Yoga-based intervention to alleviate inflammation, pain, and reduce medication burden in sickle cell disease – A review and framework

Sickle cell disease (SCD) is a chronic hereditary hemoglobinopathy characterized by vaso-occlusive crises, inflammation, and progressive organ damage, leading to severe pain and disability. Current pharmacotherapies, such as hydroxyurea, L-glutamine, and crizanlizumab, can mitigate disease severity but are limited by their high costs, side effects, and accessibility challenges. Emerging evidence suggests that yoga, an integrative mind–body practice, may be a safe, feasible, and cost-effective adjunctive therapy for SCD. Biologically, yoga may mitigate inflammation (e.g., reducing IL-6, CRP, and TNF-α levels), improve autonomic balance and vascular function, and enhance sleep quality, thereby potentially decreasing vaso-occlusive crises and pain sensitization. Psychologically, yoga reduces stress, anxiety, depression, and pain catastrophizing while improving coping, resilience, and perceived control. Socially, yoga fosters peer support, empowerment, and cultural adaptability, which may alleviate stigma, improve adherence, and lessen healthcare burden. Preliminary trials in SCD populations have demonstrated the feasibility and acceptability of yoga, with trends toward pain reduction and enhanced quality of life, although the evidence remains limited by small sample sizes and methodological heterogeneity. Integrating yoga into SCD care may help reduce inflammation, pain, and medication dependence, particularly in low-resource settings. Larger randomized controlled trials combining clinical, psychological, and biomarker endpoints are warranted to establish the efficacy and optimize intervention protocols for sustainable and holistic SCD management. Given these limitations, this narrative review synthesizes broader evidence to construct a biopsychosocial framework that can provide theoretical foundation and guiding principles for future SCD-specific yoga research.