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MOJ Yoga & Physical Therapy
Improvement of Early Arthritic Symptoms with
Pawanmuktasana Anti-Rheumatic Series
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Volume 2 Issue 2 - 2017
1Faculty of Medicine, AIMST University, Malaysia
2Ministry of Health, Malaysia
*Corresponding author: Komathi Selvarajah, Faculty of
Medicine, AIMST University, Malaysia, Tel: +60123957051;
Received: May 17, 2017 | Published: June 28, 2017
Mini Review
MOJ Yoga Physical Ther 2017, 2(2): 00018
Arthritis is a common term that is used to describe conditions that results in joint
    
greatest impact on morbidity and costs enormous healthcare expenditure. Studies
        
general wellbeing. This review mainly focuses on arthritic symptoms can be alleviated
by pawanamuktasana (anti rheumatic series).
Keywords: Pawanmuktasana; Joint Pain; Arthritis; Pathophysiology; Yoga
arthritis. These includes, degenerative arthritis (leading to osteo
     
psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic
arthritis and systemic lupus erythematosus), infective arthritis
(septic arthritis) and metabolic arthritis (gout and pseudogout).
The major symptoms of arthritis include limited function and
pain at the joints [2]. Management of arthritic condition remains a
great challenge to clinicians despite of advancement in health care
sectors [3,4]. Globally, an estimated 22.7% (54.4 million) of adults
had doctor-diagnosed arthritis, with high prevalence in women
(23.5%) than in men (18.1%). The prevalence increased with age
[5]. Arthritis foundation predicted more than 78 million people
are expected to be diagnosed to have arthritis by the year 2040.
The arthritis condition share similar pathophysiological
changes at joint region. Many factors like infection, co-
morbidities, environmental, trauma, stress and hereditary factors
can cause joint damage and contribute to the trigger of immune
  
       
which patient presents with symptoms like pain, joint swelling,
redness and reduced range of movement [6].
Recent Studies conducted at University of California at Los
Angeles Medical Center have proved that there is positive effect
on chronic arthritis. In another study which was conducted
      
reductions in pain and noticeable improvements in joint stiffness
among osteoarthritis patient [7].
The practice of asanas in Yoga system commences with
Pawanmuktasana series. Right practice of Pawanamuktasana
[8]. Etymologically this word Pawanmuktasana is composed
of three Sanskrit words: pawan meaning ‘wind’ or ‘air’ mukta,
‘liberation’ or ‘freedom’ and asana, ‘posture’ [9]. Pawanmuktasana
basically refers to series yoga poses that involves the whole joint
regions from head to toe which release air in the body. Adopting a
regular practice of asana makes the body physically and mentally
Diagnosis Arthritis
Clinical evaluation of arthritic pain basically starts with
a comprehensive history, physical examination, laboratory
      
pain at one or multiple joints. The pain usually characterized
by an intermittent, dull aching or throbbing that may worse
with restricted movement of the joint. It can be associated with
stiffness as well. Patients may express depressive symptoms as a
On physical examination tenderness can be elicited along the
joint line and surrounding tissues. Range Of Movement decreased
   
symptoms like warmth, swelling, effusions, and stress pain, may
be present. Untreated Long term arthritic patient may end up
with muscle wasting and weakness [12].
The primordial goals of treatment in arthritic patient are to
relief pain, improvement in joint function and prevention of joint
damage. These are achieved with both pharmacologic and non-
pharmacologic therapeutic modalities. Thus the management
is effective when it includes physical measures to reduce joint
loading, an appropriate exercise regimen, medications, and,
occasionally, surgery. Patient awareness and education is essential
    
modulate the autoimmune response and secondly help to
modulate the pain response. The common drugs that are used to
treat arthritic symptoms include; simple analgesics; non-steroidal
     
         
than one joint [1]. The causes of arthritis depend on the form of
Improvement of Early Arthritic Symptoms with Pawanmuktasana Anti-Rheumatic
Series 2/3
©2017 Selvarajah et al.
Citation: Selvarajah K, Arumugam K (2017) Improvement of Early Arthritic Symptoms with Pawanmuktasana Anti-Rheumatic Series. MOJ Yoga
     
has showed that although drugs noticed to give better outcome
clinically and radiologically, however long term drug therapy raise
concerns regarding cardiovascular risk and other complications
With regard to non-pharmacological management, many
clinical trials have proved that exercise programs may
improve pain and function [16-17]. As such performing yoga
     
to musculoskeletal system and helps to reduce pain, disability
 
proved that patient who performs pawanmuktasana shows lower
  
         
changes due to weight and stiffness at joint which restrict the
proper alignment and stretch of various postures. In case of
pawanmuktasana it is very easy to perform by anyone at any
at just in sitting position. It is evident that there is no pressure or
excess weight exerted on the joint. Thus joints are mobilized safely
to stimulate the circulation, secretion and absorption of synovial
       
and simultaneously revitalizes the tissues around the joints.
Elimination of toxic gases reduces the degenerative changes due
to normal or abnormal activity.
Regular practice of pawanmuktasana brings steady and
progressive improvement on any disease ranging from diabetes
to hypertension or even from constipation to cancer or any other
kind of illness [20]. Regular practice of pawanmuktasana brings
steady and progressive improvement on any disease ranging from
diabetes to hypertension or even from constipation to cancer or
any other kind of illness. It is recommended to perform these
series asana for ten times at each position with periodic rest in
between two or three asanas. The details and steps are given
within the book on Asana Pranayama Mudra Bandha, by swami
satyanandha saraswathi from page 21-44. The asana in each
 
of pawanmuktasana parts over a period of months brings about a
  
is advisable to learn the steps and alignment of the posture form
the train personnel’s. Long term practice of these anti rheumatic
series proven to reduce the typical rheumatic symptoms [17-20].
Proper practice with mindfulness on posture and movement at
joint position creates suppleness at joints, relaxes stiff muscles
and allows the escape of trapped gases within the joint. Thus
 
In summary, pawanmuktasana is a carefully designed series of
asana which anybody can practice without worsening the existing
ailment. It is evident that regular practice of pawanmuktasana
tones muscles, eases the mobility of joint and improves venous
circulation around the joints. Healthy lifestyle and diet also plays
key role in alleviating arthritic symptoms. This review presented
the brief note regarding the effectiveness of pawanmuktasana
anti-arthritic series in controlling early symptoms of arthritis and
  
inspired me to review this wonderful topic. I also would like to
convey my gratitude to my husband and yoga friends who have
guided throughout this review.
Conict of Interest
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        
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Improvement of Early Arthritic Symptoms with Pawanmuktasana Anti-Rheumatic
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Objective To perform a systematic literature review (SLR) on pharmacological and non-pharmacological treatments, in order to inform the European League Against Rheumatism (EULAR) recommendations for the management of early arthritis (EA). Methods The expert committee defined research questions concerning non-pharmacological interventions, patient information and education, non-steroidal anti-inflammatory drug, glucocorticoid (GC) and disease-modifying antirheumatic drugs (DMARDs) use, as well as on disease monitoring. The SLR included articles published after the last EULAR SLR until November 2015 found in the MEDLINE, EMBASE and Cochrane databases and abstracts from the 2014 and 2015 American College of Rheumatology and EULAR conferences. Results Exercise programmes may improve pain and physical function in patients with EA. Patients with EA treated within the first 3 months of symptoms have better clinical and radiological outcomes than those treated beyond 3 months. The clinical and radiological efficacy of GCs is confirmed, with similar efficacy of oral and parenteral administrations. Long-term data raise concerns regarding cardiovascular safety when using GCs. Step-up DMARD therapy is as effective as intensive DMARD therapy ‘ab initio’ for the long-term outcome of EA. Short-term superiority of intensive therapy with bDMARDs is not maintained on withdrawal of bDMARD. Patients with early psoriatic arthritis have better skin and joint outcomes when tight control is used compared to standard care. Conclusions The findings confirm the beneficial effect of exercise programmes and the importance of early drug therapy and tight control. They support the use of methotrexate and GCs as first-line drugs, although the long-term use of GCs raises safety concerns.
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This study aimed at studying the effect of yogic package (YP) with some selected pranayama, cleansing practices and meditation on pain intensity, inflammation, stiffness, pulse rate (PR), blood pressure (BP), lymphocyte count (LC), C-reactive protein (CRP) and serum uric acid (UA) level among subjects of rheumatoid arthritis (RA). Randomized control group design was employed to generate pre and post data on participants and controls. Repealed Measure ANOVAs with Bonferroni adjustment were applied to check significant overall difference among pre and post means of participants and controls by using PASW (SPSS Inc. 18th Version). Observed result favored statistically significant positive effect of YP on selected RA parameters and symptoms under study at P<0.05, 0.01 and 0.001 respectively that showed remarkable improvement in RA severity after 40-day practice of YP. It concluded that YP is a significant means to reduce intensity of RA.
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Yoga is an ancient Indian way of life, which includes changes in mental attitude, diet, and the practice of specific techniques such as yoga asanas (postures), breathing practices (pranayamas), and meditation to attain the highest level of consciousness. Since a decade, there has been a surge in the research on yoga, but we do find very few reviews regarding yogic practices and transcendental meditation (TM) in health and disease. Keeping this in view, a Medline search was done to review relevant articles in English literature on evaluation of physiological effects of yogic practices and TM. Data were constructed; issues were reviewed and found that there were considerable health benefits, including improved cognition, respiration, reduced cardiovascular risk, body mass index, blood pressure, and diabetes. Yoga also influenced immunity and ameliorated joint disorders.
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The objective of this study is to assess the findings of selected articles regarding the therapeutic effects of yoga and to provide a comprehensive review of the benefits of regular yoga practice. As participation rates in mind-body fitness programs such as yoga continue to increase, it is important for health care professionals to be informed about the nature of yoga and the evidence of its many therapeutic effects. Thus, this manuscript provides information regarding the therapeutic effects of yoga as it has been studied in various populations concerning a multitude of different ailments and conditions. Therapeutic yoga is defined as the application of yoga postures and practice to the treatment of health conditions and involves instruction in yogic practices and teachings to prevent reduce or alleviate structural, physiological, emotional and spiritual pain, suffering or limitations. Results from this study show that yogic practices enhance muscular strength and body flexibility, promote and improve respiratory and cardiovascular function, promote recovery from and treatment of addiction, reduce stress, anxiety, depression, and chronic pain, improve sleep patterns, and enhance overall well-being and quality of life.
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Many causes of arthritic pain are encountered in clinical practice. Osteoarthritis is the most common form of arthritis in the United States, afflicting tens of millions of people. The authors review current literature on the treatment of patients with osteoarthritis. They discuss nonpharmacologic therapy such as physical therapy, weight reduction, and osteopathic manipulative treatment. Pharmacologic treatment of patients with osteoarthritis includes acetaminophen, nonsteroidal anti-inflammatory drugs, tramadol hydrochloride, and opiate analgesics in patients who failed all other treatment modalities. Patients who failed medical management should be referred for consideration for surgery.
Background The patients with rheumatoid arthritis (RA) are less physically active than the general population [1]. Physical exercises improve muscle strength, range of movements, aerobic capacity and bone density in patients with RA [2–4]. However, some physicians fear to recommend the intensive exercises. Objectives To compare the efficacy of two exercise programs in patients with early RA during 6 months. Methods 51 patients with early RA (92,2% females, age of 18 to 53 years, disease duration of 2 to 17 months) were randomized into 3 groups. At hospital stage 15 patients underwent 10 high-intensity dynamic exercises using gym apparatus Enraf-Nonius for 45–60 min, including aerobic part (En-Cardio) and 18–20 muscle-strengthening exercises (En-Dynamic Track), 18 patients – 10 therapeutic exercises for joints for 45 min under the supervision of a trainer. At outpatient stage the exercises lasted for 6 months 3 times a week. 18 patients received only drug therapy (control). Tender and swollen joint count, pain on 100-mm VAS, erythrocyte sedimentation rate (ESR), DAS28, HAQ, RAPID3, the average powers of knee extension and ankle flexion by EN-TreeM movement analysis were evaluated at baseline and at 6 months. Results After 6 months in the both exercise groups there were statistically significant differences from the control group in most parameters (p<0,05). Efficacy of the intensive gym exercises was higher than the therapeutic exercises by tender joint count, HAQ, RAPID3 (p<0,05). Adherence to the regular therapeutic exercises for 6 months was better (77,8%) then to the gym exercises (60,0%). Predictors of the regular high-intensity gym exercises were the young age (under 40 years) and the very early stage of RA. Most patients, who regularly did exercises, had DAS28 low disease activity (66,7% in the gym group and 57,1% in the therapeutic exercises group vs 36,7% in the control group, p<0,05). Conclusions The both 6-month exercise programs reduce pain, increase functional status, quality of life and power of motion without detrimental effect on disease activity. References Disclosure of Interest None declared
Rheumatoid arthritis (RA) is a systemic autoimmune disease which is characterized by chronic inflammation of the joints. Patients experience chronic pain and suffering, and increasing disability; without treatment, life expectancy is reduced. It is imperative to identify patients early so that control of inflammation can prevent joint destruction and disability. Although great advances have been made in the developed nations, early diagnosis remains a great challenge for developing countries during the Bone and Joint Decade (2000-2010) and beyond. Developing countries face important and competitive social, economic, health- and poverty-related issues, and this frequently results in chronic diseases such as RA being forgotten in health priorities when urgent health needs are considered in an environment with poor education and scarce resources. Epidemiological studies in developing countries show a lower but still important prevalence in different regions when compared to that in Caucasians. It seems that the severity of RA varies among different ethnic groups, and probably starts at a younger age in developing countries. Practising rheumatologists in these regions need to take into account several important problems that include suboptimal undergraduate education, inadequate diagnosis, late referrals, lack of human and technical resources, poor access to rheumatologists, and some deficiencies in drug availability. Infections are very important in RA, and special care is needed in developing countries as some endemic infections include tuberculosis, human immunodeficiency virus (HIV), hepatitis B, and hepatitis C. These infections should be carefully taken into account when medications are prescribed and monitored. This chapter presents published information covering the main challenges faced in these environments, and suggests strategies to overcome these important problems in RA management.
While surgical interventions often relieve severe pain for those with osteoarthritis (OA), there are thousands of patients with this common and disabling condition who do not receive surgery. Pharmacologic and nonpharmacologic interventions may offer a reduction in pain and improvement in physical functioning. To help patients with OA, nurses should conduct thorough assessments based on pathophysiology, and plan appropriate care with the patient. In this first article of a two-part series, the pathophysiology and classification of OA are presented. Assessment factors are discussed, and pharmacologic interventions are presented. Part 2 of this series, to run in the November/December issue, will focus on nonpharmacologic interventions and evaluation.
Current evidence suggests that although persistent arthritic pain is initiated and maintained by articular pathology, it is also heavily influenced by a range of other factors. Strategies for treating arthritic pain are therefore different from those adopted for acute pain. Although published guidelines offer general assistance, the complexity of underlying mechanisms requires that measures designed to relieve pain must take into account individual biological, psychological and societal factors. It follows that a combination of both pharmacological and non-pharmacological approaches offers the best opportunity for therapeutic success, although determining the effectiveness of such complex interventions remains difficult. Pharmacological therapy is often prolonged, and safety and tolerability issues become as important as efficacy over time.
Estimated and Projected Number of Adults with Doctor-Diagnosed Arthritis in the United States
National Health Interview Survey (2013-2015) Estimated and Projected Number of Adults with Doctor-Diagnosed Arthritis in the United States.