Yoga Found Noninferior to Strengthening Exercises for Knee Osteoarthritis Pain Relief

Published in JAMA Network Open, a randomized clinical trial comparing yoga with strengthening exercises in adults with knee osteoarthritis (OA) found that yoga was noninferior for reducing knee pain and showed modest advantages in several secondary outcomes, including function, stiffness, and mental health.

The study, conducted in Southern Tasmania, Australia, enrolled 117 participants aged 40 years or older with moderate knee pain (mean baseline visual analog scale [VAS] score of 53.8 mm). Participants were randomized to either a 12-week yoga or strengthening exercise program, followed by a 12-week home-based phase. Both groups performed the same frequency of sessions per week.

The primary outcome—difference in knee pain over 12 weeks as measured by VAS—did not show a statistically significant difference between the two groups. The between-group difference was −1.1 mm (95% CI, −7.8 to 5.7 mm), remaining within the prespecified noninferiority margin of 10 mm. According to the authors, “yoga was found to be noninferior to strengthening exercise for reducing knee pain,” supporting its potential as an alternative intervention for knee OA.

Among 27 secondary outcomes evaluated over 12 and 24 weeks, seven favored the yoga group. At 24 weeks, the yoga group showed significantly greater improvements in WOMAC pain (−44.5 mm), function (−139 mm), stiffness (−17.6 mm), and patient global assessment (−7.6 mm). They also performed better on the 40-meter fast-paced walk test (1.8 seconds faster).

In addition, participants in the yoga group reported a modestly greater improvement in depressive symptoms at 12 weeks (PHQ-9 score difference: −1.1) and quality of life at 24 weeks (AQoL-8D score difference: 0.04). Both groups reported only mild adverse events.

“Incorporating yoga as a viable alternative or complementary exercise modality in clinical practice may help broaden therapeutic options for managing knee OA,” the study concluded.

These findings suggest that clinicians can confidently recommend yoga as a safe and effective option for patients with knee OA, particularly those seeking alternatives to conventional exercise programs.

Reference
Abafita BJ, Singh A, Aitken D, et al. Yoga or strengthening exercise for knee osteoarthritis: a randomized clinical trial. JAMA Netw Open. Published online April 1, 2025. doi:10.1001/jamanetworkopen.2025.3698