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

THE HOT STONE MASSAGE

The Hot Stone massage is a therapeutic massage technique in which a heated stone is held by the massage therapist who uses it to apply the customary and traditional Swedish massage strokes. Because they have the tendency to absorb heat and retain it for extended periods of time, the stones which are used are usual smooth, black volcanic basalt rocks of various sizes and shapes. For the most part, these rocks are heated in water at 120 to 150 degrees Fahrenheit. Native Americans are known to also have used hot stones for medicinal purposes but those were heated by direct fire. This technique of fire-heated stones was restored by Mary Nelson, a native of Tucson, Arizona and she trademarked it as LaStone Therapy.

Primarily due to the effects of the heat from the stones, the Hot Stone massage is profoundly calming and delightfully relaxing as it rapidly releases the tension out of every soft tissue, be it muscle, tendon or ligament, which is included in this treatment while gentle and comforting peace washes over the client almost immediately. The hot stones are used throughout the entire session to massage, to stroke, to press, to manipulate and to knead the clients soft tissues. On occasion, heated stones are laid out to rest at strategic spots along the spine as well as in the palms of the clients hands and between the toes. This maneuver promotes the optimal flow of energy throughout the entire body. As soon as the stones cool down, the massage therapist will replace them with newly heated ones but areas that are inflamed, injured or swollen, will often be treated with cold stones instead of the hot ones.

To derive the most out of the Hot Stone massage therapy, clients are encouraged to:

* Indicate any discomforts such as those which might be created by stones which are too hot, by the massage therapist applying pressure with too much force, by the background music which may be too loud, by the room temperature which could be too hot or too cold and so on.

* Refrain from consuming a heavy meal and to abstain from ingesting any amount of alcohol shortly before the session.

* Arrive in plenty of time to check in and to relax before the treatment.

* Take a sauna, a steam bath or a hot tub before the session as it will relax and soften the muscles for better end results from the entire treatment. If the hot tub was treated with chlorine, the clients are asked to take hot showers in order to rinse off the chemical.

* Remove all their clothing and be assured that they will remain completely covered with a towel. This will give the massage therapist better access and direct contact with the skin.

* Take slow, deep breaths throughout the session as it helps to relax the body and release more toxins.

* To banish irrelevant thoughts from racing through their heads by concentrating on the feel of the therapists movements over their bare skins.

* Get off the massage table after the session very slowly as dizziness may set in otherwise.

* Absorb the full results of the massage treatment by allowing some quiet time in a peaceful place.

* Drink extra water after the massage to flush out and wash away the toxins released during the treatment.

The Hot Stone massage is beneficial in many ways as it promotes deep muscle and soft tissue relaxation, eases stress, releases toxins, alleviates pain, improves circulation and calms the mind. Quite appropriately, therefore, there is an impressive list of ailments which are treated with Hot Stone massages and they are:

* Muscle aches and pains due to over use, injury or stress.
* Back pain caused by injury, poor posture or misuse.
* Multiple Sclerosis (MS).
* Arthritis.
* Fibromyalgia.
* Stress, anxiety, nervousness and depression.
* Insomnia.
* Any number of circulatory problems.

The Hot Stone massage requires specialized training, it involved more preparation time for disinfecting and heating the stones, the session are often somewhat longer than usual and more time is spent cleaning up. As a consequence, the Hot Stone massage tends to be more costly than any other conventional and basic Swedish massage. But it is worth it and you are worthy of it!

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