 minutes, or sit on the chair, eyes open, resting your gaze on something in the room (our trauma-sensitive yoga practice). Corpse pose only if lying still feels safe: "Lie still for at least 5 minutes, up to 10" (the move page's dose), knees bent, eyes open is fine.
Leave out breath holds and fast breathing: skip the holds in box and 4-7-8 breathing, and any breath of fire; use slow breathing instead. Lying still with your eyes closed, poses on all fours or face down, and child's pose with your head down are always optional. Leave out headstands, shoulder stands and plough. In a wheelchair or after an amputation, use the seated versions and ask your rehab team about standing work.
3D demoBox breathingBeginner · No equipment
3D demo4-7-8 breathingBeginner · No equipment
3D demoSphinx pose (Salamba Bhujangasana)Beginner · No equipment
3D demoSupported headstand (Salamba Sirsasana)Expert · A wall
3D demoSupported shoulderstand (Salamba Sarvangasana)Advanced · No equipment
3D demoPlow pose (Halasana)Advanced · No equipmentOur 25-minute class: our own selection, sitting then standing at a chair with an optional back block, untested as a whole. Our trauma-sensitive yoga practice is the core class for PTSD; seated chair yoga and the wheelchair workout need no standing.
A 25-minute yoga class for veterans: sitting, then standing at a chair, an optional back block and an eyes-open finish, with every pose your choice.
25 minBeginner15 movesBench or boxA gentle 20-minute yoga practice, sitting and standing with your eyes open, where every pose is optional and you can stop at any point.
20 minBeginner11 movesBench or boxA 15-minute chair yoga routine done entirely sitting: slow breathing, neck, shoulder and wrist stretches, seated twists and side bends, and a calm finish.
15 minBeginner16 movesBench or boxA free 20-minute chair yoga class for older adults: slow breathing, gentle seated stretches and twists, standing poses holding the chair, and a calm finish.
20 minBeginner18 movesBench or box, something with weightA gentle 20-minute yoga sequence for back pain, based on the first weeks of a 12-week trial programme: lying, all-fours and standing poses, then rest.
20 minBeginner12 movesFirm cushionA 30-minute workout in your wheelchair: a warm-up, seated cardio, four shoulder exercises from a trial programme, and stretches for the front of the shoulders.
30 minBeginner14 movesBench or box, bandA 25-minute gentle yoga class for complete beginners and over-50s: slow breathing, a warm-up, supported standing poses, floor poses and a closing rest.
25 minBeginner14 movesNo equipmentThese are the warning signs from our yoga for PTSD, back pain, Pilates for nurses and yoga guides, word for word, with the veterans' services in their own words. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999.
Call 999 or go to A&E if:
In England, call 111 and select the mental health option, use 111 online, or ask for an urgent GP appointment.
Call Samaritans free on 116 123, any time, day or night (UK and Ireland). If you're under 19, you can also call Childline on 0800 1111.
Text SHOUT to 85258, any time.
Contact your mental health crisis team if you have one.
In the US, call or text 988, the 988 Suicide and Crisis Lifeline, any time. Veterans can call 988 and press 1, or text 838255.
In England, Op COURAGE is the NHS mental health service for people leaving the forces, reservists, veterans and their families. You can contact it yourself or through a GP or a charity, however long ago you left.
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What each service says about itself:
If you're 18 or over (or 16 or over in some areas), you can also refer yourself to NHS talking therapies without seeing a GP.
The NHS says don't stop taking PTSD medicine unless you're told to by a doctor, even if you feel better.
A flashback, panic or feeling cut off from your surroundings: stop, sit with your feet on the floor, look around and breathe slowly, then tell your therapist (our suggestion).
A breathing exercise brings on panic, dizziness, tingling or a feeling of being smothered: stop it and breathe normally.
If yoga keeps making symptoms worse, change the setting or the type of practice rather than pushing through, and talk to your therapist (our suggestion).
You can say no to any hands-on adjustment, and a teacher registered with Yoga Alliance must get your explicit consent each time.
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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.
Call 999 or go to A&E: back pain with chest pain, or back pain that started after a serious accident, such as a car crash.
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Same day (GP or NHS 111): back pain and you feel hot, cold, shivery or generally unwell, or severe pain that starts suddenly or is getting worse quickly.
Same day: leg weakness that is getting worse.
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Back pain that hasn't improved after a few weeks of looking after it at home, stops you doing day-to-day activities, worries you, or you're struggling to cope.
Pain that doesn't improve with rest or is worse at night, or pain that is worse when you sneeze, cough or poo.
Unexplained weight loss, or a lump, swelling or change in the shape of your back.
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Call 999 if:
Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.
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A joint pain that is sharp, gets worse during a session, lingers into the next day or changes how you move is a reason to use an easier version, and to see a GP or physiotherapist if it keeps happening (the rule in our plans). Muscle soreness for a day or two after something new is normal. In a hot class, stop if you feel dizzy, sick or unwell; our hot yoga guide lists the signs of heat illness.
With glaucoma, or high blood pressure that isn't under control, skip headstands, shoulder stands and long head-down holds. With osteoporosis, swap deep forward folds for a flat-back hinge from the hips, and twist smoothly. In pregnancy, our yoga in pregnancy guide covers the changes. NCCIH advises beginners to avoid headstands, shoulder stands, the lotus position and forceful breathing.
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.
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Changing your sleep habits hasn't helped, you've had trouble sleeping for months, or it's affecting your daily life in a way that makes it hard to cope.
Your breathing stops and starts while you sleep, you make gasping, snorting or choking noises, or you always feel very tired in the day. If someone has seen it happen, it can help to bring them with you.
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.
The VA says yoga is not recommended as a treatment for PTSD, and guidelines put trauma-focused therapy first. Self-rated benefits fade, clinicians' ratings don't clearly change, and treatment for pain with PTSD needs a trauma-focused part.
No study we found tests this. Feeling emotional in a pose is common and not a sign that trauma is leaving the body; trauma-focused therapy is what treats PTSD.
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In the VA trial cited for this, opioid use fell in both groups equally. In the other VA trial, pain medicine use didn't differ.
In one trial, fast breathing and breath holds unsettled some people with PTSD, and one had a flashback during a breath hold. Slow breathing is the gentler choice.
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The VA trial classes used chairs, straps and blocks, and the VA's guidance says most people can use yoga, including wheelchair users.
It can help some veterans with back pain, stress and PTSD symptoms, as an addition to care. In VA trials, yoga eased back pain a little in one trial and not in another, and trauma-sensitive yoga helped PTSD symptoms over 3 months in women veterans. It's safe for most people, but no guideline recommends it as a treatment for PTSD.
It may ease symptoms for a while, but it isn't a treatment on its own. Trauma-focused therapy is what helps most, and guidelines make no recommendation for or against yoga. Use yoga alongside therapy or while you wait for it; our yoga for PTSD guide covers trauma-sensitive yoga in full.
A gentle class built on choice: invitational language, every pose optional, no pressure and no hands-on adjustments without your agreement. It follows trauma-informed principles of safety, trust, choice, collaboration, empowerment and cultural consideration.
Yes, as a way to move with pain, injury or limited balance, though no trial has tested chair yoga in veterans. The VA says most people can use yoga, including wheelchair users, and our class can be done sitting.
Small studies without a comparison group, including women veterans after military sexual trauma, reported benefits, but there are no good trials. Lying still with your eyes closed can bring up memories for some people, so keep your eyes open or sit up if you need to, and keep going with therapy.
A little, for some people: twice-weekly classes for 12 weeks helped function at 6 months in one VA trial, but once a week did no better than a self-care book in another. The VA and DoD back pain guideline neither recommends nor rules it out.
It hasn't been properly tested for sleep in veterans. CBT for insomnia is the recommended treatment, and a gentle evening practice can sit alongside it.
It hasn't been shown to: in the VA trial, opioid use fell in both groups equally. Don't change any medicine without talking to your prescriber.
Stop, sit with your feet on the floor, look around the room and breathe slowly, then tell your therapist. Skip breath holds and fast breathing if they unsettle you, and leave out any pose that doesn't feel safe.
Yes, with seated and wall versions and your rehab team's advice first. No study has tested yoga in veterans with an amputation or spinal cord injury, so our amputee and spinal cord injury guides are the place to start.
Yes: yoga is one of the complementary approaches the VA must make available to veterans, and it says 84% of its sites offer it. Ask your VA care team; in the UK, ask your GP or Op COURAGE about mental health support.
In the UK, call 999 in an emergency, 111 and select the mental health option, or Samaritans on 116 123; in England, Op COURAGE supports veterans. In the US, dial 988 then press 1 for the Veterans Crisis Line, or text 838255.
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.
