Tag: American College of Rheumatology

YOGA AND ARTHRITIS: A REVIEW

YOGA AND ARTHRITIS: A REVIEW
Dr. Manoj Dash, BHMS, DYT,Ph.D.

Yoga is an ancient Indian science and way of life, which influences the functioning of the brain and the rest of the body. Several studies have shown that the practice of yoga has a definite role in the promotion of positive health, including mental health, characterized by improved cardio-respiratory efficiency, autonomic responses to stressors, sleep, muscular endurance, and `higher brain functions. With an increase in the incidence of stress-related ailments, related to the rapid pace of life today, yoga has been evaluated as a treatment for such disorders in several controlled trials. The disorders, which were most likely to respond to yoga, with reduced symptoms and need for medication, were bronchial asthma, non-insulin dependent diabetes mellitus, anxiety neurosis, and rheumatoid arthritis. THE CONCEPT OF HEALTH According to the World Health Organization (WHO) the state of health is defined as a state of complete physical, mental, social and spiritual well being and not merely an absence of disease or infirmity. It is clear from this definition that health and ill-health are not two discrete entities as commonly understood but health should be conceived as a continuous function indicating the state of well being.The ancient Indian science, Yoga, has its origin in the Sankhya philosophy of Indian culture, which is about 8000 years old (Nagarathna, 2001). Yoga includes a wide range of techniques (e.g., physical postures, regulated breathing, cleansing techniques, meditation, philosophical principles, and devotional sessions, surrendering to the Supreme). These techniques bring about a calm and balanced state of mind, and are expected to help the spiritual evolution of the individual. However, yoga has more pragmatic applications in medicine. In order to understand these, it is important to know the concepts of health and disease in Yoga texts. According to yoga, man is in perfect health and homeostasis at his subtle levels of existence. All diseases are classified as (i) stress-related (adhija) and (ii) not stress related, e.g., injuries (anadhija) (Vasudeva, 1937). Yoga has been considered especially useful in the management of stress related disorders by getting mastery over the excessive speed of the mind. The technique to reducing the rate of flow of thoughts with deep internal awareness is yoga. This review will describe the therapeutic applications of yoga in the management of arthritis. Physical activity is an essential part of the effective treatment of osteoarthritis (OA) and rheumatoid arthritis (RA), according to treatment guidelines published by the American College of Rheumatology (Hochberg, 1995; Newsome, 2002). In persons with arthritis, exercise is safe and does not exacerbate pain or worsen disease (Ettinger,1997; Minor,1999; O’Grady,2000;Bearne,2002). In fact, exercise may play a key role in promoting joint health (Forrest,1994) , since those who do not exercise often suffer more joint discomfort than those who do (Nordemar,1981). However, regular physical activity is especially important for people with arthritis, who often have decreased muscle strength, physical energy, and endurance (Lyngberg,1988). The psychological benefits of exercise such as stress reduction, fewer depressive symptoms, improved coping and well-being and enhanced immune functioning (Taylor,1985;Scully,1998;Fox,1999 Paluska,2000) also contribute to greater overall health.Scientific studies on yoga Yoga has been used in the management of a wide range of diverse ailments. While there is a great deal of anecdotal evidence of the benefits of yoga, to date only a handful of scientific studies have been conducted on persons with OA and RA (though several more are currently underway). The study conducted in England demonstrated that hand grip strength significantly improved following yoga in rheumatoid arthritis patients (Haslock,1994). It was subsequently proven that yoga resulted in similar benefits in rheumatoid arthritis patients in an Indian population (Dash, 2001). Studies in osteoarthritis of the hands and carpal tunnel syndrome show greater improvement in pain during activity, tenderness and finger range of motion (Garfinkel, 1994). These above studies have shown promising results with some improvement in joint health, physical functioning, and mental/emotional well-being. Perhaps most importantly, yoga has an important positive effect on quality of life. People with arthritis may also enjoy yoga more than traditional forms of exercise, and exercise enjoyment is an important predictor of adherence(Ryan,1997;Trost,2003).This is particularly important considering that, on average, 50% of sedentary individuals will drop out of exercise within 6 months (Dishman,1990).In summary, yoga can be a meaningful and enjoyable alternative to traditional forms of exercise such as aerobics or aquatic exercise with important health benefits. Yoga can play an important role in reducing stress and frustration that results from pain and disability, and increasing positive feelings and wellbeing. Drug treatments for OA and RA have improved markedly in the last few years. Despite this, arthritis cannot be cured, and even the best medications and medical care can only help a little. There is a great need for additional activities patients can do to reduce pain, disability, and take control of the overall impact arthritis may have on their lives. Thus, the evidence suggests that, when combined with a program of good medical care, yoga may provide important additional physical and psychological health benefits for arthritis patients. Finally, it has to be emphasized that while yoga has important therapeutic benefits, the practice of yoga is very important in the promotion of positive health and human potential in body, mind, and spirit (Scott, 1999).References:1.Nagarathna R. Yoga in medicine. API Text book of medicine (6th ed), 2001. 2.Vasudeva Sharma PL. Laghu yoga vasistha (in Sanskriit); Nirnaya sagar prakashan, Bombay 1937,P 684.3.Hochberg MC, Altman RD, Brandt KD, Clark BM, Dieppe PA, Griffin MR et al. Guidelines for the medical management of osteoarthritis. Part II. Osteoarthritis of the knee.American College of Rheumatology. Arthritis Rheum 1995; 38(11):1541-1546.4.Newsome G. Guidelines for the management of rheumatoid arthritis: 2002 update. J Am Acad Nurse Pract 2002; 14(10):432-437.5.Minor MA. Exercise in the treatment of osteoarthritis. Rheum Dis Clin North Am 1999; 25(2):397-415, viii.6.Bearne LM, Scott DL, Hurley MV. Exercise can reverse quadriceps sensorimotor dysfunction that is associated with rheumatoid arthritis without exacerbating disease activity. Rheumatology (Oxford) 2002; 41(2):157-166.7.O’Grady M, Fletcher J, Ortiz S. Therapeutic and physical fitness exercise prescription for older adults with joint disease: an evidence-based approach. Rheum Dis Clin North Am 2000; 26(3):617-646.8.Ettinger WH, Jr., Burns R, Messier SP, Applegate W, Rejeski WJ, Morgan T et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). JAMA 1997; 277(1):25-31.9.Forrest G, Rynes RI. Exercise for rheumatoid arthritis. Contemp Intern Med 1994; 6(11):23-28.10.Nordemar R, Ekblom B. [Effects of long-term physical therapy in rheumatoid arthritis]. Lakartidningen 1981; 78(15):1561-1564.11.Lyngberg K, Danneskiold-Samsoe B, Halskov O. The effect of physical training on patients with rheumatoid arthritis: changes in disease activity, muscle strength and aerobic capacity. A clinically controlled minimized cross-over study. Clin Exp Rheumatol 1988; 6(3):253-260.12.Paluska SA, Schwenk TL. Physical activity and mental health: current concepts. Sports Med 2000; 29(3):167-180.13.Fox KR. The influence of physical activity on mental well-being. Public Health Nutr 1999; 2(3A):411-418.14.Scully D, Kremer J, Meade MM, Graham R, Dudgeon K. Physical exercise and psychological well being: a critical review. Br J Sports Med 1998; 32(2):111-120.15.Taylor CB, Sallis JF, Needle R. The relation of physical activity and exercise to mental health. Public Health Rep 1985; 100(2):195-202.16.Haslock I, Monro R, Nagarathna R, Nagendra HR, Raghuram NV. Measuring the effects of yoga in rheumatoid arthritis. Br J Rheumatol 1994; 33(8):787-788.17.Dash M, Telles S. Improvement in hand grip strength in normal volunteers and rheumatoid arthritis patients following yoga training. Indian J Physiol Pharmacol 2001; 45(3):355-360.18.Garfinkel MS, Schumacher HR, Jr., Husain A, Levy M, Reshetar RA. Evaluation of a yoga based regimen for treatment of osteoarthritis of the hands. J Rheumatol 1994; 21(12):2341-2343.19.OConnor D, Marshall S, & Massy-Westropp N. Non-surgical treatment (other than steroid injection) for carpel tunnel syndrome. Cochrane Database Syst Rev. 2003; (1): CD003219.20.Trost SG, Sallis JF, Pate RR, Freedson PS, Taylor WC, Dowda M. Evaluating a model of parental influence on youth physical activity. Am J Prev Med 2003; 25(4):277-282.21.Ryan RM, Frederick CM, Lepes D, Rubio N, Sheldon KM. Intrinsic motivation and exercise adherence. International Journal of Sports Psychology 1997; 28(4):335-354.22.Dishman R. Determinants of participation in physical activity. In: Bouchard C, Shepard R, Stephens T, Sutton J, McPherson B, editors. Exercise, Fitness, and Health. Champaign : Human Kinetics, 1990: 75-102.23.Scott AH. Wellness works: community service health promotion groups led by occupational therapy students. Am J Occup Ther. 1999; 53(6): 566-74. About the Author
I am a Doctor, doing my Ph.D.in Yoga. My topic of interest is to conduct Yoga Retreat, take class for Yoga Teacher and Medical professionals for in depth Research findings, and also Interest to conduct research in various field of yoga, both experimental and theoretical. I have been Traveling to all EUROPIAN countries.My contact: [email protected] web page:http://www.geocities.com/manojrieneke/Research.html

Relief From Arthritis: A Who’s Who in Arthritis Treatment for

Relief From Arthritis: A Who’s Who in Arthritis Treatment for Newly Diagnosed Patients
John Robben

Newly diagnosed arthritis patients can easily become overwhelmed
with the myriad of information, treatment options, help and
professionals available to them, while still trying to find
relief from their disease. In an effort to demystify who does
what, this article will point out each of the people you’ll most
likely be interacting with during your arthritis treatment and
explain their role in helping you find relief from arthritis.

Arthritis Treatment Specialist: Acupuncturist

Considered foreign to most Americans, acupuncture has become a
beacon in the arthritis treatment sphere. By placing small,
sterile needles into very specific points on the body,
acupuncture is said to relieve stress, increase endorphins and
remove blockages that are pain-causing, thus providing relief
from arthritis. For a list of fully trained osteopaths who are
also acupuncturists, visit the American Academy of Medical
Acupuncture for more information.

Arthritis Treatment Specialist: Chiropractor

Chiropractors are the hands-on, trained manipulators that
actually realign the joints, muscles and tendons that may be out
of whack. Although they are not medical doctors, chiropractors
may refer their findings to your family doctor or rheumatologist
for further investigation. The American Chiropractic Association
can give you a better idea as to what exact these professionals
can do to help you find relief from arthritis.

Arthritis Treatment Specialist: Massage Therapist (LMT,
CMT)

Relief from arthritis isn’t only found in the bottom of a
medicine bottle or at the hands of a surgeon; many arthritis
treatment plans strongly suggest a massage therapist as an aide
to reduce muscle tension or to increase one’s range of motion.
However, not all massage therapists are trained the same: check
with the American Massage Therapy Association for certified
arthritis treatment specialists in your area.

Arthritis Treatment Specialist: Orthopaedic Surgeon (MD)

Specializing in the evaluation and treatment of the bones,
joints and tissues, orthopedic surgeons usually work on a
referral-based system from your family doctor. These types of
doctors will determine whether or not your arthritis treatment
will focus on surgery, non-surgical options or a combination
thereof. The American Academy of Orthopaedic Surgeons can answer
most of your general questions about surgical arthritis
treatment options that can bring relief from arthritis symptoms.

Arthritis Treatment Specialist: Physical Therapist

Sometimes known as occupational therapists as well, physical
therapists help with the daily management of the disease by
showing patients practical, hands on tactics to find relief from
arthritis. This can include heat/cold therapy, assistive
techniques (different ways of doing the same thing so that there
is less pain but with no reduction of mobility), introducing
tools that can help with day-to-day living and exercises that
increase flexibility and mobility. Contact the American Physical
Therapy Association for more information.

Arthritis Treatment Specialist: Rheumatologist (MD)

A rheumatologist is a doctor who specializes in the treatment of
muscle and skeletal problems, such as lupus, osteoporosis and
gout. Rheumatologists work closely with your family doctor to
ensure your arthritis treatment is specific and specialized. The
American College of Rheumatology provides “professional
education” to its members and publishes several journals related
to arthritis treatment and the relief from arthritis symptoms.

About the author:
John Robben is the owner/operator of Ultimate Water Massage
(est. 2000), a Washington-based company that offers over 2000
products to ease your pain and your life. Visit for more
information, tools, supplies and tips for relief from arthritis
pain at http://www.ultimatewatermassage.com/.

No Pain, No Gain Isn’t True of Arthritis, But Exercise

No Pain, No Gain Isn’t True of Arthritis, But Exercise Is Still Important
David Silva

National Institute of Arthritis and Musculoskeletal and Skin DiseasesRecent studies have shown that exercise may acually help people with arthritis in a number of ways. It can reduce joint pain and stiffness. It can increase flexibility, muscle strength, and endurance. And it can also help with weight reduction and contribute to an improved sense of well-being.Most comprehensive arthritis treatment plans should include an exercise regiment. Rest and relaxation, proper diet, medication, and instruction about proper use of joints and ways to conserve energy (that is, not to waste motion), as well as the use of pain relief methods should also be included in treatment plans.What types of exercises are best for people with arthritis? Try these three:Range-of-motion exercises to help maintain normal joint movement, relieve stiffness, and increase flexibility.Strengthening exercises to help keep or increase muscle strength. Strong muscles help support and protect joints affected by arthritis.Aerobic or endurance exercises to improve cardiovascular fitness, help control weight, and improve overall function. Weight control can be important to people who have arthritis because extra weight puts extra pressure on joints. As always, people with arthritis should discuss their options with their doctors before starting on an exercise program. Easy, range-of-motion exercises and low-impact aerobics are gennerally a good way to get started. And make sure to ask your doctor about any sports or exercise programs in which you currently participate. Some programs may do more harm than good.You should also be aware that your doctor may decide to refer you to a physical therapist. A therapist with experience in arthritis can design an appropriate home exercise program and teach you about pain-relief methods, proper body mechanics, joint protection, and conserving energy.So what’s the best way to get going? First, always first, discuss your exercise plans with your doctor.Next, start with supervision from a physical therapist or a qualified athletic trainer.Apply heat to sore joints.Stretch and warm up with range-of-motion exercises.Start strengthening exercises slowly with small weights (a 1 or 2 pound weight can make a big difference).Progress slowly.Use cold packs after exercising.Add aerobic exercise.Ease off if joints become painful, inflamed, or red and work with your doctor to find the cause and eliminate it.Like any exercise program, choose a program you enjoy and make it a habit.Range-of-motion exercises should be done at least every other day. Strengthening exercises also should be done at least every other day unless you have severe pain or swelling in your joints. Endurance exercises should be done for 20 to 30 minutes three times a week unless you have severe pain or swelling in your joints.Additional information on arthritis and exercise can be found at the following resources:Arthritis FoundationThe Foundation publishes a free pamphlet on exercise and arthritis and a monthly magazine for members that provides up-to-date information on all forms of arthritis. http://www.arthritis.orgAbout Arthritis TodayInformation on the causes, symptoms, and treatments of arthritis.http://www.aboutarthritistoday.com/arthritisexercise/Spondylitis Association of America (SAA)SAA sells books, posters, videotapes, and audiotapes about exercises for people who have arthritis of the spine.http://www.spondylitis.orgAmerican College of Rheumatology/Association of Rheumatology Health ProfessionalsThis association provides referrals to physical therapists who have experience designing exercise programs for people with arthritis. The organization also provides exercise guidelines developed by the American College of Rheumatology.http://www.rheumatology.org About the Author
About Arthritis Todayhttp://aboutarthritistoday.com

For Arthritis Patients the Wrong Doctor Could Spell Disaster

For Arthritis Patients the Wrong Doctor Could Spell Disaster
Rudy Silva

For Arthritis Patients the Wrong Doctor Could Spell Disaster

New Book “Take Back Control of Your Arthritis: The 12 Critical Steps” Debuts During National Arthritis Awareness Month in May

San Antonio, Texas – April 14 /Xpress Press/ – Choosing the wrong physician may have disastrous consequences for an arthritis patient,” says Dr. Joel Rutstein, a board-certified rheumatologist and author of the new book “Take Back Control of Your Arthritis: The 12 Critical Steps.”

Dr. Rutsteins book debuts during May, which is also National Arthritis Awareness Month.

“Finding a Doctor You Can Trust” is the books first chapter and first step in Dr. Rutsteins 12-step road-map, which teaches arthritis sufferers how to avoid “the wrong doctors” and better self-manage their rheumatic condition.

How do you know if you are seeing the “the wrong doctor”?

— Dr. Rutstein suggests asking yourself the following questions the next time you see or call your doctor. If you answer yes to any of them, you may be seeing a physician who is not providing treatment that is in your best interest.

— Is your doctor unsympathetic when it comes to your complaints about pain?

— Does your doctor under-treat your pain, or do you feel your doctor does not believe your complaints of pain?

— Is your doctor excessively busy or a “bad listener”? Does he or she seem uninterested in hearing your medical history or evaluating your multiple complaints?

— Is your doctor too rough when examining your joints and muscles? Do you sometimes leave the medical office in more pain then when you arrived?

— Finally, is your doctor a poor communicator? Is your doctor not explaining your diagnosis and plans for treatment clearly and in simple and understandable terms?

Patients should spend as much time picking the perfect doctor as they would the perfect spouse, cautions Dr. Rutstein. “After all, your physician is the medical expert responsible for making life and death decisions concerning your health.

“Take Back Control of Your Arthritis: The 12 Critical Steps,” ($19.95, 229 pages) is available for sale at www.ArthritisMall.com or by calling toll free 800-980-6255. Multiple helpful video programs, including innovative exercise videos, are also available for purchase at the site.

About Dr. Joel E. Rutstein

Dr. Rutstein is the publisher of ArthritisCentral.com, one of the largest patient information websites dealing with the subject of arthritis and osteoporosis. A Spanish language version of the site may be accessed at www.ArtritisCentral.com.

In 1978, Dr. Rutstein founded the Arthritis Diagnostic & Treatment Center in San Antonio. He is currently the clinic’s director. He is a fellow member of the American College of Rheumatology and the American College of Physicians and is also the Clinical Professor of Medicine at the University of Texas Health Science Center at San Antonio. BestDoctors.com recently named Dr. Rutstein as one of the “Best Doctors in America for 2003-2004.”

About the author:

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