Monthly Archives: June 2017

Heal Fibromyalgia With Yoga

Fibromyalgia is a condition characterized by:

  • pain throughout the body over an extended period of time
  • inability to sleep well
  • fatigue
  • stiffness
  • cloudy thinking
  • depression
  • reduced ability to function in activities of daily life

Scientists are still trying to figure out what causes fibromyalgia and how to provide help to those who suffer from it.

A 2010 study indicates that a Yoga program incorporating asanas, pranayama, and meditation may reduce pain and fatigue, elevate mood, and improve coping skills in fibromyalgia sufferers. This year, another study reported that Yoga classes can decrease pain, increase acceptance of pain, and alter levels of cortisol.

The latest study of Yoga for fibromyalgia appears in the International Journal of Yoga Therapy. Eleven people found relief from stiffness, anxiety, and depression. They reported more days of feeling good and fewer days of missed work, effects that reached statistical significance. Participants also reported less pain and fatigue overall, but the latter didnt register as significant with statistical analysis.

To achieve these results, subjects met once per week for eight weeks. Each class session lasted for 75-minutes and included 10-minutes of initial calming breath work with meditation followed by 15-minutes of group sharing and learning about current theories and therapies for fibromyalgia. The asana portion of the class was 35-minutes in length and incorporated several postures including:

  • gentle surya namaskar (sun salutations)
  • tadasana (mountain)
  • vrksasana (tree)
  • setu bandha sarvangasana (bridge)
  • supta virasana (reclining hero)
  • supta baddha konasana (reclining bound angle)
  • marjariasana (cat)
  • adho mukha svanasana (downward-facing dog)
  • supta padangusthasana (reclining big-toe)
  • balasana (child)

Each class ended with a 15-minute guided meditation in savasana.

This latest study didnt have a control group, and therefore results may have been placebo or the result of increased social interaction and sharing as group therapy. Still, taken together, these three studies of Yoga-based programs are promising.

Several types of exercise have been shown to be beneficial for fibromyalgia. It makes sense that combining asanas, a form of exercise, with meditation (which has been shown to relieve depression, a significant component of the syndrome) can provide significant relief from symptoms.

If you have fibromyalgia, you can feel better with a conscious practice of Yoga. Take care not to overdo it at first. Practice asanas gently and bring daily meditation into your life if you have not done so already. You have the right and the power to heal, and Yoga can help you do just that.

Yoga promotes a healthy diet low in inflammation-causing triggers. It helps to re-condition muscles that are often de-conditioned in people with fibromyalgia. It facilitates the reprogramming of stress circuits, and it teaches an acceptance of, and a willingness to learn from, pain and other stressful experiences. If you suffer from fibromyalgia pain, please give Yoga a try.

References:

Carson JW, et al. A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia. Pain 2010; 151: 530-539.

Yoga For Fibromyalgia

“Oh, my aching body!”

Some people simply hurt all over. Their muscles are extremely tender. They’re tired all the time. Their thinking can be fuzzy, and anxiety and depression are often lurking in the background. And the doctors can’t find anything wrong. All the lab tests come out negative. If that’s your life, it’s likely you have a condition known as fibromyalgia.

It’s a frustrating diagnosis, both for patients and for doctors. It’s vague and subjective. There’s nothing visible and no proof from a blood test. But fibromyalgia pain is very, very real. And it hurts! No one wants to live with fibromyalgia, so everyone is looking for a treatment.

Treatment is frustrating, too. We can drug fibromyalgia sufferers with tranquilizers and pain medications, with antidepressants and anti-anxiety medicines, but those simply mask the problems. They make them tolerable, bearable perhaps, but they don’t fix anything. They don’t cure the fibromyalgia pain.

Drug companies are now exploring novel ways to tackle fibromyalgia’s new classification as a Central Sensitivity Syndrome, meaning that the central nervous system (the brain and spinal cord) processes information regarding pain and tenderness in abnormal ways.

But I say we should be working with the body naturally, with the mind naturally, to figure out how to “re-tweek” the pain processing back to its normal way. The central nervous system is “plastic” after all, meaning that it can continue to reorganize itself throughout life in response to environmental stimuli.

To do that, we first need to figure out what things in our environment have contributed to the abnormal pain processing. Inflammation may be key, as fibromyalgia pain occurs in unusually high frequency in patients with auto-immune disorders like lupus and rheumatoid arthritis as well as some chronic viral infections like hepatitis C. Adopt an anti-inflammatory diet such as the one promoted by Dr. Andrew Weil.

Another key may be in the way we process stress. Both principal effectors of the stress response, the hypothalamus and pituitary axis as well as the sympathetic nervous system, are over-activated, or functioning abnormally, in fibromyalgia. For this, Yoga can help fibromyalgia pain tons. We know that Yoga lowers stress through both pathways.

A new randomized, controlled study of Yoga for fibromyalgia was just published in the journal, Pain. The authors, based at a university in Oregon, looked at 53 female fibromyalgia patients who were either placed in an 8-week Yoga program (gentle asanas, meditation, pranayama, group discussions and Yoga-based coping skills instructions) or placed on a waiting list with only standard care for treatment. The women in the once-per-week Yoga program showed significantly greater improvements than the control group that was wait-listed. They had less pain, less fatigue, improved mood, and they felt they could cope better with their remaining symptoms. So, this study and several others prove that you should definitely try yoga to treat fibromyalgia. I will consider how to treat fibromyalgia with yoga properly in the next article.

Anxiety and Yoga

Anxiety sucks. It stinks when everyday stuff gets you so worked up and worried that you can’t sleep, can’t focus, and can’t function. It happens sometimes to most of us.

When a prevalent state of anxiety persists for at least six month, it can be diagnosed as an anxiety disorder. Life becomes fear and uncertainty. For some, living becomes unbearable.

And it’s common. Eighteen percent of the population suffers from debilitating anxiety at some point in every year.

Anxiety doesn’t always make a lot of sense. Often, people realize they are anxious way out of proportion to the situation. Intellectually knowing something isn’t a big deal just doesn’t make a difference. They can’t relax. Tension builds. They may startle easily, feel fatigued, and have headaches and tension in the muscles of the neck and shoulders. Some even tremble, twitch, sweat, throw-up, pee all the time, feel short of breath, get lightheaded or have hot flashes.

Anxiety is usually treated with drugs, ones that are pretty addictive like the class of medicines called benzodiazepines. Valium is in that category, and so is Ativan. They work by modulating the GABA system. GABA stands for gamma-aminobutyric acid, and it’s the main “downer” neurotransmitter that balances the brain’s natural “upper” neurotransmitters.

 

In August of this year, a study done at the Boston University School of Medicine showed for the first time that a behavioral intervention, Yoga, appears to increase the level of GABA in the thalamus of the brain, and the increased GABA was associated with reports of lower anxiety levels by the study participants. The Yoga sessions were 60 minutes long and were attended three times per week for 12 weeks1.

Older studies have also proven Yoga’s beneficial effects when it comes to treating anxiety2,3,4,5,6,7. One even showed that Yoga worked better than benzodiazepines (the tranquilizer drugs)2.

If you’re feeling overly anxious and worried about everything large and small, then please give Yoga a try before resorting to medicine. It’s a beautiful, natural healing method that beats drugs any day.

If you’re already on anti-anxiety medicine, then add an hour of Yoga at least three times a week. If you give it a good try and are consistent with your practice, then you’ll likely be able to taper down on the dose of drugs (in consult with your physician). You may even be able to stop them altogether – and that means stopping their side effects, both the known ones and the occult.

 

Reference:

  1. Streeter CC, Whitfield TH, Owen L, Rein T, Karri SK, Yakhkind A, Perlmutter R, Prescot A, Renshaw PF, Ciraulo DA, Jensen JE. Effects of Yoga Versus Walking on Mood, Anxiety, and Brain GABA Levels: A Randomized Controlled MRS Study.J Altern Complement Med. 2010 Aug 19.
  2. Vahia NS et al. Psychophysiologic therapy based on concepts of Patanjali. A new approach to the treatment of neurotic and psychosomatic disorders. Am J. Psychother. 1973 Oct;27(4):557-565.
  3. Vahia NS et al. Further experience with the therapy based upon concepts of Patanjali in the treatment of psychiatric disorders. Indian J Psychiatry. 1973;15:32-37.
  4. Harrigan JM. A component analysis of yoga: the effects of diaphragmatic breathing and stretching postures on anxiety, personality and somatic/behavioral complaints. Dissertation Abstracts International. 1991;42(4A):1489.
  5. Platania-Solazzo A et al. Relaxation therapy reduces anxiety in child and adolescent psychiatric patients. Acta Paedopsychiatr. 1992;55(2):115-120.
  6. Michalsen A et al. Rapid stress reduction and anxiolysis among distressed women as a consequence of a three-month intensive yoga program. Med Sci Monit. 2005 Dec; 11(12):CR555-561.
  7. Kabat-Zinn J et al. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry. 1992;149:936-943.

Yoga Helps Asthma

A reader’s recent question:

“I suffer from asthma every winter. Last year I tried yoga for 5 weeks. I tried various styles, but it did no good. Have you heard of any success in treating asthma with yoga?”

Asthma is a chronic disorder in which the airways and lungs become inflamed. With inflammation, the smooth muscles in the airways constrict causing decreased air flow (NHLBI, 2004). Asthma attacks can cause a multitude of symptoms including wheezing, breathlessness, chest tightness, and coughing (NHLBI, 2004).

Avoiding contact with environmental “triggers” can control asthma. Tobacco smoke, dust mites, cockroach allergen, outdoor air pollution, pets and mold are considered important triggers of an asthma attack (CDC, 2003, 2004; U.S. EPA, 2005, 2007).

Yoga can also help to control asthma.  Specifically, the technique of neti can help one to avoid inhalation of environmental triggers and infectious microbes which exacerbate symptoms.  Please see our in-depth article on neti.

Beyond neti, Yoga has been shown to alleviate asthma through asanas, pranayama meditation, and relaxation with stress reduction.

Here’s an article published in the reputable British Medical Journal about Yoga and asthma.  The authors found a positive effect. Note that they included relaxation therapy (10 minutes in savasana daily), pranayama, and neti.

Below is an abstract from the Journal of Asthma:

J Asthma. 1986;23(3):123-37. An integrated approach of yoga therapy for bronchial asthma: a 3-54-month prospective study. Abstract:  After an initial integrated yoga training program of 2 to 4 weeks, 570 bronchial asthmatics were followed up for 3 to 54 months. The training consisted of yoga practicesyogasanas, pranayama, meditation, and kriyasand theory of yoga. Results show highly significant improvement in most of the specific parameters. The regular practitioners showed the greatest improvement. Peak expiratory flow rate (PFR) values showed significant movement of patients toward normalcy after yoga, and 72, 69, and 66% of the patients have stopped or reduced parenteral, oral, and cortisone medication, respectively. These results establish the long-term efficacy of the integrated approach of yoga therapy in the management of bronchial asthma.

Heres a link to another article supporting the efficacy of Yoga for asthma.

Although savasana is a great asana to help control symptoms, practice of Yoga for asthma should include bhujangasana, the cobra pose, as it also is a good one for symptom reduction.  It helps to expand the chest.

 

To round out a natural approach, consider the effects of food on asthmatic symptoms. There are indications that up to 15% of asthmatics have a dietary component to their disease.  The milk protein, casein, is the biggest culprit.  A trial of avoiding it in milk, cheese, yogurt, semi-sweet chocolate, etc for at least two to three weeks might be worth a go.  If that doesnt help, a similar trial of excluding eggs or wheat from the diet might be of benefit.

A daily practice of Yoga for asthma includes neti, bhujangasana, meditation, at least 10 minutes in a progressive relaxation sequence in savasana, and at least five minutes of pranayama will help to reduce the frequency and severity of asthma symptoms.

Yoga For Chronic Low Back Pain

“I had thought my life would never be the same again after my back condition was diagnosed, but I cannot say how much this has helped.  I have a new lease on life and have no back pain now.”   trial participant testimonial

In my mailbox last week was the latest edition of Annals of Internal Medicine, the premier publication of the American College of Physicians, an organization for internists of which I am a member. Glancing at the table of contents on the outer cover, I was thrilled to see the leading article was one about Yoga, Yoga for Chronic Low Back Pain. A Randomized Trial. (you can view it online here)

After a chilly fall walk down my long country lane back to the house, I settled into a comfy chair to warm up and read the latest report.

In the United Kingdom, a group of researchers at the University of York and the University of Manchester teamed up with some British Wheel and Iyengar Yoga teachers to study 313 patients with chronic or recurrent low back pain. At several centers across England, Yoga teachers taught a program of 12 classes, each 75-minutes in length. During the one class each week, participants were instructed on a philosophical theme (like steadiness) before beginning a series of calming, standing, chair-seated, lying, and relaxation postures.

Asanas incorporated into the program were held for 10 to 15 seconds and included:

Tadasana (Mountain Pose)

Modified Ardha Matsyandrasana (Half Lord of the Fishes)

Makrasana (Crocodile)

Bhujangasana (Cobra)

Pavana muktasana with both knees to chest (Wind Releasing)

Supta bhadrasana (Reclining Bound Angle)

Shalabhasana (Locust)

Savasana for 5 – 20 minutes (Corpse)

Of course, a Yoga class wouldnt be Yoga without addressing the mind as well as the body, and participants were encouraged to increase positivity and self confidence in daily life. Mental focusing and awareness were required.

This carefully constructed program for low back pain included encouragement and instructional tools for participants to continue at home. A manual with four home sequences and a relaxation CD were provided, and they were given the goal of practicing twice per week forever.

The study findings?

The Yoga group had better back function at the end of the 12 weeks than a control group receiving usual care, and the improvement remained a year after the program began. There was no significant change in subjective reports of pain between the two groups. Four subjects in the Yoga group reported increased pain compared to none in the control group. None of the pain was deemed medically serious.

Pain scores remained unchanged according to statistical analysis, and the Yoga group was better able to function and to deal with daily life than the group who received no Yoga training. According to the authors, Yoga seems to be a safe and effective activity that clinicians could consider recommending for patients with a history of low back pain.