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

What Causes Childhood Arthritis?

What Causes Childhood Arthritis?
David Chandler

What is childhood arthritis?Childhood arthritis is a disease that occurs in children under the age of 16. It causes pain, stiffness, and swelling in one or more of the joints. This pain, stiffness, and swelling are called inflammation. With childhood arthritis, the inflammation lasts longer than six weeks, and is not caused by an injury or other illness. Childhood arthritis is also called juvenile arthritis.How common is childhood arthritis? It affects 1 in 1,000 US children under the age of 16. Both boys and girls are affected by childhood arthritis. Arthritis is not just a disease of old people. In fact, approximately one in 1,000 children under the age of 16 suffers from arthritis. Juvenile arthritis is among the most common chronic childhood disorders.What causes childhood arthritis?The exact cause of childhood arthritis is unknown. Childhood arthritis does not usually run in families and cannot be passed from one person to another. The onset of childhood arthritis may follow an infection or injury, but these events do not cause the arthritis. With childhood arthritis, the body’s immune system stops working properly. The immune system’s job is to fight off germs and disease. However, in a child with childhood arthritis the immune system attacks healthy tissues. What triggers this process is unknown.What can you do about childhood arthritis? If your child has inflammation, in one or more joints for more than six weeks your doctor may perform a physical examination of your child and order tests, such as x-rays and blood tests to find out what is causing the inflammation. There is not just one single symptom, sign, or test that will give a diagnosis of childhood arthritis.If your doctor thinks your child has childhood arthritis, he or she will usually refer your child to a rheumatologist (pronounced room-a-tol-o-jist). A rheumatologist is a doctor who has received special training in the diagnosis and treatment of problems involving inflammation of the joints, muscles and other parts of the body. About the Author
For more information, visit www.ArthritisInfoCenter.com

Frequent Headaches and Migraine in Children

Children who get frequent headaches and migraine attacks have chronic illness. Such children and their parents face problem to adjust with school and their rules. Extra preparations and steps should be taken to cope with such illness. Pediatric specialist in migraine and headaches exist should be consulted for treatment and other precautionary & preventive measures. Also the triggers vary from child to child, which should be recognized accurately.

Firstly, it is the strict attendance rule in most of the schools that children with chronic illness find it difficult to deal with. To add to it, majority of the schools have zero tolerance policy regarding medications, even including over the counter medicines. Reports of students getting expelled for merely carrying Advil in school with them are common. Prior to making appointment with the doctor, it is recommended that parents read the policy of the school the child is attending. It is good to ask questions before hand, than feeling sorry later. Some of the schools asks for letter or medical record as a proof, incase the student didnt attend because of a health problem. Some schools consider sick leaves as regular leaves and in this case, the attendance gets affected greatly.

School nurses can be given the prescribed medicine so that they can give the medicine to the child at the required time. If this is the case, things such as medicine storage location and availability of substitute should be checked. Apart from not attending regularly, the child can sometimes be unable to take part in co-curricular activities especially physical education and outdoor recess. Other possible options should be discussed with the teacher. Usually a recommendation letter from the physician will do the needed. In all the cases, some kind of medical identification can be carried by the child at all times. If the child is attending an after school babysitter or program, directly after school, extra measures should be taken. The babysitter or program in charge should be told about the problem in advance. Their cooperation can be asked for timely administration of the medicine and for taking special care of the child. If the child himself is grown enough to understand the matter, the child should be educated about taking medications. They should also be made to understand that it is harmful to take medicines from any un-trustable source even if their fellow students do. Budge them to ask questions and clarify any of their fears of concerns.

Most of the children lack the ability to convey their problem properly. The situation is further aggravated because of different kinds of headaches. They can be related to chronic illness, tension, sinus or fever. Only diagnosis can bring out the correct problem. If the rate of headache becomes more frequent, like more than twice a month, doctors appointment should be taken instantly. Younger kids find it more difficult to explain the problem. If they become cranky, restless, irritating, tired, is having sleeping disorders and is not eating properly, a problem surely exists. Most of the children complain of headaches during exams because of increased stress. Seventy five percent of the children experience headaches because of tension. If so, stress management education, along with counseling, should be given to the kid.

Headaches can be an indication of other problems, too. So, thorough diagnosis is highly recommended. The childs previous medical history provides important clue. Prior to the doctors appointment, notes can be made after referring the medical history. Maintaining a log about the childs headache frequencies, pain location, time of occurrence, symptoms, etc. also helps. If not due to illness, headaches can also be a result of head injury. Sometimes, headache can be hereditary, like in the case of migraines.

Headaches can also be caused because of infections, vision problems, odd levels of blood pressure, neurological problems, muscle weakness, improper ear balance or serious problems such as tumor, blood clots, etc. If the doctor is not able to diagnose the problem, he/she can refer the child to a headache specialist or neurologist. Test such as CT scan or MRI are done if there is a serious problem. After the diagnosis, the doctor prescribes medication or will ask to take over the counter medicines. According to a study, children who face headaches and migraine take overdose of over the counter medicines for immediate pain reliving. In some of the cases, the parents are clueless about this situation. This practice is risky and mostly children above six years are involved in such cases.

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Male Menopause: Symptoms and Treatment

The term “male menopause” is used to refer to the condition of men who have hormone levels drop after mid-life.

Male menopause is a subject of controversy in the medical society. In the case of women, menopause is related with the termination of a bodily operation, like when the monthly menstruation periods stop. Also, a critical drop in the hormone levels in women occurs along with menopause. For these reasons, doctors are debating on whether male menopause really exists.

In the case of men in their middle and elderly years, smaller quantities of testosterone are being created by the testicles. This is believed to be the underlying reasons behind the occurrence of symptoms of male menopause.

Men with menopause usually suffer from irritability, sleep disturbance, low sex drive, sweating, anxiety, sadness, memory problems, and erectile dysfunction.

In most cases, erectile dysfunction may be caused by other disorders. But testosterone deficiency may be one possibility.

It is important that men who suffer from symptoms related to low levels of testosterone be subjected to medical investigations like blood tests to evaluate testosterone levels.

Other reasons for having short testosterone levels include testicular dysfunction and probable inherited features.

As a treatment, hormone replacement therapy is being recommended for men with low levels of testosterone and symptoms that come with it.

Hormone replacement may not be applicable to older men who seek treatment for their erectile dysfunction unless they actually have very minimal levels of androgen. As for younger men with known hormone deficiency, it has been proven that nominal doses of testosterone can improve interest in sex.

Testosterone replacement therapy, which is also called as androgen replacement therapy, aims to reduce the symptoms brought about by male menopause. This method is a lifelong treatment, since testosterone deficiency is generally a permanent condition.

Testosterone replacement therapy is usually given as an oral prescription, implants, or injections.

The injection of testosterone is usually carried out once every two weeks.

The oral drugs are especially prescribed to those who can’t stand injections or implants.

The testosterone implants, which are being inserted under the skin of the buttock or abdomen work for a period of months. The implant works by releasing testosterone directly into the bloodstream.

Androgen therapy, however, comes with potential side effects and risks.

With low testosterone levels, the prostate tends to shrink. Hormone replacement therapy cannot recover a physically reduced prostate since it does not have influence in the levels of prostate specific antigen.

Androgen therapy may not be a cause of increased risk of prostate cancer for those who have naturally greater testosterone levels in the same age bracket.

On the other hand, the safety of hormone replacement therapy and its possible effects on the prostate, mental functioning, and cardiovascular system still need to undergo proper researches. Moreover, there is also a need to assess the probable benefits of androgen therapy on the bones and muscles.

Androgen therapy is said to increase the risk of heart diseases, although researches on this subject are uncertain. It is a known fact, however, that those with low testosterone levels have been found among heart attack victims. This opens the possibility that hormone replacement therapy could help prevent cardiovascular diseases.

Older men undiagnosed of prostate cancer should also take caution when being applied with androgens.

Sleep apnea, or the cessation of breathing during sleep, is also considered as a rare risk with hormone therapy.