Exercise therapy is suggested as a first-line treatment to improve joint pain and loss of function caused by osteoarthritis (OA), a musculoskeletal disorder that affects more than 595 million people worldwide. Yoga and strengthening exercises are both known to be effective ways of managing knee OA, but is one better than the other?

A study that compared yoga and strengthening exercises head-to-head for knee OA found that despite their distinct mechanisms for relieving pain and improving physical function, neither was superior to the other.

Pain management in patients with knee OA improved over 12 weeks, and yoga was just as beneficial as conventional strength exercises, according to the results published in JAMA Network Open.

s an alternative or complementary approach, could offer meaningful benefits for individuals with knee OA, such as noticeable improvements in knee pain, quality of life, and depression.

Evidence suggests that performing strength-based exercises can relieve pain due to mechanical stress by increasing muscle strength around the knee and improving joint function. Yoga, on the other hand, focuses on breathing techniques, physical postures and mindfulness to reduce stress, increase flexibility, and help with pain management.

Clinical guidelines often recommend yoga to manage discomfort caused by knee OA. However, there is a lack of high-quality evidence to support these recommendations, as many studies exploring the efficacy of yoga have involved small sample sizes, showed a high risk of bias, and failed to use standardised diagnostic criteria.

To better understand the effectiveness of yoga in managing knee OA compared to an evidence-based strengthening exercise program, researchers recruited 117 patients from Southern Tasmania, Australia. All those selected reported knee pain levels of 40 or higher on a 100 mm visual analog scale (VAS)—a tool used to measure subjective experiences such as pain where higher value corresponds to greater pain.

A total of 58 participants were randomised to the yoga program and 59 to strength training, with more than 70% women in each group. The 24-week intervention for both groups included two supervised and one home-based session per week for 12 weeks, which was followed by three unsupervised home-based sessions per week for weeks 13 to 24.

The primary outcome of this study was to compare changes in knee pain via differences in VAS score over 12 weeks. The researchers found that both groups reported lower pain scores but there was no significant difference in knee pain reduction between the yoga and strengthening groups as the average difference in pain scores was minimal (−1.1 mm).

For one exercise option to be considered clinically more viable than the other, the difference in VAS knee pain between the groups has to be below 15 mm and yoga meets the criteria to be considered not worse than strengthening exercise.

The findings of this study establish yoga as an effective exercise option for those seeking non-pharmacological ways of dealing with knee OA.