Tag: Treatment Of Osteoarthritis

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

Searching for Osteoarthritis Pain Relief?

Searching for Osteoarthritis Pain Relief?
Kristy Haugen

Osteoarthritis or degenerative joint disease is a wear and tear disease of the joints typically seen in the older adult (usually over 60 years of age). Cartilage within the joints breaks down causing pain as the bones rub against each other. Osteoarthritis is commonly found in the knees, hips, hands, spine, and feet.
Obesity is a risk factor for developing osteoarthritis in the knees and hips. These weight bearing joints carry much of the weight causing increased wear and tear. Weight loss can significantly reduce the chance of developing osteoarthritis and can alleviate pain in people who currently have osteoarthritis.
Currently osteoarthritis treatment is limited because no medications are capable of preventing or retarding the disease process. Osteoarthritis treatment involves focusing on pain relief, the maintenance of quality of life, and functional independence. Let us take a look at some of the treatments that currently exist for osteoarthritis.
Many doctors recommend acetaminophen (Tylenol) as the initial analgesic (pain medication) of choice for the treatment of osteoarthritis. Acetaminophen has very few side effects. When using acetaminophen as a pain reliever, remember to follow the directions correctly. Acetaminophen is commonly overused by patients. You are recommended to not exceed 4,000 mg of acetaminophen in a twenty-four hour period. Acetaminophen is metabolized or processed by the liver. Excess acetaminophen can cause damage to the liver. Acetaminophen is also found in other pain medications such as Darvocet, Percocet, and Tylenol Cold. In fact, acetaminophen is found in quite a few prescription pain medications.
Traditionally NSAIDs (nonsteroidal anti-inflammatory drugs) have been useful in the treatment of osteoarthritis associated pain. One major concern with the use of NSAIDs is irritation to the stomach lining. In more severe cases, gastrointestinal bleeds or ulcers may form. NSAIDs can affect the bodys blood clotting ability and interfere with kidney function. NSAIDs should always be taken with food to decrease stomach irritation or upset. Do not drink alcohol while taking NSAIDs. However, these drugs should not be taken for extended periods of time unless directed otherwise by a qualified medical provider. Some common types of NSAIDs are ibuprofen (Advil), naproxen (Aleve), and aspirin.
Cyclooxygenase-2 inhibitors (COX-2 inhibitors) are a class of NSAIDs. COX-2 inhibitors suppress arthritis pain much the same way but with less stomach irritation. Many of us know of COX-2 inhibitors but not by this name. Vioxx (refecoxib), Celebrex (celecoxib), and Bextra (valdecoxib) are COX-2 inhibitors. Vioxx and Bextra have been removed from the market. These drugs can significantly increase the risk for stroke and heart attack. Celebrex remains on the market but does have a black box warning stipulating this drug also can increase the risk for cardiovascular events and gastrointestinal bleeding.
Capsaicin (Capsagel, Zostrix) which is derived from chili peppers can be applied topically for the treatment of osteoarthritis pain. Capsaicin will cause vasodilation, itching, and burning to the skin but after repeated applications desensitization will occur, decreasing ones pain. Methyl salicylate creams such as Ben-gay can also be used for osteoarthritis pain. Studies have shown that oral glucosamine and chondroitin supplements have a mild to moderate analgesic effect with arthritis.
For osteoarthritis patients who cannot tolerate their pain, glucocorticoid injections may be done. Glucocorticoids are similar to the hormone cortisol in the body. Glucocorticoids help alleviate pain by decreasing inflammation and swelling within the joint. Side effects are typically seen if you receive these injections too frequently.
Hyaluronan (viscosupplementation) injections can be injected directly into the joint for treatment of osteoarthritis. This medication helps supplement the synovial fluid. The synovial fluid is a lubricating fluid allowing the bones to move smoothly within the joint. This injection should relieve pain and improve your mobility of the joint. This treatment involves 3-5 shots within 5 weeks. You may experience pain and swelling after the injections but this should dissipate. Reduced osteoarthritis pain may last up to 6 months.
For patients that have decreased function and mobility of the joint, surgical intervention may be necessary. Surgical involvement should also be considered in patients whose pain has progressed to unacceptable levels. However, good surgical candidates are usually considered ideal for surgery. Certain health conditions can affect post-operative rehabilitation and healing. Surgery can hold just as much of a health risk as medications have side effects.
Osteoarthritis is not curable but there is hope for the future with advancements in medicine. Along with the above treatments for pain management, it is also important to remain active and healthy. Exercising regularly can help maintain mobility of the joint. Exercise also creates natural pain relievers such as endorphins. Pain may be a part of osteoarthritis, but pain doesnt have to be a part of your life!
Copyright 2006 Kristy Haugen

About The Author

Kristy Haugen is a mother working to finish her second bachelor degree in Chemical Engineering. She is also a Licensed Practical Nurse with a current bachelor degree in Biology and Chemistry. She writes to inform consumers about nutrition and health topics. Learn more about weight loss supplements at http://weightlosssupplements.vitaminmaniac.com. Learn more about vitamins and your health at http://blog.vitaminmaniac.com.

Arthritis Pain Relief! Weighing Over the Counter Medications and Supplements

Arthritis Pain Relief! Weighing Over the Counter Medications and Supplements in the Treatment of Osteoarthritis
John Robben

Chronic arthritis pain isn’t something to ignore: not only can
it affect your quality of life, it can also deplete your
emotional stores (leading to anxiety and/or depression) and
muscle fitness (leading to weakness or complete muscle
breakdown).

But whether you suffer from osteoarthritis (“wear and tear” of
the joints), rheumatoid arthritis (inflammation in the joints)
or gout (excess uric acid that accumulate in the joints), relief
from your arthritis pain is available. This article will discuss
the pros and cons of over the counter (OTC) medications and
supplements for osteoarthritis, focusing on managing arthritis
pain and maintaining the ability to use the joint in question.

Arthritis Pain Relief: Acetaminophen

Of the drugs in our list of arthritis pain relievers,
acetaminophen is widely accepted as the OTC with the least
amount of undesirable side effects and the lowest long-term
costs. However, acetaminophen does nothing to reduce
inflammation associated with arthritis pain, normally can only
treat mild to moderate cases of osteoarthritis and can easily
become toxic if mixed with alcohol.

Arthritis Pain Relief: NSAIDs

NSAIDs help sufferers with both arthritis pain and inflammation
and are quite inexpensive (like acetaminophen). However, long
term usage has been shown to cause upset stomach and other, more
serious side effects (such as skin rashes or speeding up the
progression of osteoarthritis by interfering with cartilage
repair and promoting cartilage destruction).

Arthritis Pain Relief: Glucosamine and Chondroitin Sulfate

Combined together, glucosamine and chondroitin sulfate are
excellent supplements in the fight against arthritis pain: they
are said to increase mobility, reduce osteoarthritis pain and
form the building blocks for cartilage growth. However, those
allergic to shellfish must avoid glucosamine at all costs (since
it’s derived from the shells of shrimp, lobster and crab).

Arthritis Pain Relief: MSM

MSM (Methylsulfonylmethane) has been studied extensively (for
over twenty years) as an arthritis pain relieving supplement. By
blocking pain transmitters in the affected nerve, MSM users find
similar arthritis pain relief to acetaminophen, but without the
potential liver toxicity. Some osteoarthritis sufferers have
also noticed a reduction in inflammation of the joints also,
since MSM reduces histamine levels (linked to allergy-related
inflammation).

Arthritis Pain Relief: SAMe

SAMe (S-adenosyl-L-methionine) has been shown to reduce
inflammation in osteoarthritis sufferers as much as NSAIDs.
However, SAMe takes a longer time to see symptom reduction, but
offers less gastrointestinal discomfort than NSAIDs in general.
Arthritis pain sufferers should ensure enough B vitamins are
ingested along with SAMe to feel the full effects, and expect
slow but steady arthritis pain relief.

Arthritis Pain Relief: Gamma Linolenic Acid (GLA)

Found in evening primrose and borage oils, GLA is an omega-6
fatty acid said to help lessen arthritis pain, stiffness and
swelling. Few side effects have been recorded, however all
omega-6’s are blood thinners and may increase the risk of
bleeding if taken with NSAIDs.

As with all OTC supplements and drugs, check with your doctor
first before starting any arthritis pain reducing regimen on
your own. You may also want to monitor your liver and kidney
function for most of the medications discussed above since
almost all have a slight risk of side effects. Start with the
lowest dosage possible to see how your body and your illness
tolerate the item, and be patient: you’ll never be sure if a new
supplement or medication is actually working if you don’t take
adequate time to test.

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 arthritis pain. Visit for more information,
tools, supplies and tips for living with arthritis at
http://www.ultimatewatermassage.com/.