Yoga and Lupus – Presence of Mind, Presence of Being

I used to think that yoga was a one-size-fits-all program, but that it would never quite fit me. Suffering from back and knee pain, a traditional yoga practice seemed out of reach to me and would only exacerbate the discomfort I already experienced – when it was supposed to do the exact opposite. Now, I know differently.  Yoga can be modified to suit all levels: including the beginner who may experience pain due to illness or injury and the advanced, practiced yogi who has learned to be mindful of body and soul.


While the practice of yoga requires a certain amount of awareness and mindfulness, most practices are more about breathing and how it relates to movement. A good practitioner is one who can breathe with ease through many postures, not one who can fold themselves like origami. A good practitioner also knows her own physical and mental limitations and remains mindful of the here and now. Yoga does not mean being able to do a perfect backbend – it is about treating yourself with kindness while not letting your thoughts get carried away with the past or future.

According to Cyndi Lee of Yoga Journal, the practice of yoga is a “method or discipline.” Yoga is the union of breathing, meditation, postures, observances, restraints, concentration, absorption and the withdrawal of senses. According to Lee, yoga can help us shape our relationship with the outer world as we find “liberation and enlightenment” through practice.


The Many Benefits of Yoga

As someone who has lupus or any autoimmune or inflammatory disease you may be asking whether yoga is right for you. According to the Mayo Clinic, yoga may prove beneficial by reducing stress, improving fitness, and allowing you to manage chronic health conditions more effectively.

In a 2013 article in Current Rheumatology Reports, researchers who reviewed published literature about the benefits of yoga suggest that practicing yoga may benefit individuals with rheumatic disease and may “help decrease inflammatory mediators including C-reactive protein and interleukin-6.” In the studies surveyed, researchers found a “consistent trend suggesting some evidence of improvement in pain, function, mood, energy, and self-efficacy with regular yoga practice.” The researchers also acknowledge that one of the important aspects of yoga may be the emphasis it places on “acknowledging and accepting day-to-day variability in feelings of well-being and energy.”

In 2010, researchers at the Oregon Health & Science University (OHSU) in Portland, Oregon conducted a randomized controlled trial on women with fibromyalgia by having them participate in an 8-week yoga program. At the end of the program, the women showed “significantly greater improvements on standardized measures of [fibromyalgia] symptoms and functioning including pain, fatigue, mood…acceptance, and other coping strategies.” Participants were asked to not only participate in class, but to practice at home as well. Those who “practiced more yoga had better outcomes on several measures.”


Hatha and Bikram and Yin, Oh My! Which Yoga Practice is Right for You?

Christine Yu of Daily Burn notes that yoga is not a “one-size-fits-all” practice – it’s dependent on age, health, temperament, etc. Even if you find a practice that seems to suit you, as someone who has lupus, you will always want to discuss your fitness goals with your healthcare practitioner and take into consideration your current health, fitness level, any overlap diseases you may have, and any physical limitations or injury you experience.

The eight major styles of yoga include:

  1. Hatha – Slower-paced and gentle, Hatha is often a good place to start for beginners and is the type of yoga predominantly practiced in the West. Hatha focuses on postures and should leave you feeling relaxed.
  2. Vinyasa – Faster-paced with more of a flow, Vinyasa is almost like a dance as you move from one pose to the next while breathing in rhythm. Your heart rate will definitely rise when practicing vinyasa.
  3. Iyengar – Iyengar integrates the use of props – bricks, straps, bolsters, blankets – into practice as you hold poses for longer while concentrating on body alignment. In Iyengar, you will work within your own range of motion safely.
  4. Ashtanga – Challenging, Ashtanga follows the same pattern of poses with each practice, enabling you to build internal heat as you time your breath to the movements. Although more rigorous, this is a great practice if you like predictability and to be able to hone your craft.
  5. Bikram – Practiced in a heated room (typically 105 degrees Fahrenheit and 40% humidity), you will work through the same series of 26 poses during each class – and sweat like the dickens. Bikram is not for those with serious medical conditions. A slight twist on Bikram is heated yoga, which is also practiced in a heated room, but the practice changes from class-to-class.
  6. Kundalini – This is a more spiritual practice that incorporates physically challenging postures with intense breath work. You will also chant, sing, and meditate while practicing. It can be a challenging practice, but also more holistic than some others.
  7. Yin or Restorative – Yin or restorative yoga offers a more Zen-like experience as you will hold postures for much longer, often several minutes at a time. It targets deeper connective tissue – fascia – and you may use props to aid in movement. Those with connective tissue disorders will want to steer clear of Yin, however.
  8. Anusara – Relatively new, Anusara can be rigorous for both the body and Specifically sequenced, Anusara will allow you practice loving kindness as your heart opens with acceptance and understanding.

If you and your healthcare practitioner have decided that starting a yoga practice is the way to go, the Mayo Clinic suggests the following questions when choosing a practice, class and instructor:

  • What are the instructor’s qualifications?
  • Does the instructor have experience working with lupus or autoimmune disease?
  • Is the class suitable for beginners or people with physical limitations?
  • What are the benefits of this particular class/practice?


Personal Perspective – An Interview with Chiaki Ishimura-Smillie

Chiaki Ishimura-Smillie grew up in Japan and is now living with her husband and family in Portland, Oregon. Chiaki is a certified yoga therapist. She also has lupus.

Chiaki was diagnosed in Japan over twenty years ago while spending eight months in the hospital. During that time, she experienced symptoms ranging from photosensitivity to nephritis. She attributes the tenacity of her doctors, the Japanese healthcare system, and family support with the level of attention and care she received and the improvements in health she experienced. Chiaki attributes her yoga practice to improving her relationship with lupus. Which in turn, has led to experiencing fewer and less severe symptoms.

“Getting sick was unfortunate, but it’s not the end … studying yoga also helped me think that way,” Chiaki says. “Studying yoga and becoming [a] certified yoga therapist was my way to help others who may be able to lessen [their] suffering and reduce the chances of flare up.” Being present is another practice Chiaki has learned to incorporate into her daily life.

Chiaki instructs a very gentle and mindful yoga practice. Having attended her class, I appreciate the fact that I was never pushed beyond my emotional and physical limits.  I didn’t feel overexerted, and I left feeling less tense, less stressed and without pain. Chiaki reminds her students to be aware of their breath throughout the practice – her use of humming during exhaling aids tremendously with breathing. Chiaki has a calming presence – she’s unintimidating and compassionate and reminds you to do your best, but not push yourself too far.

Chiaki recommends that if you are looking for other yoga therapists in and outside the Portland area, visit the International Association of Yoga Therapists’ (IAYT) website at Members of IAYT, such as Chiaki, champion yoga as “a healing art and science.”

You can watch my full interview with Chiaki below.



You can view Chiaki and a portion of her yoga practice here:

Gentle Yoga with Chiaki 2 Neck Rotation
Gentle Yoga with Chiaki 3 Twist Movement
Gentle Yoga with Chiaki 4 Isometric Knee Push
Gentle Yoga with Chiaki 5 Outside Knee Push
Gentle Yoga with Chiaki 6 Front and Back Ankle Push
Gentle Yoga with Chiaki 7 Arms Behind the Back and Stretch
Gentle Yoga with Chiaki 8 Easy Abdominal Breathing

In Conclusion

Practicing yoga doesn’t mean you have to adapt a new lifestyle – it can become part of your lifestyle even if you have lupus (with your healthcare practitioner’s consent, of course). With so many practices to choose from, if you are interested in starting a yoga practice to help with symptom management and improved overall well-being, you should be able to find one that’s right for you, even if you have to mix-and-match practices a bit. Practicing yoga is not about being the most adept at poses – it’s about accepting where you are today – not anticipating tomorrow – and remembering to breathe in the precious moment.




A beginner’s guide to 8 major styles of yoga. (2019). Retrieved from:
Bartlett, S., Bernatsky, S., Bingham, C., Haaz, S., & Mill, C. (2013). Yoga in rheumatic diseases. Retrieved from:
Bennett, R., Carson, J., Carson, K., Jones, K., Mist, S., & Wright, C. (2010). A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia. Retrieved from:
Ishimura-Smillie, C. (2019, January 3). Interview with Liz Heintz.
The international association of yoga therapists. (n.d.). Learn about IAYT. Retrieved from:
Yoga Therapy: Relieve pain, Manage Stress. (2021, June 17). Retrieved from:
Yu, C. (2017). The beginners guide to every type of yoga out there. Retrieved from:



Author: Liz Heintz

Liz Heintz is a technical and creative writer who received her BA in Communications, Advocacy, and Relational Communications from Marylhurst University in Lake Oswego, Oregon. She most recently worked for several years in the healthcare industry. A native of San Francisco, California, Liz now calls the beautiful Pacific Northwest home.

All images unless otherwise noted are property of and were created by Kaleidoscope Fighting Lupus. To use one of these images, please contact us at [email protected] for written permission; image credit and link-back must be given to Kaleidoscope Fighting Lupus.

All resources provided by us are for informational purposes only and should be used as a guide or for supplemental information, not to replace the advice of a medical professional. The personal views expressed here do not necessarily encompass the views of the organization, but the information has been vetted as a relevant resource. We encourage you to be your strongest advocate and always contact your healthcare practitioner with any specific questions or concerns

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