What have the gnawing aches of osteoarthritis got to do with your mind? Some scientists now reckon that a positive mental attitude could be one of the key elements to curbing-even possibly reversing-the condition.
Many of the alternative "body therapies" also involve some element of the mind, or harnessing the healing powers of the "life-force", or chi. Others, such as chiropractic and the Alexander Technique, can improve posture. We review some of the major body/mind therapies in this section, as well as simple 'self-help' things you can do, such as low-impact exercise and meditation.
The Mind Therapies
It is now recognized that a patient's emotional or psychological state may affect the course and perception of his disease, and that intervention, in the form of group therapy, may help perceptions of pain.
The effectiveness of short, intensive programmes of patient education has been evaluated in several studies. In one, individuals with ankylosing spondylitis showed improvement in terms of rates of depression and severity of the disorder at three weeks and this improvement continued until the end of the trial at six months. The researchers noted, however, that motivating the patients to continue their home-exercise programme past the six-month mark remained one of the biggest problems.
Another study looked at the effect of group treatment on chronic pain and the emotions linked with it-anger, anxiety and depression-on a group that included sufferers of low back pain, tension headache, rheumatoid arthritis and ankylosing spondylitis. A cognitive behavioural programme, which included components of relaxation, cognitive restructuring and the promotion of well-being, was used and the effect on the different groups assessed. Subjects with inflammatory rheumatoid diseases showed improvement on all fronts.
Patients with rheumatoid arthritis may also benefit from a cognitive behavioural programme. In one 12-month trial, subjects showed greater confidence in using coping strategies to deal with pain, as well as improvements in their emotional state.
Of course, what one person finds relaxing, another might not. One small study supports the idea that we must choose methods of relaxation carefully. Thirty women with rheumatoid arthritis were told to relax, listening to the music of their choice, while researchers studied the effect this had on their perceptions of pain. The results of the study, based on questionnaires completed before, during and after listening to music, showed that this kind of relaxation could be a valid way to help chronic pain.
Hypnotherapy may also be useful. In a controlled study of patients with fibromyalgia, 40 patients were randomized either into hypnotherapy or physical therapy groups for 12 weeks. Follow-up was at 24 weeks. In the hypnotherapy group, the subjective scores of pain, morning fatigue and sleep patterns all showed improvement, though objective assessment of the disease progression showed no change.
Meditation and Visualisation
Meditation is a very effective technique for stilling the mind, taking control and reducing pain.
There are many meditation techniques or approaches. There are those that count the breath, or focus on a religious icon, while visualisation is an increasingly popular technique that involves the mind imagining some life-enhancing image such as a sun-drenched beach. Other methods start with a prescribed mantra, or on the "Om" word, or on a koan or illogical saying beloved of the Zen Buddhist tradition.
The Body Therapies
The Alexander Technique is a re-education in movement aimed at making us more aware of the way we use our bodies and releasing unnecessary physical tension and imbalance. The technique has been widely endorsed as a practical way to treat or prevent back, neck and shoulder pain caused by poor posture and inappropriate muscle movements. Practitioners also believe the technique can help problems of breathing, circulation, digestion, headaches, and stress-related disorders.
The technique was developed in the late nineteenth century by Frederick Matthias Alexander, an Australian-born actor who developed vocal problems, which affected his performances. Eventually he discovered that a habitual tensing of his neck muscles was causing compression of the neck and spine, but by realigning his head, neck and spine, he found he could resolve the problems with his voice.
Alpha-Pulse Therapy (APT) uses pulsed electromagnetic fields to treat a wide range of bone and joint disorders. Pulsed magnetic fields have been used for years, and have been subjected to several scientific studies that show that they can be useful in treating chronic degenerative conditions such as osteoporosis, swelling and post-surgery cases as well as low-response, intractable illnesses such as fibromyalgia.
There is some evidence to show that magnetic therapy can correct the breakdown of spongy cartilage and other tissues in the joints, which usually happens in cases of osteoarthritis. In the laboratory, these treatments have been shown to increase the metabolic rate of cartilage cells.
The word "biofeedback" was coined in 1969 to describe laboratory procedures (developed in the 1940s) that trained research subjects to alter brain activity, blood pressure, muscle tension, heart rate and other bodily functions that are not normally controlled voluntarily. Biofeedback is a training technique in which people are taught to improve their health and performance by using signals from their own bodies.
Developed in the 1950s by the late Tom Bowen in Geelong, Australia, the Bowen Technique attempts to marshall the body's own healing resources through sequences of small, gentle moves at specific sites on the body. There is no forceful manipulation, just gentle cross-fibre manoeuvring of a muscle, tendon or ligament. The Bowen Technique supposedly taps into the body's natural feedback system that monitors the state of each muscle. As well as releasing any tension within the muscles, the moves also work on energy blocks (caused by injury, tension or disease), allowing increased energy flow and, eventually, healing to take place.
Chiropractic specializes in the diagnosis and treatment of conditions that are due to mechanical dysfunction of the joints and their effects on the nervous system. After medicine and dentistry, it is the third largest primary health care profession in the West.
Poor, inadequate or incorrect function in the spine can cause irritation of the nerves that control our posture and movement. This spinal nerve stress (which may be caused by factors such as accident, poor diet, lack of exercise, poor posture and anxiety) can lead to the symptoms of discomfort, pain or disease.
Craniosacral therapy is a gentle, non-invasive technique, which focuses on the craniosacral system of the body, which includes the skull, the entire spine, cerebrospinal fluid, and the spinal membranes. A therapist can sense abnormalities in the cranial pulse or rhythm, which ranges from 6-12 cycles per minutes. Through gentle manipulation, the therapist can unwind the myofascial system affecting craniosacral imbalances to allow the body to self-correct and allow the cerebrospinal fluid to regain a natural rhythm and flow.
Trauma, infection, stress, inflammation and poor posture are all common causes of craniosacral dysfunction. Left untreated, craniosacral imbalance can cause multiple musculoskeletal symptoms, which often cannot be treated successfully by conventional means.
Developed through 40 years of research by Dr. Moshe Feldenkrais, this technique utilises movement and attention to enhance our natural abilities to learn. Dr Feldenkrais' own physical problems led him to a lifelong exploration of ways to improve movement and functioning. His investigations reflected his various fields of expertise (physics, neurology, martial arts, cybernetics, body mechanics, and psychology) and resulted in a method that is a unique synthesis of science and aesthetics.
Applied kinesiology is both a system of diagnosis and treatment first developed by a chiropractor called Dr George Goodheart, Jr, who observed that a muscle dysfunction could affect the performance of organs and glands. An applied kinesiologist will examine the muscles and relate muscle strength to the state of a patient's health. If a patient has a weakness in an organ or gland, a kinesiologist will look for a weakness in certain muscles which correlate with the weak organ; strengthening those muscles, and improving any postural problems or range of motion will help to achieve normal internal organ function. These procedures are also used to restore normal nerve function.
McTimoney chiropractic is a particularly gentle and effective whole body manipulative technique. This technique was developed by John McTimoney and subsequently is taught by licensed members of the McTimoney Chiropractic Association at the McTimoney Chiropractic College. The body of knowledge of the technique is handed down by McTimoney chiropractors. Adjustments are carried out following assessment of the spinal function by palpation.
It aims to correct the alignment of bones of the spine and other joints of the body, to restore nerve function, to alleviate pain and to promote natural health.
Neurostructural Integration Technique (NST)
NST is a very gentle form of massage of specific muscle groups, designed to create an energy flow and vibration between them. Some observers say the massage is so light that it cannot be doing any good, although there have been legions of patients who testify otherwise.
It evolved from the Bowen Technique, and is considered to be the most successful of the therapies to grow from it. It is thought to be quicker and smoother than the other post-Bowen therapies, but, like the Bowen Technique itself, it helps the body to regulate and rebalance itself so that the body's own self-healing processes can begin to function properly again.
Osteopathy is an established and recognized system of diagnosis and treatment, which lays its main emphasis on the structural and functional integrity of the body. It is distinctive by the fact that it recognizes that much of the pain and disability that we suffer stems from abnormalities in the function of the body structure as well as damage caused to it by disease.
Whilst back pain is the most common problem seen, osteopathy can help with a wide varied of problems including changes to posture in pregnancy, babies with colic or sleeplessness, repetitive strain injury, postural problems caused by driving or work strain, children with glue ear, the pain of arthritis and sports injuries among many others.
Reflexology is a 20th century version of an ancient healing and relaxation technique that may be even older than acupuncture. Western reflexology was developed by Dr. William Fitzgerald, an American ear, nose, and throat specialist, who talked about reflexology as "zone therapy." It is also practised in several cultures, including Egypt, India, Africa, China and Japan.
Reiki, which means 'universal life force energy' in Japanese, is an ancient hands-on method of natural healing. Life-force energy is said to run through every living thing along an energetic grid system not dissimilar to that of traditional Chinese Medicine. When we are healthy, positive and well, this energy flows freely. However, during particularly stressful periods in our lives, the tension we experience slows down or restricts this energy flow in various parts of the body, adversely affecting health.
Shiatsu is a traditional hands-on Japanese healing therapy. It can help with a variety of chronic conditions, including the joint pain and reduced mobility usually associated with arthritis.
As with acupuncture, shiatsu believes that vital energy, known as Ki or chi, flows through the body in a series of channels called meridians. Illness occurs when this energy is blocked, practitioners believe, and it is their task to free this through a series of massages. These can range from gentle holding, pressing with the palms, thumbs, fingers, elbows, knees and feet on the meridians and, sometimes, more dynamic rotations and stretches are also used.