How Yoga Helps Medical Conditions: Symptom Improvement

by Baxter (with Nina)

Painted Composition Design for Medicine
by Gustav Klimt

Last week in my post How Yoga Helps with Medical Conditions: Prevention, I discussed how to use yoga for prevention. Today I�m going to focus on how you can use yoga to improve symptoms. To put it simply, this means you are using yoga to:  

1. Relieve symptoms caused by a medical condition without curing it. In this case, although you�re not curing the medical condition, you�re using yoga to achieve either temporary or long-term improvement of symptoms. For example, someone with chronic low back pain from a ruptured disc can use yoga very effectively to reduce or relieve pain. But because yoga cannot repair the ruptured disc, the underlying condition isn�t cured and may occasionally still produce pain.  

2. Relieve symptoms and cure a medical condition with yoga alone. This means that you are using yoga to resolve the symptoms caused by your underlying condition but you are also using it to resolve the underlying disorder itself, so it is unlikely to return. For example, someone with stress-related headaches could use yoga�s pain management techniques to reduce headache pain and yoga�s stress management techniques to eliminate the headaches themselves.

Now let�s take a closer look at these two different ways you can use yoga for improving symptoms.  

Yoga for Symptom Improvement Alone

Yoga is extremely effective for providing symptom improvement for a large number of medical conditions, even if it does not lead to a cure. Typically you use a combination of tools for symptom improvement, including asana (active, gentle, restorative and supported inversions), stress management tools, and equanimity tools. Since yoga has the potential to improve the symptoms of just about any medical condition, here are just a few examples:

1. Respiratory conditions, such as emphysema and chronic cough. See How Yoga Fosters Respiratory System Health for information on using yoga for respiratory system health.
2. Chronic pain, such as chronic low back pain and fibromyalgia, and post recovery from surgery. See How Yoga Helps with Pain for using yoga for pain management.
3. Immune-related conditions, such as rheumatoid arthritis, multiple sclerosis, and HIV/Aids. See How Yoga Helps Your Immune System for using yoga to support the immune system and How Yoga Helps with Pain for pain relief.
4. Digestive conditions that are aggravated by stress, such as irritable bowel syndrome and peptic ulcer disease. See How Yoga Helps Your Digestive System for information on using yoga to support your digestive system.
5. Cardiovascular conditions, such as coronary artery disease and irregular heart rhythms. (Of course, while avoiding practices that could aggravate the condition, such as vigorous styles of asana practice, long-held standing poses, and full inversions.)
6. Emotional illness, such as anxiety and depression.
7. Brain conditions that lead to worsening cognitive function, such as early stage dementia and mini strokes as a complication of diabetes.
8. Palliative care (including pain management and stress reduction) for those who do not want to use western medical options, such as for end of life care.

Yoga for Symptom Improvement with Curing 

Although there are actually very few conditions that yoga can cure by itself (most complete healing with yoga occurs when yoga is used as an adjunct to other forms of care), there are five categories of medical conditions that yoga alone can potentially cure:

1. Musculoskeletal Conditions. These include acute minor injuries such as common sprains and strains, and a certain subset of more significant acute injuries, including back and neck pain. Using asanas for physical benefits combined with mindfulness techniques and stress management techniques can promote tissue healing.
2. Stress-Related Headaches. For some people, yoga�s stress management tools can resolve stress headaches.
3. Unhealthy Breathing Patterns. Yoga�s tools for cultivating the health of your respiratory system can reverse some abnormal breathing patterns.
4. Stress-Related Digestive Problems. Stress management techniques can resolve some minor digestive problems that are caused by stress.
5. Emotional Conditions. For certain people with mild forms of chronic stress, anxiety, and depression, a combination of practicing asanas for emotional wellbeing with yoga�s stress management and equanimity tools can resolve emotional problems. 

For now, our evidence on the ability of yoga to �cure� many of these conditions is anecdotal (reported by individuals not proved in a scientific study). However, we have seen so many people benefit from using yoga to help with these conditions that until we do have studies to back us up, we recommend giving yoga a try. 

In general, however, before you attempt to address a particular medical condition with yoga, I recommend that you get guidance from both an experienced yoga teacher or yoga therapist and your doctor. And keep in mind that unlike when you have been prescribed an antibiotic to cure a specific infection, you can�t use yoga for two weeks to cure these conditions and then just discard it. So for many of these conditions, part of a �yoga cure� involves ongoing maintenance.

For example, if you successfully used your yoga tools to heal an acute bout of lower back pain, your use of yoga to maintain your improvement would not stop there, as returning to your old habits that may have contributed to the back pain in the first place could bring it back on. So from that point on, you would use your yoga practice to maintain the healing you have achieved and reduce the chances of re-injury. 

Finally, before pronouncing yourself �cured,� we recommend that you monitor your condition for a reasonable amount of time, say 1-2 years, especially if you are dealing with a more complex issue, such a severe low back pain or depression.

In fact, for many of these conditions, yoga alone may not be enough to bring about a cure. So you may need to combine yoga with strategies that your doctor recommends, such as specific physical therapy exercises for that ankle or appropriate anti-depressant medications for that depression. This is especially true for many emotional conditions. For emotional conditions that are more severe or that just do not seem to responding quickly to your practice, I strongly recommend that you combine yoga with other forms of treatment, such as therapy or medication. 

In these situations, yoga is acting as an adjunct to your western medical treatment, which I will get into in more detail next week. But as I mentioned in How Yoga Helps with Medical Conditions: Prevention, yoga is a great complement to western medicine. The ultimate goal is your ongoing wellness! 

The Bottom Line 

Keep in keep in mind that there are no guarantees for using yoga either for improving symptoms or curing a medical condition. However, the mounting evidence that yoga at the very least improves symptoms for many conditions should encourage you to give it a try!

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Desert Island Yoga Poses

by Nina

The other day I got an email from the manager of a web site for men (which shall remain nameless for now) asking me to recommend 3 to 5 poses that I thought men should practice every day. At first, I rebelled at the thought. As you know, we at Yoga for Healthy Aging recommend in general for both men and women alike that you mix it up and practice a wide variety of poses throughout the week. In addition, we also believe that everyone is different�and their lifestyles and exercises routines are different�so that there is no one single set of poses that will work best for all people. But the truth is that I could not resist the thought experiment that this query provided. It's like one of the "desert island" games: if you could take only 3 to 5 yoga poses with you to a desert island, which ones would you take?

And then I thought that if I came up with a good list, it might inspire some people to get started with the practice, and that is always a good thing. So just for fun, here's what I came up with. And if you'd like to join in the game, please do by leaving a comment on this post!

1. Reclined Leg Stretch (Supta Padangusthasana). Stretches muscles in your legs and hips that can become tight from desk jobs and/or many other types of exercise, such as running, hiking, or cycling. For long-lasting results, hold at least 1.5 minutes. See Featured Pose: Reclined Leg Stretch.

2. Downward-Facing Dog pose (Adho Mukha Svanasana). Stretches tight shoulders and legs at the same time it cultivates upper body strength (try holding it for 1 to 3 minutes!). See Featured Pose: Downward-Facing Dog Pose.

 3. Warrior 2 pose (Virabradrasana 2). Cultivates both upper and lower body strength while also increasing hip flexibility and improving balance. Featured Pose: Warrior 2 Pose.

4. Tree pose (Vrksasana). Cultivates leg strength, and shoulder and hip flexibility while challenging your balance. See Featured Pose: Tree Pose. 

5. Legs Up the Wall pose (Viparita Karani). Reduces stress levels, which is so important both for physical and psychological health. Bonus is a good stretch for your legs and, if you take your arms into a cactus position, a good stretch for chest and arms as well. You can do this at the end of any yoga practice or on its own anytime you need to de-stress. See Featured Pose: Legs Up the Wall Pose.

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Cannabinoids, Alzheimer's Disease, and Yoga

by Ram

There�s some good news for people with Alzheimer�s disease (AD) and for those who are potential carriers of this disease! Researchers from the Salk Institute discovered that marijuana harbors several potent active compounds that clear the toxic amyloid protein that accumulates in AD brains and which is believed to elicit toxicity resulting in memory loss. Although previous other studies have offered similar evidence that cannabinoids (the chemical compounds present in marijuana) might be neuroprotective and reverse symptoms of Alzheimer�s, this particular study got a lot of media attention since the study also demonstrated the anti-inflammatory properties of cannabinoids. Inflammation is an underlying hallmark of AD and with its dual function of clearing toxic amyloid protein and blocking inflammation, gives marijuana a very unique and important role in allowing people with memory loss due to AD to function normally. But does this mean that we all turn to being potheads just to reap the benefits from this neuroprotective weed? Before we seek out alternative routes, let us look a bit deeper into this psychoactive plant and its natural properties. 

Cannabis, the botanical name for weed or marijuana, has three subspecies: sativa, indica, and ruderalis. Hemp, cannabis, and marijuana all belong to the same plant species: cannabis sativa. This plant is known to synthesize a wide range of psychoactive compounds. One specific class of psychoactive compounds is the cannabinoids that affect many important body-mind functions, including an individual�s movement, feelings, and reactions. Interestingly, cannabinoids are produced naturally in the body by humans and animals (endocannabinoids), plants (phytocannabinoids-in cannabis and some other plants), and synthesized artificially (synthetic cannabinoids). Tetrahydrocannabinol (THC), the most important plant cannabinoid, is also the most widely researched compound, although it is just one of more than 400 known psychoactive compounds. A myriad of physiological effects are attributed to THC including: euphoria, stimulant, muscle relaxant, anti-epileptic, anti-emetic, anti-inflammatory, appetite stimulating, bronchio-dilating, hypotensive, anti-depressant, and analgesic effects. 

Interestingly, one of the main endocannabinoids produced by the human body is termed Anandamide (from the Sanskrit and yogic term Ananda=Joy, bliss, delightful). Anandamide has manifold functions, both physically and physiologically, including eating and sleep patterns, pain relief, rewards, motivation, and pleasure. Studies are underway to boost its levels in the body to treat anxiety and depression. 

Remember the term �runner�s high?� It�s a short-term contentment, bliss, elation, and well-being experienced by people involved in all kinds of physical exercises, including but not limited to athletics, long distance running, and swimming. Yoga practitioners also experience similar feelings and we call it being in the zone (Positive Psychology vs. Yoga Philosophy). Recent studies have attributed these euphoric feelings to the release of various �feel good endogenous chemicals� that produce this response and one such compound is Anandamide. 

So how do THC, Anandamide, and other cannabinoids elicit their neuropsychotic function in the mind-body system? Located in the brain are numerous receptor proteins that specifically bind to cannabinoids. Just as a specific key opens a specific lock, so is the relationship between the cannabinoids and its receptors. When a cannabinoid (endo, plant, or synthetic) engages a specific receptor, it regulates numerous endogenous neurotransmitters and thus elicits physiological and behavioral responses including appetite, pain-sensation, mood, and memory. However, when a person takes the cannabinoid from outside, the combination of the external and the body�s own natural cannabinoid completely overwhelms the receptor system throughout the brain and body. This then disrupts the normal neural communication and throws the entire physiological system off balance. 

I have already written about Alzheimer's disease (AD) on this blog before (Memory Loss�Meditation to the Rescue). AD is a progressive disease of the brain and the predominant form of dementia, and is characterized by loss of memory and reduced cognitive abilities. As the disease progresses, the individual is unable to perform activities of daily living or recognize loved ones. AD is also the sixth leading cause of death in the U.S. and the total number of those affected by the disease is expected to double by 2050. At the moment, there is no drug to cure or treat this disease. The disease is characterized by an accumulation and build-up of toxic amyloid protein that: a) affects normal nerve-nerve communication, b) damages the areas of the brain involved in memory, and c) promotes neuronal cell death by triggering neuroinflammation.

In this new study Amyloid proteotoxicity initiates an inflammatory response blocked by cannabinoids by researchers at the Salk Institute, tetrahydrocannabinol (THC), the active compound in marijuana, not only appeared to remove the toxic amyloid beta protein in the brain, it also reduced inflammation in the cells thus revealing a dual neuroprotective function. The researchers have cautioned that the study was done in laboratory cell models outside of a human setting, and the findings are preliminary that need to be tested in humans in a clinical trial. What this means is that at this moment there�s no solid evidence to recommend marijuana for people with AD. What then is the alternative? 

Remember, I mentioned endogeneous cannbinoids and Anandamide in particular above. Well, as it turns out, meditation and deep diaphragmatic breathing (pranayama) triggers the production of endogeneous Anandamide and other similar compounds that not only trigger the feel-good response but also block anxiety and the sensation of pain (see High: Insights on Marijuana (The Endocannabinoid system and other Neuroscience) Sebastian Marincolo). While I did not find any scientific study of the effects of yoga asanas on the endocannabinoids system, from my personal experience, I can say that a daily practice of yoga will definitely stimulate the endocannabinoid pathways. When you are engaged in a posture where the asana challenge matches your skill, you have an undivided focus and get totally involved, forgetting everything else but the pose. You are in a state of �flow,� or as Desikachar puts it, �in the zone.� This state requires a whole lot of initial effort to make it accessible (Positive Psychology vs. Yoga Philosophy), but it offers unlimited opportunity to explore and control all mental aspects, including attitudes, emotions, concentration, intent, and faith. Notice how the experience builds contentment and brings a sense of accomplishment. It�s a great positive spiral, and it results in improved health and happiness. My belief is that this emotional state is due to the surge of endogeneous Anandamide and other feel-good chemicals. Thus, instead of smoking pot, one can derive the same benefits of the cannabinoid system through a combination of yoga, meditation and pranayama�I call that �yoga high�!

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How Much Physical Activity is Enough?

by Nina

The Walk by Vincent van Gough

After reading all those posts by Ram and me (Sitting is the New Smoking, The Ill Effects of Prolonged Sitting (Part 2), The Ill Effects of Prolonged Sitting (Part 1)) about the dangers of being sedentary and/or inactive, you might be wondering exactly how much exercise do you need to do to counteract the time you spend sitting. (A great many of us work at desk jobs, so for many of us spending many hours a day sitting is just a fact of life.) Fortunately for us, some scientists had the exact same question. A recent study in The Lancet called Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women reported the results of a systematic review (meta-analysis) of data from 16 studies that associated daily sitting time and physical activity with �all-cause� mortality. 

I don�t want to keep you in suspense, so I�ll just tell you what they found: 60-75 minutes per day of physical activity seemed to eliminate the increased risk of death associated with too much sitting time. Here�s the conclusion of the study: 

�High levels of moderate intensity physical activity (ie, about 60�75 min per day) seem to eliminate the increased risk of death associated with high sitting time. These results provide further evidence on the benefits of physical activity, particularly in societies where increasing numbers of people have to sit for long hours for work and may also inform future public health recommendations.� 

Now that might leave you with an important question: do I have to do all that exercise in single session?

In the NPR piece in which I heard about this study Care To Offset All Your Office Sitting? It'll Take Just An Hour A Day, Allison Aubrey asked the lead author of the study, Prof Ulf Ekelund, PhD, those very questions. He told her that the answer is yes, you can do your exercise in bits and pieces, at different times of the day, and with different types of exercise He said just be sure that the intensity of your exercise is high enough to get your heart rate up (walking at a brisk pace, for example). He also added, somewhat encouragingly, that even 20 minutes reduces some of the risk. But the more you can exercise you can do, the better. 

So that means if you're practicing yoga for exercise, you don't have to do a single practice that is at least one hour long�you could, for example, do one half an hour in the morning and one half an hour in the evening.  And you could also do a shorter practice and combine with a brisk walk or a bicycle ride or any other physical activity that you enjoy. 

I�m sure we�ll be hearing more on this topic in the near future and they'll probably be changing their minds like they always seem to do. But I say for now aiming for 60 minutes of physical activity per day is a reasonable goal to aim for. Are you with me?

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Video of the Week: Dynamic Powerful Pose (Utkatasana)

This dynamic pose strengthens your legs, hip, back, and arms, at the same time it opens your chest and shoulders.

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How Yoga Helps with Medical Conditions: Prevention

by Baxter (with Nina)

Hygieia by Gustav Klimt

In our post 5 Ways Yoga Can Affect Your Health from a while back, I identified six ways that yoga helps with your health. And although that way of framing how yoga supports good health is still accurate, Nina and I recently realized we could simplify our list of six into a more helpful list of three: 1) prevention, 2) symptom improvement, and 3) as an adjunct to other forms of treatment. Today, I want to discuss what we mean by �prevention.� To put it simply, this means you are using yoga to: 

1. Prevent diseases or conditions from developing.
2. Prevent a disease or condition that you already have from getting worse. 

Now let�s take a closer look at both of these ways you can use yoga for prevention.

Preventing Diseases or Conditions from Developing  

One valuable way you can use yoga for prevention is to promote your overall health in general. Yoga is particularly effective for this because a well-rounded yoga practice that includes an active asana practice, stress management practices, and equanimity practices can help prevent diseases and conditions caused by sedentary behavior and/or chronic stress, such as obesity, heart diseases, cancer, and diabetes. Because a well-rounded asana practice includes active strength, flexibility, balance and agility practices, yoga can also help prevent problems related to being sedentary, including osteoporosis, sarcopenia, balance problems, and falls. And yoga�s stress management practices are good preventative medicine for fostering good emotional and mental health, at the same time they helps foster physical health.

Another valuable way to use yoga for prevention is to focus on preventing a particular disease or condition that you�re concerned about. For example, if you have risk factors for osteoporosis, you can emphasize strength practices to build both bone and muscle strength. Or, if you have cardiovascular diseases running in your family, you can emphasize cardiovascular health practices to prevent the development of high blood pressure, heart attacks, strokes, irregular heart rhythms, and congestive heart failure.

Preventing Diseases or Conditions from Getting Worse 

If you already have a medical condition, depending on the type of condition, you may be able to focus on preventing it from progressing further. Yoga is particularly beneficial for conditions that benefit from working on physical skills, cardiovascular practices, and stress management. In general, some conditions that yoga can help prevent from getting worse include: osteopenia, osteoporosis, sarcopenia, arthritis, diabetes, and high blood pressure. 

Here are a few examples of how it works: If you have sarcopenia of the muscles or osteopenia and osteoporosis of the bones, you can focus on appropriate strength-building practice to hold the condition at bay and in the case of osteopenia prevent it from progressing to osteoporosis and, in some cases, even reversing it somewhat. If you have arthritis, you can focus on flexibility practices to prevent more loss of mobility in your joints, sometimes delaying or maybe even avoiding a joint replacement.

And if you already have high blood pressure, you can focus on lowering your numbers with asana and stress management practices to prevent it from progressing to heart attack, stroke, irregular heart rhythm, or congestive heart failure.

For All Types of Prevention 

Keep in mind that yoga alone may not be enough for the best prevention approach. So you may need to combine yoga with other preventive strategies that your family doctor recommends, such as more aerobic activities or special dietary recommendations. But yoga is a great complement to western medicine. The ultimate goal is your ongoing wellness!

And it is equally important to remember there are no guarantees, and eventually with age and time, we will have to face some serious illness. But it is surely worthwhile to try to delay them in the meantime!

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Sitting is the New Smoking

by Nina

Woman Smoking by Kitagawa Utamaro

�Being out of shape could be more harmful to health and longevity than most people expect, according to a new, long-term study of middle-aged men. The study finds that poor physical fitness may be second only to smoking as a risk factor for premature death.� �Gretchen Reynolds, New York Times 

Have you heard the phrase �Sitting is the New Smoking� yet? Because recently I�ve been hearing it more and more often. And although lthough Ram didn�t use it in his recent post The Ill Effects of Prolonged Sitting he did say, �For people who engage in prolonged sitting activities, their risk of heart attack is about the same as smoking.� 

His post cited three different studies that showed the dangers of spending too many hours a day sitting. (That post got me to spend more time standing up at my sit-stand desk!) Then just a week later I read a NY Times article Being Unfit May Be Almost as Bad for You as Smoking about a new study on the longevity of men who were active versus those who were inactive (they measured aerobic capacity to indicate the subjects' general level of activity and fitness). What was special about this study was that it focused on a large group of about 1,000 healthy Swedish men of age 50, and followed them through the rest of their life spans (45 years!). (Many of these types of studies in the past have been done on older people for much shorter periods of time.)

The conclusion of the study Low aerobic capacity in middle-aged men associated with increased mortality rates during 45 years of follow-up was this:

�In this representative population sample of middle-aged men, low aerobic capacity was associated with increased mortality rates, independent of traditional risk factors, including smoking, blood pressure and serum cholesterol, during more than 40 years of follow-up.� 

And not only was poor fitness/low aerobic capacity second only to smoking as a risk factor for increased mortality, it was actually even unhealthier than high blood pressure or high cholesterol! Yes, the study found that the men who were rated as highly fit but who had high blood pressure or high cholesterol levels tended to live longer than men who were rated as �out-of-shape� but who healthy blood pressure and cholesterol levels. 

And although the study just focused on men (an ongoing problem in scientific studies), the NY Times reported that: 

But �there is no reason not to think� that the rest of us would also share any beneficial associations between fitness and longevity, said Per Ladenvall, a researcher at the Sahlgrenska Academy at the University of Gothenburg, who led the study. Past studies involving women have found such links, he said. 

Perhaps I am preaching to the choir by sharing this information (because you may already be practicing yoga on a regular basis and understand all its many benefits), but for those who are not yet physically active or who have family members or friends who are not active, the takeaway is clear: start being more physically active! The New York Times article concluded by quoting the Dr. Ladenvall saying that even small amounts of physical activity can have a positive effect.

�Encouragingly, if you now are concerned about the state of your particular aerobic capacity, you most likely can increase it just by getting up and moving. �Even small amounts of physical activity,� Dr. Ladenvall said, �may have positive effects on fitness.�

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