A recent study comparing yoga and traditional strength training for knee osteoarthritis revealed that both methods offer similar pain relief, challenging assumptions about which exercise approach may be more effective.

On a 100-mm VAS, a pain rating of 40 or higher generally indicates moderate to severe pain, with 45–74 considered moderate and 75–100 rated as severe.

Participants were randomly assigned to either a yoga group or a strengthening exercise group, engaging in two supervised sessions and one home-based session each week for the first 12 weeks, followed by three home-based sessions per week for the next 12 weeks. The primary aim of the research was to evaluate the change in knee pain between the two exercise approaches after 12 weeks, using VAS where 0 indicates no pain and 100 indicates the worst possible pain.

The results showed a slight decline in pain for both forms of exercise—the yoga group experienced a pain reduction of 17.7 points, while the strengthening exercise group saw a decrease of 16.7 points. The difference of only 1.1 points between the two groups wasn’t “statistically significant,” indicating that both approaches worked equally well for pain management.

“Yoga did not significantly reduce knee pain compared with strengthening exercises,” the study authors wrote.

Benefits Beyond Pain Relief

Although both groups experienced comparable pain relief at the 12-week point, the study demonstrated that participants who practiced yoga exhibited more significant improvements in various secondary outcomes by the 24-week mark.

“We observed modest but statistically significant differences in several secondary outcomes, indicating a medium-term benefit of yoga compared to strengthening exercises,” the study authors wrote.

The yoga group reported modestly better outcomes in depression levels, quality of life, and physical performance, measured by a fast-paced walk test, compared to the strengthening group.

“Additionally, adherence to the yoga program was higher than that for the strengthening exercises, which may partly explain the differences seen in the secondary outcomes at the 24-week mark,” they added.

Advancements were noted in areas including pain reduction, function, and stiffness, with the yoga group reporting greater improvements in their Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, a disease-specific tool used to evaluate a patient’s osteoarthritis (particularly in the hip or knee), at the 24-week mark. The WOMAC primarily measures pain, stiffness, and functional limitations in people with OA of the hip or knee, rather than directly measuring disease progression.

The researchers pointed out while neither intervention significantly outperformed the other in reducing knee pain, the “modest benefits” associated with yoga suggest its role as a viable option for improving symptoms and quality of life for those living with knee osteoarthritis.

Expert Recommendations for OA Management

The “best” exercise for someone with OA is progressive strengthening mixed with mobility and stretching, Zach Smith, who has a doctorate in physical therapy and is founder/owner at HIDEF Physical Therapy in Seattle, told The Epoch Times.

The most important thing that those with OA should consider is ensuring that they’re managing symptoms of pain and swelling in the joint, Smith said, meaning that for people who have OA, the top priority in their self-care and treatment should be focused on controlling the discomfort and inflammation they experience in their affected joints.

“I like to keep pain level under 3 out of 10 and avoid things that make the knee swell up,” he said. “Those symptoms are your body telling you that you are doing too much.”

Although the study does show yoga interventions help reduce pain symptoms, and improves function and quality of life, it also had more adverse events linked to treatment when compared to strengthening, Mansi Shah, senior physical therapist at Northwell Sports Therapy and Rehabilitation Services, who was not involved in the study, told The Epoch Times.

Furthermore, she added, there are many forms of yoga, including meditation yoga, breathing yoga, yoga with movement, and postural yoga. “The study does not state whether they use a specific form or combination of yogas,” Shah said. This lack of specificity is important because different yoga styles have varying levels of physical exertion, focus on specific muscle groups, and potential risks.

“I think there is place for yoga, which can be a powerful tool in therapist’s toolbox because of its efficacy,” Shah said, adding that further research needs to be done on specific forms of yoga with traditional physical therapy treatment to address knee OA.

Smith recommends a “well structured” strength, walking, and cardiovascular program as well. “Exercises like walking, stair climbing, jogging, strength training, and biking can all help substantially in improving and even restoring cartilage health,” he said.

He also emphasized the importance of progressive loading in OA prevention and treatment: “You shouldn’t just do the exact same thing for all time, you should progress and change what you do in your training.”