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 You Should Know About Arthritis

What You Should Know About Arthritis
Robert Thatcher

Should the person experience some muscle pain which lasts more than 2 or 3 days, there is a strong chance that one has arthritis.
Arthritis is a common disease that affects millions of people worldwide. This can be felt in the persons joints, skin and organs inside the body. Should the person feel anything wrong, it is advisable to go straight to the doctor.
Doctors have discovered that there are over 100 types of arthritis. Given the number, the doctor will not be able to know which one is affecting the person without an examination.
There are 2 common forms of arthritis. The first is rheumatoid arthritis which is considered a chronic disease. There is inflammation in the joints caused by cartilage damage. Anyone who has this will suffer long term joint damage that will lead to chronic pain and disability. Pain is usually felt when waking up in the morning and will gradually disappear during the day.
Rheumatoid arthritis is a problem that will not go away. This happens in three stages. The first is swelling. The second is the rapid division and growth of cells. The third is when these cells release enzymes that will eat the bone causing the joint to lose shape until the person will not be able to move it anymore.
Since this is systemic disease, it can spread and affect other organs in the body. The best way to prevent is from happening is detecting it early to prevent the person from being disabled.
This can be treated with proper medication and therapy. There many drugs available that the patient can use. Some drugs offer pain relief to reduce the inflammation. Others can just do one function.
The second is called osteoarthritis. This happens more often than rheumatoid arthritis but unlike the first, there is no inflammation present. The cartilage in the joint is damaged and will eventually degenerate. Pain will slightly be felt when the person gets up but this will hurt later on during the day.
Osteoarthritis can either be primary or secondary. When it is primary, it is often associated with age. It is similar to a car where the parts have to be replaced due to wear and tear. Doctors consider this to be normal as people grow older.
The secondary type is often associated with something else that has caused this to happen. Some of these factors are an injury that took place, heredity, obesity and bone density.
Osteoarthritis can be treated with medication, exercise, weight control, joint protection, physical and occupational therapy. This is done to relieve the pain and slow the progression of the disease.
Both of these are caused by different things. The common thing between these 2 types is that joint pain can happen anywhere in the body.
Given the many medications available to treat this disease, the patient has to be aware of the side effects of each before choosing which one to use. The doctor should explain these to the person in order to make the right decision.
Arthritis and its different forms will not go away. Since this is an insurable disease, the best thing that the doctor and others can do until a cure if found is to help the patient ease the pain the slow the growth of the disease.

About The Author

Robert Thatcher is a freelance publisher based in Cupertino, California. He publishes articles and reports in various ezines and provides arthritis resources on http://www.your-arthritis-resources.info.

Rheumatoid arthritis treatment

Rheumatoid arthritis treatment
Robert Kokoska

Rheumatoid arthritis is a condition where involves inflammation
of joints which leads to further swelling and pain. It causes an
upset inside the body where the immune system starts attacking
joint tissue, cartilage and other organs.

However the causes of rheumatoid arthritis are still not known
fully. This type of arthritis is the most common and affects one
in every 100 people. Rheumatoid arthritis affects people of all
ages but mainly effects people within the ages of 30 – 50. Women
are three times more likely to be effected as men. Patients
carrying this form of arthritis most often complain of
fluctuating pain and inflammation of joints, which can get gets
worse during flare-ups.

This article aims to offer an insight into several treatments
that can be used against rheumatoid arthritis.

There are two main kinds of drugs used against rheumatoid
arthritis; first line drugs, fast acting drugs, and second line
which are slow acting drugs.

First line drugs include nonsteroidal
anti-inflammatory drugs (NSAIDs). Examples of NSAIDs are
aspirin, ibuprofen and etodolac. These can be used to reduce
pain and swelling of joints.

Aspirin has long been used to decrease inflammation. It can be
used to treat rheumatoid arthritis by using doses that are
higher then those used during fever. Newer types of NSAIDs are
effective as aspirin and require fewer intakes per day. However
just like all medication, it has its own side effects which
include stomach pain, abdominal pain and a few others. In order
to minimize the side effects of NSAIDs, they are regularly taken
with meals.

Another type of first line drugs includes Corticosteroids. They
are more powerful then NSAIDs and are given either orally or
through an injection to the inflamed areas such as joints.

Corticosteroids are given in small doses, mainly during
flare-ups as it reacts more strongly to inflammation. However it
can have serious side effects on the body if given for an
extended period of time in high doses. These include weight
gain, easy risk of infection, easy bruising and others. The side
effects can be minimized by decreasing the level of doses given
to the patients slowly as the condition of the patient improves.
A sharp decline in the doses given to the patient is discouraged
as it can lead to flare-ups and other symptoms of the disease.

Second line drugs include Disease-modifying
Anti-rheumatic Drugs or DMARDs. These drugs are mainly used to
prevent destruction of joints and deformity. DMARDs are used for
an extended period of time in order to be effective. DMARDs can
often be used with a combination of other second line drugs as
therapy.

Some examples of DMARDs include Sulfasalazine,
Hydroxychloroquine, D-penicillamine and others.

Apart from the above methods, there are some other approaches
that can be used to treat rheumatoid arthritis. The patients can
undertake exercise that can help them improve their physical
condition and improve joint mobility. Additionally it is
important to have a healthy intake of food.

Many often patients with rheumatoid arthritis can experience
weight loss. This can be combined with medication and therapy to
come up with a more potent combination against the condition.
Depending on your position, you can under go either
physiotherapy or occupational therapy. This will help improve
flexibility, mobility, and reduce pain in your joints.

The aforementioned approaches to rheumatoid arthritis have been
used time and again. However it is essential to seek your
nearest doctor to get firm guidance. Each arthritis case shall
be dealt on an individual basis.

With the passage of time, new and more effective treatments
against arthritis are starting to come through. However the only
way to gain the maximum benefit from the existing treatments
will be to remain punctual throughout the course of the
medication. It is important to constantly consult your doctor
and keep him or her up to date with your condition, so that the
doctor can advise you further and give more effective feedback.

About the author:
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Relief for Arthritis

Relief for Arthritis
Nestler

Inflammation or degeneration of the joints is a common problem
especially as one ages, and sufferers are constantly on the
lookout for arthritis
relief.

Popping a pill may be the first thought that comes to mind,
perhaps a pain killer or one of the anti-inflammatory
medications. The latter come in the form of pills, ointments,
gels or salves and may provide the desired relief. However, if
the problem persists, use of medication should be discussed with
a physician so the sufferer is aware of possible side-effects
and precautions with their use.

In spite of the pain, moderate daily exercise, such as swimming,
walking, or perhaps physical therapy is critical if the
arthritis sufferer is to maintain mobility in the joints. A
therapist will help design an exercise program which, when
interspersed with rest periods, will help reduce joint
inflammation. Moist heat is helpful in reducing pain and
increasing ease of movement. Heat is soothing and infra-red is a
penetrating heat. Placed about 60cm or 24inches from the
affected joint, for about 20 minutes, up to 3 times daily, it
may be helpful, especially just before beginning an exercise
routine. However, there is probably no long term benefit.

A physiotherapist may give advice on maintaining correct
posture, during sitting and standing. Some individuals seek
relief from various forms of alternative medicine. . Needless to
say, excess body weight aggravates the problem.

In severe cases, surgical procedures may be necessary;
artificial joints may be implanted to replace those damaged
beyond repair.

Some detective work on the part of the sufferer may be called
for. By determining when the symptoms pop up, it may be possible
to manage some of the suffering. Pain in a joint may be felt
during or after use, or after a period of inactivity. Discomfort
may signal a change in the weather or be felt during it.

Although there’s no cure for arthritis, available treatments can
relieve pain and help you remain active. At the first signs of
the illness, treatment should begin. Rest and easy exercise such
as swimming may be effective starting points along with some
over the counter medications to ease the pain and improve joint
functioning.

Among the treatments your doctor may suggest are medication,
self-care, physical therapy and occupational therapy.
Occasionally surgery is recommended.

In addition, how well you live with arthritis often depends on
your behaviors and attitude. If you actively manage your
arthritis, you may be able to gain control over your pain.

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