Monday, March 4, 2019

Yoga Can Help With Multiple Sclerosis Symptoms

Elasticity, Umberto Boccioni, 1912, Oil on Canvas, Milan, Italy
by Ram Rao

Neurons which serve as the core components of the brain and spinal cord of the central nervous system are electrically excitable cells. Neurons process and transmit information via electrochemical signals thereby forming complex neural networks. These signals travel intraneuronally through specialized junction points called synapses. 

In order to ensure rapid and efficient transmission of information, neurons are endowed with an insulating sheath called myelin. The presence of myelin ensures speedy transmission of electrochemical impulses along the myelinated neuron to the next neighboring neuron. It also helps prevent the electrochemical signals from randomly leaving the neuron thereby permitting agile communication for long-distance signaling and to sustain such signals. Myelinated neurons (neurons that are endowed with the myelin sheath) are white in appearance, hence the term "white matter" of the brain. Under a microscope, myelinated neurons appear like strings of sausages. The main constituent of myelin is cholesterol and it also has about 15–30% proteins. The predominant protein is myelin basic protein (MBP).


For reasons that are unclear, the body’s defense system in some individuals recognizes the myelin basic protein as “foreign” and starts attacking it. This self-driven inflammatory condition is Multiple Sclerosis or MS. When the body’s defense system lays seize on the myelin, the protective sheath loses its structural and functional integrity resulting in disruption of the smooth neural communication. The more myelin is destroyed, the slower and less efficient the nerve impulses are. Eventually, as the disease progresses, it can cause the nerves themselves to deteriorate or become permanently damaged.

The signs, symptoms, severity, and duration of MS will vary depending on the extent of nerve damage, and which nerves get affected. Some people may have low grade inflammation most of their lives, while others may develop severe chronic symptoms that never go away. Women are more than twice as likely to develop multiple sclerosis as men. MS usually affects people between the ages of 20 and 50 years, and the average age of onset is approximately 30 years. 

Common early signs of MS include: vision problems; tingling and numbness in joints, fingers, and toes; pain; spasms; weakness; fatigue; balance problems; dizziness; bladder issues; sexual dysfunction; and cognitive problems. As the disease progresses, symptoms may become more severe. While MS is not a fatal disease, there is currently no cure for it. People with MS have essentially the same life expectancy as the general population. Anti-inflammatory treatments modify the course of the disease and can help to manage the symptoms as well as recover from the inflammatory attacks. Physical and occupational therapies are a great way to manage the condition.


While yoga does not cure MS, through its postures and breathing techniques, it helps to focus the mind and pay attention to the body. For example, for people with full blown symptoms of MS, mornings can be an ordeal as the body is tight and rigid from the previous night’s sleep. The practice of yoga can ease many of the physical symptoms and emotional challenges through breathing and stretching exercises to help individuals successfully complete tasks and do things for the rest of the day with less pain and discomfort. Several of the yoga postures can safely address many MS symptoms such as loss of bladder control, balance, and fatigue. Several research studies discuss the benefits and potential role of yoga as an alternative treatment of symptom management for individuals with MS and describe how yoga can improve their quality of life.


In all of the research studies involving yoga, the opinion among subjects with MS was unanimous: subjects reported improvements in mental and emotional health, concentration, bladder control, vision, and ability to withstand pain better. Yoga has been shown to lessen fatigue and increase energy level. Fatigue is one of the most common symptoms of MS. Furthermore, subjects also revealed improved motor coordination, better capacities for walking without losing balance or coordination of gait, and improvement in being able to stand up from a sitting position.


For people with MS who are practicing yoga, the emphasis is on:


(a) Improving strength and flexibility- Asanas include among others Mountain pose (Tadasana), Warrior poses (Virabadrasana 1-3), Boat pose (Paripurna Navasana), Chair Pose (Utkatasana), Side angle (Parsvakonasana) and Sun Salutation (Surya Namaskaram).


(b) Balance- It is always advisable to use the wall and/or props to keep steady and maintain balance in each pose.


(c) Agility- Always start with slow, precise changes of position in asana practices, such a slow Sun Salutation. Take one pose and vary it in several different ways including using blocks, straps, and other yoga props.

Based on the gravity of the symptoms, individuals with MS can easily adapt the postures to their comfort level. People who have difficulty holding a yoga pose without assistance can use blocks and other assistive devices to get the benefit from the pose when flexibility and other issues interfere. People in wheelchairs can benefit from chair yoga and other suitable props that will help them to get to the pose and benefit from it. Together with a short pranayama and meditation practice (Interview with Patrice Priya Wagner on Meditation for Multiple Sclerosis), yoga gives people with MS coping tools they can use for the rest of their lives. All of the research studies together with anecdotal reports are steps in the right direction as they show that a yoga program is very effective in improving the quality of life for people with MS.



Rammohan Rao (Ram) comes from a family of Ayurvedic practitioners and Vedic teachers in India tracing back to the illustrious Vedic-acharya Rishi Kaundinya (although Ram admits he cannot do the Eka pada or Dwi pada Kaundinyasana). With a doctorate in Neuroscience, Ram was a Research Associate Professor at the Buck Institute for Research on Aging. He focused on various aspects of age-associated neurodegenerative diseases with emphasis on Alzheimer’s disease. In addition, Ram completed the academic training at the California College of Ayurveda (CCA) and received his certification as Clinical Ayurvedic Specialist. He has been a faculty member of the California College of Ayurveda and teaches in their Nevada City location. Ram is also a dedicated Hatha yoga practitioner and is a Registered Yoga Teacher from Yoga Alliance USA. In his spare time he offers consultations in YAMP techniques (Yoga, Ayurveda, Meditation & Pranayama). Ram has published several articles in major Yoga/Ayurveda magazines and has been a featured speaker in several national and international meetings and symposia. He is a member of the National Ayurvedic Medical Association (NAMA) and is on the Research Board of the Association of Ayurvedic Professionals of North America (AAPNA).


This post was edited by Patrice Priya Wagner, co-editor of Accessible Yoga blog and member of the Board of Directors.

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