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Yoga Medicine is an holistic practice which engages the mind and the body to work in unison and may be used as an alternative form of medicine to traditional practices. The primary focus of yoga is to improve posture, regulate breathing and assist in meditation to bring balance to the health (physical, mental, spiritual and emotional) of those who practice. Alternative medicine are distinct medical practices and methodologies which are not presently considered to be part of conventional medicinal practices. Yoga comprises of eight limbs, yamas (universal ethics), niyama (individual ethics), asana (physical postures), pranayama (breath control), pratyahara (control of the senses), dhāranā (concentration), dyāna (meditation), and samadhi (bliss) which work harmoniously to give yoga its potential healing properties.

Origins
Yoga began in India several thousands of years ago and is seen as an introspective discipline which combines both physical and spiritual practices to achieve  paramatman  or ultimate consciousness. Upon entering this state of bliss, one finds themselves on the pathway to enlightenment or samadhi. Yoga was practiced in the east for the purpose of achieving this spiritual enlightenment, through meditating and breathing techniques. It has however, been suggested that the form of yogic practices adopted by the west today, may not be true reflections of traditional Indian yoga.

Yoga in the Western World
During the twentieth century in the western world, yoga has become increasingly popular, since its commercialisation, which has converted the practice into a multimillion dollar business. It is estimated that almost 15 million Americans and half a million Britons, engage in forms of yoga therapy. It is common for western societies to use yoga for physical health practice more than for its philosophical and spiritual roots. In a recent American study conducted, it was noted that the desire to maintain an appealing aesthetic and flexibility, were the primary driving factors for persons who continued to practice. Although, similar studies highlighted that this is not always the case, and as a person's involvement in yoga is prolonged, their intention to practice yoga may develop spiritual and transcendent elements. " Paradoxically, it is possible that just at the point when the rest of the world seems intent on imitating the Western way of life; the West itself is actually turning away from its own historic roots and embracing an Eastern outlook (Ivtzan, I & Jegatheeswaran, S 2017, ‘The Yoga Boom in Western Society: Practitioners’ Spiritual vs. Physical Intentions and Their Impact on Psychological Wellbeing’, Journal of Yoga & Physical Therapy, vol. 5, no. 3, pp. 1-7). "Modern western medicines continue to clash with traditional medicinal practices of the east, as both claim to be the superior form of treatment. Western nations continue to place emphasis on modern medicine, whilst at least 80% of the eastern world, especially developing countries, continue to rely on traditional medicine for chronic ailments. These eastern practices centre themselves around Ayurveda which is an holistic approach to health that focusses on treating the entire person. When a body is diseased, unlike western society, it is seen as an imbalance that can be fixed through Ayurvedic practices. In addition to this, holistic practitioners promote the consumption of healthy foods, yoga, meditation and in some cases, the prescription of herbal medicine. Contrary to this, western practices tend to treat the disease or ailment in isolation.

Mental Health
Some academics argue that yoga's popularity stems from its ability to enhance psychosomatic well-being by limiting the stress response system, increasing self-awareness, quality of life and resilience. Stress can have detrimental effects on one's mental health by exacerbating mental disorders, like depression and anxiety, already in existence. Yoga also increases a sense of satisfaction for practitioners which in turn increases a sense of happiness and promotes subjective hedonism and eudaimonic well-being. Extensive research has been conducted to showcase how yogic practices may be used to alleviate various mental health issues that are endemic in society today.

Depression
Depression is one of the most prevalent mental health problems today as it now affects almost 5% of the global population. Today, the treatments available are predominantly centred around pharmaceutical s, electroconvulsive therapy, counselling therapies and lifestyle interventions. Recently yoga, particularly hatha yoga, has been suggested as an alternative form of therapy to assuage symptoms of depression owing to its spiritual teachings which prioritise a mind and body focus. For those whom are sceptical, it has also been suggested that yoga can be used as a complementary treatment. Something to note is that commencing a yoga program with a positive outlook may increase the efficacy of the treatment in alleviating depressive symptoms. " Yoga is a cognitive intervention as much as it is a physical one [because] yoga participants are invited to practice mindfulness i.e., to focus attention on their present moment experiences in a nonjudgmental way. (Uebelacker, L, Weinstock, L, Battle, C, Abrantes, A & Miller, I 2018, ‘Treatment Credibility, Expectancy, and Preference: Prediction of Treatment Engagement and Outcome in a Randomized Clinical Trial of Hatha Yoga vs. Health Education as Adjunct Treatments for Depression’, Journal of Affective Disorders, vol. 238, pp. 111-117) ."A recent study conducted to determine whether empirical evidence could support the hypothesis that yoga is an effective alternative, positively concluded that the sample group whom received yoga classes experienced greater reduction in depressive symptoms than the sample group who did not. To maximise yoga's efficacy for mental health, it is necessary for western practices of yoga to place greater emphasis on the spiritual components born in Indian tradition.

Anxiety
Yoga has proved its ability to regulate automatic nervous system activity which has assisted in the reduction of anxiety and stuttering, which may be connected to anxiety. " The practice of yoga induces parasympathetic nervous system activation (PNS: neurotransmitters responsible for relaxation response, decreasing blood pressure and heart rate; and activation of limbic regions of the brain) and suppresses sympathetic nervous system activation (SNS), which is responsible for the stress response including the release of cortisol and epinephrine (Lazar et al., 2000; Pramanik et al., 2009; Riley, 2004; Takahashi et al., 2005). "Similar to how yoga helps reduce depression, symptoms of anxiety may also be reduced by practicing mindfulness and various breathing techniques. These breathing techniques alter breathing patterns to help increase tidal volume and respiratory rate. One example of the benefits of yogic breathing techniques can be seen amongst people who stutter, particularly as a consequence of anxiety. Some studies have suggested that these breathing techniques reduce or completely eradicate stuttering, as they help a person to regain control over their speech.

Sudarshan Kriya Yoga (SKY) is targeted at breath manipulation which improves the wellness of one's body, breath, mind, soul and connection to the universe. SKY has become a novel medicinal practice whereby scientists are undergoing rigorous research to ascertain it as an evidence-based treatment. So far, people suffering from anxiety seem to have significantly benefitted from with the practice now known to increase the spontaneous respiratory coupling and cardiac autonomous control in patients.

Body Image
Body image is the way one perceives their physical and sexual aesthetic, and owing to the grave social pressures society imposes upon us, body-dysmorphia has become rife.

A recent study conducted in America suggested that college students, particularly women, constantly struggle with body-image dissatisfaction. Some of the limitations of the study were noted, for it did not take into account the social pressures that encourage persons to obsess over being thin, and, it involved only female participants. The use of female participants was justified owing to the greater likelihood for women to obsess over their weight and develop eating disorders. However, this was seen as a novel treatment for body-image, and the academics of this study noted that further research was necessary. Those who were involved in the sample, after periodically taking part in yoga classes for a two-month period, experienced a reduction in the time devoted to criticising their appearance. It seems that through the implementation of mindfulness in the student's everyday life, body objectification and dissatisfaction decreased.

Chronic Back Pain
'The most common reason people turn to non-traditional medicine, is pain, usually back pain'. A 2017 study conducted found that practicing yoga not only reduces lower back pain but decreases the likelihood of patients resorting to pain medications.

Yoga is considered an effective alternative therapy for it targets and strengthens particular muscle groups that helps improve spinal health. This in turn improves a person's posture by keeping the body healthy and supple. Through the incorporation of relaxation technique, unlike many other forms of exercise, yoga helps to better reduce the tension which our muscles retain. In addition to this, breathing techniques increase the blood flow and allow for toxins to leave the body and be replaced by nutrients. What primarily sets yoga apart from regular exercise, is it strengthens and stretches the body equally and allows a person to become more self-aware of their body's needs and limitations.

Cancer
" Given its simplicity and diverse forms, yoga is easily adaptable for most ages and clinical populations.The low intensity and modifiable nature of this exercise may be the reason why yoga has been primarily perceived as an adjunct therapy for clinical conditions, which is evident from the large number of studies conducted with patients with cancer. (Goethe, P., N. & Mcauley, P. E 2015, ‘Yoga and Cognition: A Meta-analysis of Chronic and Acute Effects’, Psychosomatic Medicine, vol 15, no. 7, pp. 784-789.)"Certain cancer research facilities in America, such as the City of Hope Cancer Centre, have noted the positive impact yoga may have for cancer patients, particularly those suffering from breast cancer. It was found in a study published in the Journal of Clinical Oncology, that several patients who partook in yoga therapy experienced lower levels of stress, fatigue and overall a better quality of life. It was explained that such positive feedback from the therapy stems from yoga's ability to regulate the stress hormone cortisol. Lorenzo Cohen, a co-author of the study explained that "better regulation of stress hormones has been linked with better [and longer] survival." In addition to this, yoga may have qualitative effects for breast cancer survivors by reducing their body image dissatisfaction ensuing treatment.

Anti-Ageing
The possibility of yoga as an anti-ageing treatment is only a recent developmental discovery, which looks at the positive impact that this practice may have on telomerase activity associated with the ageing process. Maintaining the length of telomeres is necessary for preventing cellular senescence, which is ultimately the cell-ageing process. When telomeres become inflamed or are placed under oxidative stress, they will experience shortening and speed up the ageing process. Some studies have shown that undertaking yogic practices and listening to meditative music may increase telomerase activity, thus, increasing telomeric length and slowing down the ageing process.

Substance abuse in adolescents
Adolescents are more likely to experiment with illicit substances by virtue of it being a period of perpetual change physically, biologically and socially. During this period it is integral that preventative methods to stop such behaviour are taken before these activities become habitual. A recent study conducted highlighted the weaknesses of educational prevention programs and suggests that yogic practices may be a more viable alternative. Yoga helps to reduce stress or tension which the body holds onto, ultimately improving the mood of a person and elevating them to a higher state of consciousness which can replace a substance-induced high. One may also become more self-aware through the meditative practices of yoga, enabling them to intervene more quickly when disruptive or maladaptive behaviour threatens to emerge. Lastly, it seems that overall, the efficacy of yoga in reducing substance-abuse stems from an elevated sense of self, where the person better understands what is conducive to their well-being and what is not.

Criticism
Data regarding why people practice yoga and why such people continue to practice it is quite limited. It was noted in one of the various studies surrounding this area of research, that sample sizes may be small and the data collected may be descriptive, therefore, restricting the amount of quantitative data available.

For example, yoga's alleged efficacy in reducing lower back pain is not without fault. A 2017 study that looked into this, suggested that it is unclear how yoga compares with conventional chronic back pain treatments like physical therapy, which unlike yoga, are covered by health insurance. The same study suggested that improvements in pain reduction for the group that underwent yoga therapy did not vary significantly from the other group who partook in physical therapy sessions.

Turning to the effects of yoga in breast cancer therapy, quantitative data is limited and further research is required to determine not only its efficacy but safety, to confidently rule yoga as a viable alternative to mainstream treatments like chemotherapy. So far, yoga seems to be an effective adjunct to conventional medications and treatment. "“Yoga if not practised correctly may have adverse effects; this is written in the ancient texts.There are yoga modules for specific diseases based on clinical observations, descriptions in the ancient texts, and rather inconclusive research” (Shirley Telles Patanjali Research Foundation, Haridwar, India)."Despite the many positives of yogic practice, it is not without risk. It is up to physicians to gage the physical capabilities of their patients and determine whether certain yogic practices may be conducive to their healing process. For every patient the duration and intensity will vary, and when these parameters are not abided by, the likelihood of injury occurring will increase.