A US Department of Veterans Affairs study found that yoga delivered online reduced musculoskeletal pain more effectively than in-person classes, and more people stayed the course.
Let’s pause on that.
It is not the result most people expected.
In yoga and healthcare communities alike, in-person classes are often seen as ideal. Shared physical space, real-time connection, and embodied group energy are assumed to support better outcomes. But a small, carefully designed study from the US Department of Veterans Affairs challenges that assumption, at least when it comes to musculoskeletal (MSK) pain.
In this randomised controlled trial (RCT), Veterans with MSK pain were assigned to either in-person yoga or teleyoga, which was the same yoga protocol delivered online. Both groups attended weekly 75-minute classes for 12 weeks. The findings were striking:
Only the online group experienced a statistically significant reduction in pain.
The online group also had better retention, with 83 percent of participants completing the programme, compared to just 68 percent in the in-person group.
These results raise an important question. Could the way participants accessed the class, rather than the class content itself, be what made the difference?
Why Would Online Yoga Work Better?
Many people assume that in-person yoga is more effective. Being physically present with others, receiving real-time feedback, and sharing space are often seen as essential elements of the practice. But perhaps that assumption depends on what the yoga is supporting. When the issue is musculoskeletal pain, especially the kind that makes movement and travel difficult, in-person delivery may actually create additional strain.
Attending a class outside the home often means travel, navigating physical environments, sitting upright for long periods, and managing the sensory and social demands of being in a group. For people living with MSK pain, these added demands can heighten discomfort before the class even begins.
Teleyoga removes those pressures. Participants can practise at home, set up their space in a way that works for them, lie down immediately afterward, and opt out of interaction when needed. This does not mean the class itself is easier. It means that accessing the class places less burden on the body and nervous system.
Pain tends to worsen under strain. When people can engage in yoga without pushing themselves simply to be present, the practice may become more effective. In this study, that difference seems to have mattered.
Retention Tells a Story of Fit
The higher retention rate in the online group, 83 percent compared to 68 percent, is not just a number. It tells a story about what people can realistically sustain when they are living with pain.
For many, online delivery simply fits better. It removes logistical and emotional hurdles. When someone feels physically safe, psychologically supported, and not overextended, they are far more likely to stick with a programme. In therapeutic settings, retention is not a bonus. It is often the difference between a meaningful experience and an abandoned one.
In-Person vs Online Yoga: A Curious Twist in the Numbers
Here is where it gets interesting. Among those who stayed in the study, the in-person group attended more sessions on average. They attended 77.1 percent of classes, compared to 71.8 percent in the teleyoga group. That might seem at odds with everything else. If online yoga was easier to access and more effective, why did those in the in-person group attend more frequently?
This was a randomised controlled trial, so participants did not choose their group. But how they responded after being assigned could still vary. It is possible that those who remained in the in-person group felt especially motivated by the structure or social contact of in-person settings and made an effort to attend more consistently.
It is also worth noting that dropout can affect the averages. If more people in the in-person group dropped out early, then the attendance rate only reflects those who stayed. That is likely a smaller group who were more able or motivated to attend regularly. The study did not go into detail about this, but it is an important point to consider.
Still, the key takeaway remains. More frequent attendance did not lead to better results. The in-person group, despite attending more often, did not experience a statistically significant reduction in pain. The online group, with slightly lower attendance but higher retention, did.
It is a reminder that showing up more does not always mean healing more. Sometimes, the most therapeutic setting is the one that places the fewest demands on a body already in distress.
Is This Unique to Musculoskeletal Pain?
It might be.
MSK pain is especially sensitive to movement, strain, and physical stress. For someone dealing with joint stiffness, spinal discomfort, or postural fatigue, even the act of getting to a class can increase pain before the yoga even begins. In such cases, removing the need to travel, sit upright for long periods, or manage the demands of social space may significantly ease the load on the nervous system and allow the practice to have its intended effect.
A Call for Choice, Not Competition
This study does not suggest that online yoga is better in every context. It shows that for some people, especially those in pain, it may be more accessible, more sustainable, and more effective.
The goal is not to replace in-person yoga. The goal is to make space for both, and to recognise that different formats support different needs. While some people thrive in shared physical space, others may need the quiet dignity of healing at home. While some can make the journey to a class others will not be able to attend if this is compulsory.
The lesson here is not to rush to judgment, but to ask better questions.
- What helps this person feel safe?
- What reduces their pain, not just during yoga, but before and after?
- What kind of environment makes it easier for them to keep showing up?
Online Yoga: A Scalable Future for Pain Care
This study does more than challenge assumptions about yoga delivery. It points to a broader opportunity. If online yoga can reduce pain and improve retention, it becomes a scalable and cost-effective intervention.
Teleyoga can reach people who might never attend in-person classes. This includes those with mobility issues, people in remote areas, and anyone whose pain makes travel difficult. This is not just a matter of convenience. It is about equity and access.
Supporting people in their own homes can ease suffering while reducing strain on healthcare systems. When care becomes more accessible, it becomes more effective.
It also supports those delivering care. Yoga teachers and therapists often provide exceptional service at very low cost. Online delivery makes it possible to reach more people with fewer overheads, which can allow for more appropriate pay. Scaling access should not come at the expense of those offering the care.
The takeaway is simple. Meeting people where they are is not only compassionate. It may be essential for improving outcomes across populations and for sustaining the professionals who make that care possible.
