Wednesday, December 4, 2019

Overcoming Sjögren’s Syndrome with Yoga

by Ram Rao

Autoimmune diseases are characterized by our immune system going awry and mistakenly attacking our own body tissues. The immune system is our body’s defense mechanism consisting of leukocytes, macrophages, dendritic cells, mast cells, bradykinin, histamine, interleukins, and tumor necrosis factor among others (similar to the various armed forces). 

Normally, these defense molecules protect the body from foreign particles including bacteria, virus, toxins, and all types of allergens. When the body senses these foreign invaders, it signals the immune system to send out its plethora of defense molecules to attack them, a process known as inflammation.

The immune system is extremely important as it is involved in protecting organs, tissues, and cells. In a perfect setting, the immune system will release these defense molecules only when needed––and when the threat has been sufficiently addressed, these defense molecules retreat to their garrison (specific cellular location). Thus, in a perfect setting, a body’s defense system can differentiate between foreign cells and the body’s own cells.

For reasons that remain unclear, in autoimmune disease conditions, the immune system mistakes the self––the body, including tissues, joints, muscles, nerves, or skin, as foreign. Since the “self-tissues” get recognized as “foreign,” the body’s immune system starts attacking it them. This is the negative aspect of the immune system characterized by an aberrant, out-of-control defense system––the body operating as if it is constantly under attack and the body’s defense molecules going haywire and attacking its own tissues. This results in bodily damage, and as the system goes out of control, it self-perpetuates and is the basis of chronic autoimmune conditions including, but not limited to, fibromyalgia, neuralgia, systemic lupus erythematosus, systemic sclerosis, and polymyositis.

Some autoimmune diseases target only one organ as in Type 1 diabetes that affects only the pancreas. Other diseases, such as systemic lupus erythematosus, affect several areas of the body. While the basis for the immune system to go haywire remains unclear, some people are more likely to get an autoimmune disease than others. Genetics, gender, environment, certain foods, lifestyle, and age play a role in the development of autoimmune disorders. Women get autoimmune diseases at a rate of about two to one compared to men. Some autoimmune diseases are more common in certain ethnic groups. Certain autoimmune diseases, like multiple sclerosis and lupus, run in families.

Sjögren's syndrome is a lesser-known autoimmune disease that primarily affects moisture-producing glands of the body including the tear and saliva glands. It is estimated that four million Americans are diagnosed with Sjögren’s including men and women of different ages and ethnicities. Due to the complexity of diagnosing Sjögren’s, it is believed that many individuals remain undiagnosed after years of experiencing symptoms. 

Patients with this condition have eye dryness, irritation, or painful burning in the eyes. Patients with dry eyes are at increased risk for infections around the eye that can damage the inner regions like the cornea. Some people complain of dry mouth and swelling of the glands around the face and neck. A dry mouth triggers other dental issues like dental decay, gingivitis, or oral infections. Some patients have episodes of painful swelling in the salivary glands, while others complain of dryness in the nasal passages, throat, vagina, and skin. Swallowing difficulty and symptoms of acid reflux are also common.

Treatment for Sjogren's syndrome depends on the parts of the body affected. Many people manage the dryness in the eye and mouth by using over-the-counter eye-drops. Drugs including NSAIDs (non-steroidal anti-inflammatory drugs) or steroids that suppress the immune system are normally prescribed, but steroids can trigger serious side effects. Diet, supplements, and herbs help to reduce the pain and inflammation, protect joint health and promote healing with fewer side effects. Additionally, lifestyle changes also reduce the severity of the condition.

Yoga and yoga related practice including asana, meditation, and pranayama help in mitigating the symptoms of this chronic illness and overcoming its weakening effects. While the health benefits may not appear immediately, they become evident with a sustained and regular yoga practice. Research studies provide ample evidence to show that yoga suppresses inflammation, a cardinal feature of Sjögren's syndrome.

A regular yoga practice may lower the level of several pro-inflammatory molecules in the body, thereby relieving severe pain associated with the inflamed tissue. Yoga poses stimulate flow of blood and oxygen to all the organs, joints, and tissues resulting in reduction in joint pain, improvement in mobility of joints and muscles, increased energy levels and sense of wellbeing. Patients also report improved sleep after a yoga practice.

Sitting, standing, and supine twists, sun salutation, warrior poses, and inversions in general reduce inflammation. This results in improved blood circulation, stimulates respiration, and relieves muscle and joint pain. The inflamed areas are now better equipped to combat stress and function effectively as there is improved blood circulation and oxygen.

Yoga’s pain management techniques including breath work, deep relaxation, and meditation dampen stress and bring in more mental clarity thereby decreasing the level of pain and perceived suffering. All the benefits are mostly observed in patients that have a sustained yoga practice. So, if you are diagnosed with Sjögren's syndrome or an associated inflammatory condition, think of adding yoga and yoga management practices to your list of treatment protocols.

Rammohan (Ram) Rao 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, Managing Editor of Accessible Yoga blog and member of the Board of Directors.

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