Treatment of Arthritis

Introduction

In the treatment of chronic pain the focus is on pain management. It is based on the understanding that pain is not merely a physical problem. It enables the patient to receive a variety of treatment i.e. medical, psychological as well as complementary medicine. Over and above this, it teaches the patients the skills to help themselves and to accept the fact that managing pain is a full time occupation and is a pre-requisite to enjoyment of better quality of life. It encourages the patient to change his .attitude and become an active participant in his own rehabilitation rather than a passive recipient of medical care. The treatment should not be confined to pain but given to the person so that he IS restored physically, mentally and spiritually to cope with every aspect of life while suffering with chronic pain.

Most of the people with chronic pain are written off as hopeless case They have physical problems, emotional problems and inter-personal problems. However, it is possible for most of the people to acquire high degree of skill in managing their pain without being dependent on drugs. They can regain mobility, confidence and self- esteem and can contribute positively to the society.

We shall now discuss Allopathic, Ayurvedic, Homeopathic, and Acupressure and Yogic systems of medicine for treatment of arthritis and management of pain.

Allopathic System Of Medicine

Introduction

In this system of medicine the pain and inflammation in the joint is relieved with the help of painkillers, anti-inflammatory drugs, steroids and injections. The drugs, their uses and side effects are discussed in the following sections.

Injections

Special forms of medicines are used for this purpose which when injected into the affected joint stays there and very small quantity gets absorbed into circulation.

The main drugs used are steroids, which reduce inflammation. Acids are used to burn out inflamed tissues. Irradiation is used to reduce arthritic inflammation. Besides, local anaesthetic drugs are also used in combination with above drugs for relief of pain.

Disease Controlling and Modifying Drugs

These drugs slowdown or control the damage. They take a long time to work before the results are visible. When they are effective, there is dramatic. improvement in all aspects of disease.

In case of drugs for gout, they reduce uric acid formation in the body. Other group of drugs helps kidneys to increase the amount of uric acid excreted in urine. Similarly drugs for other forms of arthritis also fall in two categories. The first category consist of immune-suppressive agents which include azathioprine and cyclophosphamide ete. The other group cures rheumatoid and other form of arthritis and includes gold, hydroxy chloroquine and sulphasalazine etc. These drugs should however be used carefully and their side effects monitored regularly by the doctor.

Surgery

Decision of opting for surgery is a part of total patient management. It is not a last resort but an important means of treating the disease. If right operation is done at a right time, it will help the patient tremendously.

All types of arthritis do not require surgery. Osteo-arthritis and rheumatoid arthritis when very severe may require surgery. People with ankylosing arthritis may require surgery of spine and hips in rare cases. The percentage of arthritic patients requiring surgery is very small. Surgery can be divided into two types

(a) Peri- articular – Outside joint

(b) Articular – On joint

Peri-Articular Surgery

It is relatively minor and includes repair of damaged tendons and ligaments and removal of cysts and nodules.

Articular Surgery

It consists of surgery in which if the synovium is bulky and inflamed and causing mechanical problem it can be removed. It is called synovectomy.

• Bone next to a painful joint is cut and fixed in a different position. It is done to correct deformity and relieve pain in Osteoarthritis and is called osteotomy.
• In a joint, which is restricted in movement and is very painful, is permanently fixed either by nailing or wiring two halves or by bone grafting. It is called athrodesis.
• In case of severely damaged joints, joint replacement surgery is performed. It can be done on knees, hips, hands, spine, foot, shoulders and elbows etc.

Artificial joints are not perfect and are not as efficient as natural joints. At times lots of complications spoil the success. A good joint replacement provides adequate range of movement for 10-15 years without pain.

Ayurvedic System of Medicine:

Introduction

According to ayurvedic system, arthritis is caused by disturbance in digestive system and metabolic activities of the body.

According to ayurvedic science, if a person has constipation, the waste products produced during digestion and the metabolic process of the body, keep accumulating in colon and rectum and water present in the feces gets absorbed in tissues. If the feces do not come out in time, it makes the digestive system weak and the waste products get absorbed in blood. 35% of stool is made up of solid products and about 20 % of it comprise of bacteria. Some bacteria present in colon produce necessary elements for the body. In case of constipation, the harmful bacteria craft come out of body and multiply. They do not allow proper functioning of useful bacteria. The poisonous elements of these harmful bacteria get mixed in blood and affect the metabolic process adversely.

During the process of digestion, in the presence of different enzymes, various reactions take place. As a result of these reactions, gas is formed. The gas generally passes out along with feces. When gas does not come out along with stool due to constipation, the pressure of gas creates lot of trouble in joints.

With chronic constipation all our efforts to relieve pain or cure the disease will not be very successful. The same is true if digestion of food takes unusually long time as in dysentery. One of the most important steps in pain relief is to control constipation as well as improve digestion of food.

Methods to Control Constipation And Indigestion

[A] Set Solar Plexus in Order

Solar plexus controls functioning of all organs and is situated below diaphragm. Solar plexus shifts upwards or downwards by lifting heavy weight as well as by severe gas trouble. Upward shifting of solar plexus leads to constipation while downward shifting brings indigestion and more motion. Solar plexus can not be set by medicines. Hence before starting any treatment of digestive systems, it is necessary to check the position of solar plexus and set it in order.

Method to Know Whether Solar Plexus is in Order

1. Lie on hard surface and press your finger or thumb in the navel, if you feel throbbing sensation like that of heart, the solar plexus is in order.
2. If solar plexus is in order, distance between right nipple and navel should be equal to that between left nipple and navel.
3. Lie down on your back. Keep arms straight on your side. Keep legs straight and toes upright. If two big toes are in level the solar plexus is in order.

Bringing Solar Plexus In Order

1. By putting weight on the navel and trying to push it towards the center. Do it a number of times till by pressing your thumb in the navel throbbing sensation is felt.
2. Lie down on your back. Exhale the breath fully. Now inhale and inflate the stomach as much as possible and keep it as long as you can. Repeat it till solar plexus is in order.
3. Put a small oil lamp on navel, cover it with metal glasshold it for some time till oxygen is burnt out and there in vacuum. Vacuum will bring solar plexus in order.Now lift the glass after one minute. Repeat it till solar plexus is in order.
4. Lie down on your back with legs straight. Ask some one to put pressure on the knee of the leg of which big toe is at lower level) and simultaneously pull up the big toe which is lower.

[B] DIET

Introduction

There is a strong relationship between intake of food and development and cure of diseases. The diet also has an impact on immune system and diseases such as arthritis, osteoporosis etc. Improving the quality of diet and supplementing it with immune boosting substances can help reduce pain and inflammation.

We need nutrients in correct amount for good health. Nature has packed unprocessed food with nutrients, minerals and vitamins. The vitamins are delicate and unstable entities that can easily be destroyed during processing of food. The food is depleted of vitamins and minerals in the process of its progress from farm to factory, factory to market, market to freezer/oven and then on to the plate. One should therefore avoid tinned, processed and preserved food.

For healthy bones and joints the diet should consist of foods that are low in fats, high in fiber content and have adequate level of vitamins and minerals. In case of deficiency of vitamins and minerals, supplements may be taken in consultation with nutritionalist. Large doses of supplement are inefficient and may cause deficiency of other nutrients. The vitamins and mineral intake supplement each other. Vitamin C is necessary for the absorption of iron, vitamin D and magnesium arenecessary for the utilization of calciunl and vitamin E protects vitamin A and D from oxidation. Sometimes large quantities of some nutrients deplete others e.g. large quantities of zinc can deplete copper, creating an imbalance of system.

• Acid/Alkali Balance in Diet

Acid /alkali balance is very important in controlling inflammatory condition. The diet that is predominantly alkaline would help in reducing inflammation. However, the dietary need is different for each individual. In general a diet consisting of 75% alkali forming foods and 25% acid forming foods is an ideal balance. Most foods and vegetables except citrus fruits and tomatoes are alkali forming. Other acid forming foods are dairy foods, meat, fish and most cereals.

In order to control inflammation and keep digestive system in order, the following diet and everyday routine should be followed.

• Fix A Meal Schedule And Stick To It:

In order to ensure regular bowel movement, fix a time schedule for food and stick to it. Do not take food at odd hours or in hurry. Do not take food when you are not feeling hungry.

• Chew Food Well:

By chewing food well, adequate quantity of salivary juices are mixed with food, which help in its digestion. Avoid taking food while watching TV, listening to radio, reading newspaper or during movement.

• Grains:

Whole grain wheat flour and unpolished rice should be used. Barley, maize, jowar and millets are helpful in controlling constipation.

• Milk AND MILK PRODUCTS:

One glass of hot milk taken two hours after night meals is good for controlling constipation. After the age of 40 years fat free milk is more useful. Vegetarians should take milk and milk products regularly.

Persons with arthritis should avoid sour curd completely. They can, however, take buttermilk made out of curd, which is not sour. Salt and cumin seeds powder should be mixed with it.

• Vegetables And Fruits:

In case of constipation vegetables are very useful. Patients should take vegetables in greater quantity particularly those with green leaves. The vegetables such as spinach, turnip, gourd, cabbage, brinjal, green papaya, carrot, capsicum, drumsticks etc. are useful. However, one should avoid vegetables, which cause constipation and produce more gas such as lady’s fingers, pumpkin, jackfruit, cauliflower & yam etc. Tomato is harmful in arthritis.

Fruit and fruit juice is very effective to prevent constipation. Fresh juice is better than canned juice. Among the fruits ripe papaya, apple, guava ete. are very useful.

Among dry fruits dried grapes berries and figs are useful, Keep them soaked overnight before eating.

• Pulses :

Pulses are main source of protein in case of vegetarian people. Besides moong, all other pulses produce gas and cause constipation. They should be taken in less quantity and ghee, garlic, ginger and cumin seeds etc. should be mixed when preparing them.

• Meat And Fish:

This food can be taken in very restricted quantity.

• Oily and Sour Food:

In arthritis one should avoid oily foods. Sour foods should also be avoided. Amla and granate can however be taken, as they are beneficial.

• Stimulating Drinks:

Large quantities of tea and coffee cause disorders of digestion and ultimately constipation. Taking tea on empty stomach is very harmful. Liquor taken in large quantity causes cirrhosis of liver. It also affects digestive system adversely. Similarly chewing or smoking tobacco is harmful.

• Spices:

Green and red chilly are harmful for stomach. But there are some spices, which are very useful for stomach and bowels and give -relief in constipation. Black pepper, ginger, cardamom, cinnamon, cloves, cumin seeds and long pepper are very useful. Besides, turmeric is a/so a good remedy to control constipation.

• Essential Vitamins and Minerals

All living beings that use oxygen also produce free radicals i.e. unstable molecules, which lack an electron. These free radicals are kept in check by body’s anti-oxidants. However if the body starts making more free radicals than it requires, there is a risk of damage to immune system and of developing chronic diseases.

As the free radicals are hazardous to health, it is important to neutralize them. Commonly recognized anti-oxidants are vitamin A, vitamin C and vitamin E and minerals zinc and selenium. An imbalance of calcium may cause bones to be porous and more prone to wear and tear.

Different vitamins and minerals useful in arthritis are discussed below.

Vitamin A

Vitamin A is found in eggs, meat, milk, liver oil and dairy products.

. Vitamin C

Vitamin C is very important for the formation of both bones and cartilages. It is abundantly found in amla. It is also found in citrus fruits and green vegetables.

. Vitamin E

Vitamin E increases oxygen supply to muscles. As an anti-oxidant vitamin E stabilizes membranes and protects them. It protects eyes, skin, liver and calf muscle tissues etc. It increases body’s store of vitamin A. It is enhanced by vitamin C and mineral selenium.

Foods rich in vitamin E are nuts, seeds, wheat germ, spinach, broccoli, butter, bananas and strawberries etc.

Calcium and Magnesium

Calcium is most abundant in body, 99% of calcium is present in bones while remaining 1 % is found in the muscles, nerves and blood stream. For absorption and proper use of calcium, magnesium and vitamin D are required.

Iron

In addition to its role in carrying oxygen to cells, iron also performs the function of an anti-oxidant. In inflammatory condition iron level in synovial fluid increases, which indicates that it helps in controlling joint damage.

Selenium

In addition to its role as an anti-oxidant, selenium helps in reducing inflammation.

Zinc Zinc is an anti-oxidant. It helps to clear certain toxic materials like cadmium and lead from the body. Zinc is essential for normal cell division. Zinc helps in reducing inflammation and is active in synovial fluid along with iron.

[C] Other Methods To Control Constipation:

Enema

Enema should only be used in a state of acute constipation. If it is taken regularly, the colon will be inactivated and will not perform its natural function.

Purgatives

Persons with chronic constipation generally become dependent on purgatives. Purgatives give-quick relief but they also cause several problems and colon becomes fully dependent on it & stops its natural function. Moreover, purgatives produce lesions in inner walls of colon.

Trephala

Take one spoon powder of three fruits (powder made from mixing Amla, Bahera and Harra in equal proportion) in one glass of water. Keep it overnight. Next morning filter it with a thin clean piece of cloth and drink it. This helps in controlling constipation, hyper acidity and high blood pressure.

Isapgol

Isapgol has been used for centuries in ancient Indian medicine. It has high soluble fiber content and is used to prevent constipation. Regular use of isapgol has also been reported to reduce cholesterol levels.

Ayurvedjc Medicine

Ayurvedic medicine is extracted from roots, bark, fruits & seeds of different trees, shrubs herbs. In arthritis these medicines are very useful in reducing pain and inflammation of joints. These roots and herbs are either use independently or in combination with other medicines. We shall discuss some important herbs, which are used in the treatment of arthritis.

[A] Ginger (Ginger Officinale)

Ginger root is used as a medicine. It is useful in rheumatoid arthritis, sciatica, cervical spondylitis etc. Ginger can be taken in the form of juice, powder, concentrate or paste.

[B] Castor Oil Plants (Ricinus Communis)

Leaves, roots, seeds and their oil are used as medicine. The leaves are boiled in water and application of that water on joint relieves the pain. Castor oil is useful for osteoarthritis, rheumatoid arthritis, and sciatic and cervical spondylitis. Castor oil is a purgative and is used to clean the stomach. The hot castor oil on application to joint relieves pain.

[C] Nux Vomica

The bark of this plant along with ripe dried seeds is used as medicine. The seeds of nux vomica are refined and powder is made out of it. This powder is very useful as medicine for osteoarthritis and rheumatoid arthritis. 100 mg of this powder should be taken twice a day with milk.

[D] Gum Guggul (Commipora Mukul)

It is used as a medicine for osteoarthritis rheumatoid arthritis. Two to three year old gum guggul is very useful for reducing cholesterol in blood and controlling obesity. After cleaning guggul, it is mixed with trephala and other medicines and different types of medicines are made out of it e.g. Yograj Guggul, Mahayograj Guggul, Chandra Prabhavati etc. which are very useful in treatment of arthritis.

[E] Garlic (Allium Sativum)

Garlic root is used as a medicine. It is very useful in curing rheumatoid arthritis, sciatica, cervical spondylitis and lumbago etc.

In addition to above roots and herbs, the root herbs of following plants are also very useful. They include Vite nigundo, Pluch lanceolata, Poederia foetida etc.

A number of ayurvedic medicines have been prepared from above roots and herbs along with others for the treatment of arthritis sciatica by Vaidyanath,Dabur, Jhandu other companies. These medicines have been found to be very useful in controlling pain and inflammation.

Homeopathy And Arthiritis

Introduction

Homeopathic medicines are made from animal, vegetable and mineral substances. These are prepared in such a way that they are nontoxic and do not show any side effects. The remedies are comparatively very cheap.

Homeopathic system of medicine is based on natural laws of healing. The most important fundamental law upon which homeopathy is based is ‘Similia Simillibus curenwr’ i.e. like is cured by like. The law of similars enables a physician to prescribe a remedy based on characteristic symptoms.

A controlled process of successive dilutions, followed by succussions, called potentization prepares the homeopathlic remedies. Lesser dilutions are called low potencies and higher ilutions are called high potencies. The process of potentization helps to use certain substances, which are otherwise inert like metals, charcoal etc. There is a running quarrel amongst homeopaths between symptomatology and pathology. This dispute has no basic fohndation because every symptom has its pathological sygnificnce It is a different matter that we are not able to correlate every symptom to its pathological aspect. This is one of the reasons that most of the homeopaths prescribe on symptoms without insisting on pathology. HoweVer, pathological tests in many cases will definitely help in arriving at the correct medication.

The main principle of homeopathy is simillimum i.e. single remedy and minimum dose. Most of the homeopaths usually give one remedy at a time. The single remedy has been proved and tested on healthy people and hence it is very effective. Some homeopaths prescribe combination drugs.However, not many studies have been done as to what the effect of more than one medicine at a time would be or what is the interaction between the drugs.

Homeopaths believe that all parts of the body are interdependent and hence they treat the patient as a whole rather than concentrating on different organs separately.Homeopathy is truly holistic.

The symptoms of a particular drug can never be exhausted. It is very difficult to remember all the symptoms and even more difficult to apply this knowledge to the benefit of the patient. Each homeopath prescribes the drugs based on symptoms and pathology as per his own experience and genius. He take into account certain aspects which may be completely ignored by others. The genius of the homeopath lies in extracting certain order in jumbled up symptoms of the drug and correlating it to the disease.

Hahneman maintained that the use of allopathic medicine is acceptable in acute diseases but in case of chronic diseases this method suppresses diseases causing more deeprooted problems. However, even in acute diseases, it is possible to detect some symptoms which are characteristic of a particular person.

In conditions requiring surgery, homeopathic physicians use remedies before and after the operation. In certain deficiency states, conventional replacement therapy is a must and drugs like thyroxin, insulin, Vitamin B12 etc’ should be prescribed in normal doses. In some severe infections such as meningitis, tuberculosis etc, conventional antibiotics along with homeopathic drugs are found to be very useful.

In chronic diseases homeopathy sometimes achieves remarkable improvement when various forms of conventional therapies have failed. In some cases both types may complement each other. A patient with severe rheumatoid arthritis may require analgesic or anti-inflammatory drugs along with homeopathic remedies. Similarly an asthmatic patient may be given inhaler along with homeopathic drugs. With successful homeopathic prescribing, it is possible to stop administration of drugs, which cause undesirable side effects.

Chronic conditions often require regular and prolonged prescribing and do not expect rapid results in every case However, in acute cases rapid response will occur with correct prescribing within hours or a day or two.

Sometimes in chronic cases, symptoms may be aggravated during the first week. It is due to the body’s stimulus response to the remedy. The skin may be itchier, the joint more painfuland even emotion stir up. This is a good sign and the response will follow soon.

Homeopathic remedies do not have long-term adverse effects but too many remedies given too frequently in high potency can cause profound disturbance and may cause difficulty for another prescriber. In such cases it is wise to stop all the remedies for few weeks.

In order to control arthritis, homeopathic medicines are required to control the following related conditions.

• Constipation and indigestion
• Obesity
• Diseases of bones
• Sciatica
• Osteo – arthritis &
• Rheumatoid arthritis

The different medicines and their characteristic symptoms are given in the following section. However, for the detailed study, works of Kent, Allen and Nash can be referred.

Homeopathic Medicines For Constipation

Different medicines for constipation are:

Alumen: There is an urge for stool all the time but there is no ability to expel the stool. Stool less frequent, drier and harder or In small pieces like sheep’s dung. Intestines do not perform well. The patient suffers from cramps and colic pain.

Alumina: There is difficulty in passing stool, through stool is soft and sticky. There is no urging for stool until there is large accumulation. Condition aggravates after eating.

Bryonia: A large, hard and dry stool which is passed with great difficulty. This is due to reduction in intestinal secretions and poor muscles. There is thirst for large drinks of cold water.

Graphites : There is no urge to defecate for many days. Stools large, knotty, united with mucus threads. There is pain during stool. Person is usually obese.

Hydrastis: Ten drops of mother tincture twice a day for few days is very useful to control constipation. When frequent use of purgatives causes constipation, this medicine is very useful.

Mercurius: Stool slimy, bloody, colic- pain during and after, cannot finish sensation. Moist tongue with intense thirst. Sweats day and night in many complains.

Natrum Mur : Hard and crumbly stool, which causes rectal bleeding, soreness.

Nux Vomica: Stool passes in small querns and rectum does not clear fully. One gets relief after passing stool but gets the urge after sometime. Symptoms are heartburn, belching, bloating of stomach few hours after eating and even constipation. Person over indulges in tea, coffee, and tobacco.

Silica: Due to insufficient expulsive power of rectum and spasmodic conditions, the stool starts out and goes back . There is soreness about the anus and oozing of mucus.

Sulphur: Feces are hard, dark and dry. There is ineffective urging for stool with burning in anus. It is painful to pass stool owing to rectal fissures. Often treatment of constipation begins with Sulphur.

Homeopathic Medicines For Indigestion

Argentum Met: Irresistible desire for sugar, gastric ailments with loud belching. Stool green with mucus like chopped spinach expelled with much sputtering. Withered and dried up person.

Bryonia: Stomach is heavy after eating and sensitive to touch. Thirsty for large drinks of cold water but may vomit after taking a warm drink. You have bitter rising and may vomit bile and water. Least movement makes stomach worse.

Carbo Veg : Plainest food disagrees and causes gas and belching. Excessive flatulence, pressing upward in stomach and abdomen. Aversion to meat, milk fatty foods.Craves for air.

Chamomilla : Attack of indigestion follows a fit of anger and irritability. Stomach full of gas, cramping in stomach and bitter taste in mouth.

China: Debility and other complains after loss of fluid, blood. Stomach feels full of gas that wouldn’t come up or go down. Sweats with great thirst. Sweating during sleep and on getting covered.

Lycopodium: Great flatulence with rumbling mostly intestinal with pressing downward. Increases from 4 to 8 P.M.after eating & in Warm room. Great thirst after sweating.

Nux Vomica: Hard diving zealous person, incline to get excited and angry soon. Over indulges in food, coffee liquor etc. Heartburn, belching and bloating of stornach a few hours after eating.

Homeopathic Medicines For Obesity

The important remedies are:

Calcarea Carb : Fair, fat, flabby and obese. Coldness general and local as if had a cold damp stockings. Afflictions from working in cold water. Sweats in general (night sweat and on exertion). Sweat on head, hands, feet etc. Can not walk far and go upstairs. Easily strained: Tardy development of bony tissues with lymphatic enlargement. Curvature of bones especially. long bones. Skull very large. Feels a sort of inward coldness. Lower extremities cold. Longing for eggs especially in the children.

Croton Tiglium : Sudden ejection of stool. Stools thin and. yellow. There is excessive nausea but not much vomiting. Pain in intestine down to the anus. It is a stimulant of small intestine.

Fucs Vesiculous : It is a functional stimulant of thyroid

Graphites : Especially adopted to persons inclined to obesity. Suited to women at the climacteric. Sad , despondent, hear better when in a noise. Sensation of cobwebs in the forehead. Stool knotty, large lump, united by mucous threads. Graphites cures complaints of many kind when there is a peculiar tendency to obesity and characteristic glutinous eruptions.

Spongia Tosta : There is pain and sense of fullness in the region of heart. There is marked anxiety, fear of death and suffocation associated with palpitation and uneasiness in the region of heart. Spongia patient is worse from warm room and from heat. He wants to be cool. However, he is better from warm drink. Sore throat worse from eating sweet things. Thyroid gland swollen. At night there are suffocating spells with stinging in throat and soreness in abdomen. It is a functional stimulant of thyroid.

Diseases Of Bones

Asafoetida: Face looks puffed, bloated and dropsical. Inflammation of periosteum. Inflammation of cartilages. Person looks fat, flabby, purple. Numbness of scalp. Numbness after pain and after sleep. Hiccough like contraction of diaphragm with expulsion of wind. Wind and flatulence all press up.

Calcarea Carb : Fat, flabby and obese. Produces deficient bones. Deficient teeth or no teeth. Feet cold and head warm, congestion in chest, anaemic, pale and waxy. Sweat of head with little exertion.

Calcarea Flour : Indurated swelling of stony hardness in glands or ligament, bony infiltration in periosteum. This remedy has cured “Rice bodies” in cartilages. It can cure eXOstosis and indurate cervical gland.

Calcarea Phos : Night sweats. General bodily weakness. Numbness in many parts. Back pain worse in stormy weather and worse in the morning especially in the curvature in spine. Tearing, shooting pain in lower limbs. Non union of fracture bones. Polypi of nose, rectum and uterus. Enlarged glands of neck. Rachititis. Rheumatoid pains in joints and limb, worse from cold.

Mezereum: Pain in long bones especially tibia. Tearing pain in periosteum. Necrosis carries etc.

Phosphorus: Delicate, waxy and anaemic subjects. Small wounds bleed much. General dropsical condition. Bloating of hands and feet. Stiffness on beginning to move especially in the morning. Rheumatic stiffness in all limbs. Complains are worse with hot and warm applications. Soreness in places up and down the spine. Necrosis of lower jaw. Carries of other parts especially tibia.Craving for cold things, ice cream or cold water.He eats often or he faints.

Silica: Silica patient is chilly. His symptoms are developed in cold damp weather. Symptoms come after bath. An offensive foot sweat which ceases after getting feet wet. Aversion to milk and diarrhea from milk. In childhood bones become soft and even necrose.

Symphytum : It is used for repair or reunion of bones.

Theridion : Stitching and pain in left chest beneath the shoulder. Vertigo with nausea especially on closing the eyes. Very sensitive to sound which penetrates the entire body causing nausea and ‘vertigo. In rachitis and caries, It goes to the root of the disease and destroys the cause.

Sciatic Pain

Aconite: Complains from exposure to cold dry air Increase in the evening, lying on left side, in warm room or warm covering. Decreases on uncovering. Dry hot skin and no sweat. Pain is attended with extreme restlessness & anxiety . Cannot bear to be touched.

Ammonium Muriaticum : Sensation of coldness between the shoulders. Patient is worse when sitting, better when walking and fine when lying down.

Arsenic Album: Great restlessness and intense burning pain. Increases in cold air from cold things. Decreases by warm air, warm applications and by sweat. Patient cannot lie down, must sit and breathe. Pain, restlessness with reduced vitality, wants to move from place to place but not relieved. Important features of remedy are restlessness, burning, prostration and midnight aggravation.

Causticum : Pains of cramping and drawing nature. Contractions of ligaments. Drawing and tearing pain in legs, knees and feet. Contraction of muscles and tendons. Stiffness on rising from seat.

Colocynthis : Cramping pain in sciatic nerve from hip down to the thigh. Decreases by pressure and heat.Increases in the evening by anger and after eating.

Gnaphalium : Intense pain along the sciatic nerve alternating with numbness.

Lycopodium: Sciatica pain starting from right and running to left. Burning sensation between the shoulders. Aggravation from 4 to 8 p.m.

Magnesia Phos : Cramping pain everywhere. Increases by cold and cold application. Decreases by heat and pressure.

Phytolacca Decandra : Pain travels down along the outside of the limb. Pain worse in wet weather and increases by motion. There is bruised and sore feeling. Phytolacca occupies a place mid way between Bryonia and Rhustox.

Rhus Tox : Symptoms worse at night when resting but better, by movement, worse during cold and in the morning. Pain grows worse with change of weather. Improves by warmth but deteriorates in damp cold weather.

Spondylosis, Articular Rheumatism, Sacroiliac Arthritis

Berberis Vulgaris: Main characteristic is bubbling sensation in the region of kidney. Pain in the region of kidney when stepping down stairs. Stiffness and lameness in the region of kidney. Increases in bed in the morning. Painful pressure in lumbar and renal region.

Calcarea Phos : Sleepy daytime and evening and sleepy in the morning. Stiffness in the morning. Aching in bones, worse from motion better during rest or from heat. Back pains worse in cold stormy weather and worse in the morning. Tearing, shooting pain in the morning. Weakness of muscles of the neck and long spine. Acts on the constitution.

Causticum : Pains of cramping and drawing nature. Drawing and tearing pain in legs, bones and feet. ContractiOn of muscles and tendons. Pains in loins when trying to get up. Painful rigidity of neck and dorsal muscles.

Rhododendron: Aggravation in wet stormy weather. Worse during rest but better during motion. However, it differs from Rhustox in the sense that it is deeper seated and felt in periosteum as in teeth and bones of fore arm and tibia. Aggravation of symptoms before thunder storm i.e. rain and storm.

Rhus Tox : Lameness and stiffness on beginning to more and on getting up in the morning. Decreases by continued motion. Increases with damp cold weather, worse at night, resting. In general great nervousness.

Osteo Arthritis

Acid Sulf: Weakness of spine: Stiffness of back when rising in the morning. Influences metabolism of cartilages.

Argentum Met: Associated with degeneration of joints. It is full of tearing pain along the nerves, predominantly of lower extremities. Pain in cartilages and along the nerve and relieved by motion. Inflamed cartilages infiltrate and form into hard knots.

Arnica: Whole body and extremities are cold but head feels hot. Arnica is useful in chronic cases of gout. There is soreness and tenderness of joints with great sensitiveness.

Aurum Met: Swelling of joints. Afflictions of cartilages and bones.Inflammation of periosteum. Thickening and Induration of periosteum. Induration of glands and cartilages about the joints.

Bryonia: Swelling of joints, great pain worse on touch or least motion. Joints red and stiff. Amelioration from pressure. Useful in second stage of inflammation of joints.

Causticum : Joint deformity with paralytic weakness and stiffness. Pain cramping and drawing in nature Contractions ligaments.

Ledum Pal: Swelling is pale sometimes oedematous increases at night, in the heat of bed. Cold water relieves.The joints become the seat of gout stones, which are painful.

Rheumatoid Arthritis

Acid Sulf : Weakness of spine. Stiffness of back when rising in the morning. Influences metabolism of cartilages.

Aconite : Complains from exposure to cold; increase in the evening, in warm room or warm covering; decrease on uncovering. Aconite is a pain remedy. Extreme restlessness and anxiety attend pain. Cannot bear the pain, nor bear to be touched. Trembling & tearing pain down the spine associated with sudden attack.

Actaea Recemosa : Muscular rheumatism, stiff neck, cannot move head. Rheumatism of belly muscles by preference.

Argentum Met: Associated with degeneration of joints. It is full of tearing pains along the nerves, predominantly of lower extremities. Pain in cartilages, along the nerves and relieved by motion. Inflamed cartilage infiltrate and form into hard knots.

Arsenic Album: Restless, burning, prostration he midnight aggravation are some of the symptoms. Attacks the joints causing pale swelling and burning pain.

Aurum Met: Swelling of joints. Afflictions of cartilages and bones. Inflammation of periosteum, thickening and induration of periosteum. Induration of glands and cartilage about the joint.

Berberis Vulgaris: Pain with numbness in the region of kidney. Rheumatism of joint, pain which increases when stepping down.

Bryonia: Dryness of mucous membranes, wants water in large quantities. Pain in joints, increases on movement. Joints swollen. Pain relieved by pressure on joint.

Cactus Grandiflorous : Rheumatism of all joints beginning in upper extremities. Palpitation day and night worse when walking and lying on left side.

Calcarea Phos : Rheumatic pain in limbs in cold weather, worse from motion. Better during rest and from heat. Stiffness in morning. Aching in bones, gouty fingers and toes that become painful in cold weather.

Causticum : Pain cramping. Rheumatism of muscles and joints. Stiffness on rising from seat. Aggravation by cold.

Chamomilla : Very irritable mood. Excessive uneasiness and anxiety. Violent rheumatic pains drive one out of bed at night.

China: Complains after excessive loss of fluid. Blood from all outlets. Blood dark and clotted. General coldness.Sometimes convulsions. Cures inflammatory rheumatism.

Dulcamara: Neck gets stiff after taking cold. Back painful. Tongue and Jaw stiff. Tongue can even be paralyzed.

Hepar Sulf: Rheumatism when patient sweats day and night without relief.

Kali Sulf : Rheumatic pain in joints moving from joint to joint.Chronic of Pulsatilla.

Kalmia Latifolia : Useful in heart troubles of rheumatic origin. Rheumatism goes downward. Pain extends down to the left hand.

Lac Caninum : Inflammatory symptoms moving from joint to joint when Pulsatilla fails.

Lactic Acid: In addition to thirst, voracious hunger and profuse urine loaded with sugar, there is rheumatic pain in joints.

Ledum Pal: Rheumatism begins in feet and travels upward. Swelling is pale sometimes oedematous. Increases at night in, heat of bed. Rheumatic gout. The joints become seats of gout stones, which are painful. Cold water relieves the pain.

Lilhium Carb : Chronic rheumatism connected with valvular heart disease. Rheumatic soreness in heart region. Pain in heart when bending.

Medorrhinum: Rheumatism of feet, ankles and soles. Pain worse in daytime.

Mercurius: Swollen flabby tongue. Gum swollen and bleeding. Breath offensive. Moist tongue with intense thirst.Pain in joints, increases after sweat. Worse at night in the warmth of bed.

trong>Nux Vomica: Zealous, over sensitive, easily exciable. Patient feels worse in the morning, after eating and In cold air. Body burning but person cannot uncover without feeling chilly.

Phytolacca Decandra : In periosteal rheumatism.Pain worse in wet weather. Pain runs down the outer side of the limb as in sciatica. Increases with movement.

Pulsatilla: Mild gentle, yielding disposition. Muscles soft and flabby. Dryness of mouth in the morning but no thirst. Swelling of joints, pain wandering from one joint to another. Increases in warm room and warm applications. Decreases in cold open air and cold food.

Rhus Tox : Pain with numbness, gets relief from movement. Relief by pressure.

Sticta Pulmonaria : Severe pain and pressure in forehead. Sticta promptly cures rheumatism of knee joint.

Sulphur: Burning everywhere, general, local and especially in feet. Redness of orifices as if full of blood. Bryonia and Sulphur complement each other.

Valeriana: Pain Worse when standing and letting the foot on the floor.

Acupressure System Of Medicine

Introduction

Acupressure is an art of treating diseases by applying pressure On specific points of the body of the patient with the hIep of thumb or other blunt objects.

Identification of of Acupressure points is end product of million of detailed of observations. It has been demonstrated that common painful diseases cause painful points in well defined anatomical locations. Pressure on these points alleviates pains.

Acupressure points were subsequently grouped into a system of channels, which run into the body. At places these channels rise to the surface of the body while at others they go deeper into the body leading to the organ.

Channels create a network in body and are paired. One of the channels has yin characteristic while the other has yang. The numbering of points from yin channel starts from feet towards head since yin energy is supposed to come from earth. The points on yang channels are numbered from the head downward since yang energy comes from sun.

There are twelve channels each linked to the function of a particular organ. Besides, there are two more channels called governor vessel and conception vessel . Conception vessels on the mid line of spine starting from half way between coccyx and anus passing through middle of top of head half Way between ears to middle of furrow between upper lip and the nose. All channels except governing vessel and conception vessel are symmetric about mid line i.e. same points are located in same places on the opposite side of the body. Transversely the body has been divided in three parts. They are on the upper part of toes and fingers of hands feet. The second part contains points of parts of body below neck and above the diaphragm. The third part contains points corresponding to parts of body below diaphragm.

There are approximately 900 points all over the body. Pressure is applied on these points to cure different ailments or to create an anesthetic effect.

Most of the organs and endocrine glands are to the left or right side of body so the corresponding points are on right or left palms and soles. The gall bladder, liver and appendix are to the right of body and their corresponding points are only on right palm and sole. Similarly, heart and spleen are on left side of body and their corresponding points are on the left palm and sole.

Further the body is divided into two parts i.e. front and back. For lower lumbago, sciatic nerves, nervous system and hips, pressure should be applied to the back of palms and soles. However, for other organs and endocrine glands, the pressure is to be applied on the front of the palms or soles.

Acupressure and Diseases

Diseases result when body is weak and unable to resist the onslaught of pathogens. These pathogens allow diseases to be grouped according to their broad symptoms.

The muscular aches that occur in association with viral infection would be classed as invasion by wind. People often complain that they catch chill when they get wet or their neck is stiff after sleeping in draught. If one has fever, heat is One of the causative factors involved in the disease process.Heat must be used to treat it. Other factors that cause disease are worry, anxiety, eating contaminated food etc. The simplest and most obvious application of acupressure technique is acute and chronic pain, The points can selected by locating the most tender tagger zones.

However, in many diseases and in case of pain, associated symptoms may be present. This might include anxiety, depression or abdominal symptoms and indigestion, which are sometimes produced by analgesic and for anti-inflammatory agents. In such cases, it may be difficult to select points purely based on patient’s localization of pain. In diseases like asthma, points selected cannot be based on tender point localization. It requires knowledge of traditional Chinese medicine. The biggest problem for any acupressurist is to define a set of points, which are clinically, most effective,

There are a large number of exceptionally well documented observations which lead us to infer that acupressure is having a fundamental effect on physiological functions which apparently modify the transmission and perception of pain.

In case there is no response to acupressure after first three sessions, it is doubtful whether any response will occur. Besides, the patient may sometimes experience a worsening of symptoms due to acupressure. It is a good sign and will last for a day or two followed by improvement. In case of musculoskeletal pain, acupressure does emerge as a consistently better analgesic therapy compared to other treatment.

Different Disorders of Joints, Bones and Muscles

Before treaing any of the above disorders, It is necessary to see the central nervous system passing through the spinal cord is in order.

The central nervous system consists of brain, sciatic never and large number of nerves coming out of sciatic nerver which pread all over the body. Whenever there is any disturbance in the spinal cord, the part of the body connected to that point is affected.

The spinal cord passes through the vertebral column. The length of vertebral column of an adult is 60-70 cm. There are 33 vertebrae, which are connected to vertebral column. Out of these 33 vertebrae, 24 are separate and mobile bones while nine are fused. In the neck, there are seven cervical vertebrae, in upper back there are 12 thoracic vertebrae and in lower back there are 5 lumbar vertebrae. In the pelvic region there are. five fused sacral vertebrae and four fused coccygeal vertebrae.

Thirty-one pairs of nerves are connected to spinal cord. These nerves are connected with different parts of the body.

Sacral – 5 – fused sacral vertebrae – Hips

Coccyx – 4 Fused Coccygeal vertebrae – Rectum, anus

Accupressure therapy entails application of pressure to the corresponding points of vertebral column in addition to the point of that organ. It is possible that the main cause of disease is in the vertebral column. For this purpose one should check the vertebral column as follows:

Lie down on your stomach with arms straight on sides.You will observe two round depressions on both sides spine in the lumbar region. In case these depressions are not visible, the problem of the system is mainly due to spinal cord. In case the depression is on the left side only, problem is connected with spinal cord and in the right side. Similarly if depression is on right side only, the problem is in the left side of spinal cord. Run two fingers from first cord of vertebrae and go on till the last. In case some vertebrae are lower, put it in proper position by rubbing it upward by pressing from both sides of spinal cord. Besides, give treatment on the point of sciatic nerve.

• Corresponding Points Of Vertebral Column:

Corresponding points for vertebral column and spinal cord start from toe and go up to the heel in feet. Similarly they are along the first finger in the back of hand. Pressure can be given on these points with the help of the thumb or with non-pointed object. The point where pain is unbearable is the point corresponding to the disease.

We shall now discuss different techniques of acupressure to cure different disorders.

Depending on severity of disease, it is possible that the cure of disease may take sometime. However, reduction in pain and inflammation will be visible after giving pressure to different points 3-4 times only.

Acupressure Points Of Different Organs In Hands

And Feet

One of the reasons of arthritis is disturbance in digestive system, hence pressure should be given to corresponding points of stomach, liver, gall bladder, small intestine, large intestine and spleen. The function of kidney and bladder should be supplemented. The function of sex glands and thyroid should be normalized. Pressure should also be given to points of nervous system.

Additional Points of Different Organs

Now we shall consider some additional points of these organs on the channels of different organs.Pressure on these points helps in curing different diseases of bones and joints.

[a] Liver

Liv-3 : This point is in the furrow on top of feet between first and second toe where the bones merge. This point promotes free flow of blood into liver. It is used to treat migraine, period problems, digestive disorders and insomnia.

[b] Stomach

St-25 : This point is 2 thumbs width on the either side of naval. It stimulates circulation of blood to bowel.

St-34 : This point is two thumbs width above the top of the knee cap in line with outside edge. It removes blood stagnation locally and helps in ameliorating the pain of knees.

St-35 : These points are known as eyes of knees and are in two dimples below the knee cap on either side. It helps in blood circulation in knee joints and reduces pain.

St-36 : : This is 4 fingers width below the knee cap outside the tibia. This point helps increased blood circulation in stomach and spleen. Pressure on this point improves weak digestion and reduces headache & pain in legs.

St-41 : Point in the middle of the foot in front of the ankle joint. It moves blood and clears heat from the stomach.

5t-43 : This point is in furrow between the 2nd and 3’d toe where the bones merge. It cools down stomach and helps in reducing acidity.

5t-44 : This point is in web at the base of second and third toe on the top of foot.It removes fullness and heat from stomach.

[c] Kidney

K-3: This point is between inside ankle bone and Achilles tendon. Pressure on this point strengthens kidney.

K-6 : This point is one thumb below the inside ankle bone at the junction of bone and muscle. Pressure on this point nourishes kidney and eliminates heat.

[d] Spleen

Sp-4 : This point is on the inside arch of foot just under the base of big toe.It calms down the stomach.

Sp-6 : This point is 4 fingers width above the inside ankle bone just behind tibia. It stimulates circulation and production of blood and eliminates dampness. It is good for poor digestion and anemia.

Sp-9 : The point is on the inside of leg below the knee joint in depression between tibia and calf muscle.It helps in blood circulation and in removing dampness and heat from knee joint.

Sp-10 : This point is two thumbs width above the top of knee cap and two thumbs width towards the inside of thigh.It helps in blood circulation in the knee joint.

[e] Small Intestine

Si-3 : The point is on the back of the hand between the bone and muscle juist before knuckle of little finger. It improves blood circulation in hand and wrist.

Si-5 : The point is in hollow on the little finger side of wrist joint. This point clears heat from small intestine channel. It improves blood circulation in wrist.

Si-12 : The point is in the middle of muscle above, the ridge of shoulder blade midway between cervical spine and the tip of shoulder. Pressure on this point increases blood circulation in neck and shoulder.

[f] Large Intestine

Li-4 : It is located in the web between the thumb and the index finger on the back of hand. It assists in bowel movement and clears wind. It is useful in reducing and curing headache, toothache, sinusitis, cold and pain in the upper body.

Li-5 : It is in the hollow at the base of the thumb on the side of the wrist joint. It improves blood circulation in the wrist and clears heat from the large intestine.

Li-10 : It is two thumbs width below the crease on the outer side of the elbow in line with the middle of the back of the wrist. This helps in the blood circulation of the arm.

Li-11 : This point is at the end of the outside elbow crease and can be found with the bent elbow. It helps in improving the blood circulation in the elbow joint. It clears heat in the large intestine channel.

Li-12 : This point is one thumb width out and up from the outer point of the elbow crease. It helps in improving the blood circulation in the elbow joint.

Li-15 : This point is on the outer side of the shoulder in the dimple created when the arm is raised to the side. It helps in the blood circulation of the shoulders.

[g] Gall Bladder

Gb-20 : This point is found at the base of the skull in the hollow between the front and the back neck muscles behind the ears. This point clears wind and calms liver. It is used in treating headache, cold, sinusitis and congestion in head.

Gb-30 : The point is on the side of the buttock, two third out along the line from the middle of sacrum to the top of thigh bone. It removes obstruction in the gall bladder channel and increase blood circulation in pelvis Joint.

Gb-31 : This point is on the outside of the thigh 3-4 inch in width above the outside crease of the knee joint. It removes obstruction in gall bladder channel and relaxes tendons.

Gb-34 : This point is on the depression on the outer side of the lower leg below the knee joint in front and below the top of the fibula. This point is good for muscle and tendon problems. It calms the liver and removes heat from the liver.

Gb-39 : This is a special point for bone marrow and is of 4 fingers width, above the outside of the ankle bone in front of fibula. It helps in improving the blood circulation in legs.

[h] Coception Vessel

Cv-4 : It is of 4 fingers width below the navel on the midline of belly.It is connected to liver, spleen and kidney. It improves blood circulation and regulates menstruation.

Cv-6 : It is of two fingers width below the navel on the midline of the belly. It regulates circulation.

Cv-12 : This point is of four thumbs width above the naval on the midline of the belly. It stimulates the spleen and stomach. It helps in the production of the blood. It alms the mind.

[i] Governing Vessel

Gv-4 : This point is in the middle of the spine between thesecond and the third lumbar vertebrae. This strengthens kidneys.

Gv-14 : This point is on the back of the neck between the seven

cervical and the first thoracic vertebrae. This regulates the temperature.

[j] Tripple Heater

Th-4 : This point is in the middle of the wrist joint on the back ofthe hand. It helps in the blood circulation and relaxes the tendons.

Th-5 : This point in two-thumbs width,above the wrist crease in the the middle of the back of the forearm. It relaxes tendons.

Th-6 : This point is of four fingers width above the wrist on the back of the forearm. It helps in blood circulation.

Th-15 : This point is above the ridge of the shoulder blade just down from the highest point of the trapezius neck muscle. It is midway between cervical spine and tip of shoulder. It helps blood circulation in neck muscles.

[k] Bladder

b-11 : This point is the about one inch width on the either side of the spine beetween the first and second thoracic vertebrae.It clears wind and is useful in ailments of the trachea, hands and arms.

b-18 : It is about an inch on the either side of the spine level with 9th and lOth thoracic vertebrae. This point regulates spleen and adrenal glands and helps in blood circulation.

b-20 : This point is about an inch on either side of the spine level with eleven and twelve thoracic vertebrae. It regulates kidney and small intestine.

b-23: This point is about one inch on the either side of spine level with second and third lumbar vertebrae. This helps in the blood circulation in the qreasts, lungs, trachea etc.

b-25: This point is about an inch on the either side of the spine level with 4th and 5th lumbar vertebrae. It is useful in ailments of sciatica, prostate, hands, feet and ankle.

b-26:This point is about an inch on the either side of spine level with 5th lumbar and 1 st sacral vertebrae. It helps in the blood circulation and strengthens ligaments which stabilize lumbar and sacral spine.

b-54 : This point is in the middle of the crease on the back of the knee. It helps in the blood circulation in the lower leg and removes dampness.

b-57 : This point is in the middle of the back of the calf where muscles and tendons meet. The point helps in blood circulation in this area.

b-60 : This point is on the outside of the ankle halfway between the ankle bone and the Achilles tendon. This reduces pain in the back and clears heat.

[I] Heart

h6 : This point is of half a thumb width from the wrist crease on the forearm on the little finger side of the palm. It moves blood circulation and heat affecting the heart. It helps in stopping hot flushes and night sweats and calms the mind.

h7 : The point is on little finger side of the wrist crease. It calms mind and improves blood circulation in the heart and the chest.

Disorder of Neck and Shoulder Joints

Neck and shoulder joints are shallow and are supported by ligaments and tendons. They allow wide variety and range of movements.

Any injury or distortion in this part causes a number of ailments, some of them are:

• Cervical spondylosis
• Cervical spondylitis
• Inflammation of bursa in the armpit
• Stiff neck
• Vertigo-illusion of revolving motion either of oneself or one’s surroundings.
• Shoulder pain or frozen shoulder
• Pain and numbness in hands and fingers.

Contrary to popular belief, common use of cervical collar by spondylitis patient is not recommended. In severe cases of spondylitis, collar can be used when one is under taking long journeys etc. Similarly, traction in every case of cervical spondylitis may aggravate the disease.

In all the above disorders pressure on the following points is recommended.

1. The internal and external part of the thumb of the right hand and leg is connected to the right side of the neck. Similarly internal and external part of thethumb of the left hand and foot is connected to the left outer side of the neck. The upper part of the thumb is connected to the upper part of the neck while the lower part is connected to the lower part of the neck. The pressure is to be given to the corresponding point of the thumb for curing ailment.

2. Pressure should be given to the point where the neck and the skull meet i.e. the starting point of the vertebral column. Pressure should be given in for 3-5 seconds three times.

3.Pressure to be given at the base of the skull in a hollow between the front and back neck muscles behind the bony prominence.( GB-20)

4. Corresponding point of neck and shoulder are also there in the palm of hands and feet and pressure should be given on them.

5.In the middle of the muscle above the ridge of the shoulder blade midway between cervical spine and the tip of the shoulder( 51-12)

6. Find this point on the outside of the shoulder in the dimple created when the arm is raised to the side. (LI -15)

7. Point is located in the web between the thumb and the index finger on the back of the hand. ( LI-4)

Disorders of the Elbow Joint

The elbow is a shallow joint, which is supported by overlapping of ligaments and tendons. Most injuries damage these ligaments and tendons. Pain in the elbow can be due to cervical spondylosis and over use of hands resulting in pulling of the muscles of the hand.

In order to control pain in elbow (tennis elbow), in addition to giving pressure on the points for control of cervical spondylosis, the pressure should be given on the following points.

1. Point one thumb width up from the outer point of the elbow crease. It is between the muscle and the upper arm bone. (LI-12)

2. Point two-thumb width above the wrist crease in the middle of the back of the forearm. TH-5)

3. It is at the end of the outside crease of the elbow.(L/ – 11)

4. located in the web between / the thumb and the index finger on the back of the hand. (LI-4)

5. It is two- thumb below the crease on the outer side of the elbow. (Point-Ll-10)

6. It is in the depression of the outer side of the lower leg below the top of the fibula. It is a point for the muscle and tendons. (Point GB -34)

Disorders of Hand and Wrist Joints

Hand and wrist joints are strong and allow a wide range of movement. When one falls, he automatically put hands to save himself and this leads to wrist injuries. There may be pain or swelling around the ligament or a bone fracture.Painmay also be due to some disturbance in the nervous system.

In addition to the general points of the joints, the fallowing specific points should be pressed.

1. Points in the web between the thumb and index finger on the back of the hand.

2. Point on the back of the hand between the bone and the muscle just before the knuckle of the little finger.

3. In the hollow at the base of the thumb on the side of the wrist joint

4. In the hollow on the little finger side of the wrist joint .

5. In case of numbness of hand and fingers, pressure on the point on the wrist crease and half a thumb width on the wrist crease on the little finger side of the palm.

Disorders of Pelvis Joint and Lumbar Region

The pelvis joint is a ball and socket joint. It allows maximum stability but only a narrow range of movements. The lumbar spine and pelvis consist of large bones with ligaments and muscular support. Wear and tear and stiffness are very common. It may be caused by spondylosis or arthritis, due to bad lifting habits and wrong posture.

In addition to general points, the pressure on the following points is very helpful.

1. Points on the side of the buttock, two third out along the line from the middle of the sacrum to the top of the thighbone.

2. Points about one inch on either side of the spine at the level with the 5th lumbar and first sacral vertebrae.

3. Points about one inch on the either side of the spine between 2nd 3ird lumbar vertebrae.

4. Point in the middle of the crease on the back of the knee (B-54)

Disorders of The Ankle Joint

They are designed to take all your weight and still be flexible. It is a strong joint but is easily twisted. It may cause ligament damage with pain and swelling. In order to cure the ankle, the pressure should be applied on the following points.

1. Point between inside anklebone and Achilles tendon.

2. Point in the middle of the foot in front of the ankle joint.

3. Point on the outside of the ankle halfway between the ankle bone and Achilles tendon.

4. Point in the depression on the outerside of the lower leg below the knee joint. It is in front of and below the top of fibula.

Disorders of Knee Joint

Knees take lot of weight of our body. They are very stable.Injury in knee may result in damage to cartilages and ligaments. The pain in knee also results from athritis. In order to cure the knees the pressure on following points should be given.

1. Corresponding points in front and back of hands and feet.

2. Points in the middle of crease on back of the knee. It improves circulation in the lower leg.

3. There are two dimples below the kneecap, called eyes of the knee.

4. Point two thumbs above the knee cap and two thumb points towards inside of the thigh.

5. Point two thumbs width above the top of the knee cap inline with its outside edge.

6. Point on the inside of the leg below the knee joint in the depression the between tibia and the calf muscle.

7. Point 4 finger width below the tip of the knee cap. outside the tibia.

Sciatic Pain

Sciatic nerve is an important nerve of our nervous system. It starts from the spinal cord at the 41h and 5th lumbar vertebrae. It passes through the back of the thigh. Before reaching the knee, it is divided into two parts. It reaches near the ankle after passing through the internal and back portion of the leg.

The pain in the leg associated with the disease is mainly due to injury in the inter vertebral disc. The pain starts from hips, travels down the back of the thigh and the outside of the leg and extends to as far as the ankle and the foot. At times loss of feeling and numbness is found. When sciatica is present, there will be nerve root pressure in the lumbar region at the bottom of the spine. It may also result in back pain.

There are a number of reasons for nerve pain. The important one’s are:

• Malformation of bones in lumbar region.
• Prolapsed inter vertebral disc.
• Diseases of urinary bladder, uterus and ovaries.
• Lifting heavy weights or injury.

For the treatment of sciatica pressure should be given to the points corresponding to:

1.Kidneys and bladder.

2.Points in hands and feet corresponding to lumbar and sacral vertebrae.

3.Points relating to sex glands.

4. Points on the outside of ankle, halfway between outside ankle bone and Achilles tendon.

5.Point on the side of the buttock, two third out along the line from middle of the sacrum to the top of the the thigh

6.Point on the outside of the thigh about 3-4 inches above the outside crease of the joint .

7. In the depression on the outside of the leg below knee joint in front of and below the top of fibula .

8. Point 4 finger width above the outside ankle bone in front of the fibula (GB-39)

9. Point in the middle of crease on the back of knee.

10. Point in the middle of the back or calf where muscle and tendon meet.

11.Points about one inch on either side of the spine at the level of the 5th lumbar and first sacral vertebrae.

12. Points about one inch on either side of the spine at the level of the 2nd & 3rd lumbar vertebra.

Disorders of Backbone

Backache may be due to back weakness or due to injury. Poor posture and lack of exercise contribute to the problem. It may also be due to spondylosis and spondylitis. In order to control backache, the following precautions should be taken:

1. When you sit on a chair or sofa, your back should be straight and knee comparatively higher than hips.

2. You should not be overweight. In standing position, the body should be straight.

3. Do not do any work while bending. In case you have to work sit, on your feet and do the work.

4. In case you lift anything, lift equal weight from both the hands.

5. Keep your back straight while doing house work or driving a vehicle etc.

6. Sleep on hard bed and use light cotton couch. In case of pain in neck use thin cotton pillow.

7. After lying down, one should not get up straight but should get up side ways putting weight of body on arms.

The lumbar region Can also become painful if you do not drink enough water. In this case kidneys will not function properly and will result in toxicity causing pain.

In order to cure back pain give pressure on the following points.

• Points about one inch on either side of the spine at the level of 2nd and 3rd lumbar vertebrae .
• Points about one inch on both sides of the spine at the level of 4th and 5th lumbar vertebrae.
• Points on the spine between 2nd and 3rd lumbar vertebrae.

Acupressure points for controlling constipation and indigestion are discussed as under:

Constipation

In Constipation pressure on following points will help:

1. Keep one hand on other on the right side of belly and produce wave like motion from your hands. The rhythm should be slow and graceful.

2. Point in the middle of chin, hard pressure should be given to this point.

3. Point located in the web between thumb and index finger on the back of the hand. It assists bowels and clears wind.

4. Point about an inch on either side of spine level with 4th and 5th lumbar vertebrae.

5. Point about one inch on either side of spine level with 9th and 19th thoracic vertebrae..

6. Point of 2 thumb width on the either side of the navel.

7. Point in the middle of wrist joint on the back of hand.

8. Points of liver and stomach in hands and feet.

Indigestion

Pressure on following points will help.

1. Points of liver and stomal;:h in hand and feet.

2. Point four thumb width above the naval on the midline of the belly.

3. Point two thumb width on either side of the naval.

4. Points four finger width below the knee cap on the outside of tibia.

Yoga and Mobility of Joints

Introduction

In case of arthritis there is severe inflammation in the joints. In order to allow maximum healing to take place naturally, it is advisable to take rest for one to two weeks. It is also recommended to take medidnes to control severe pain and inflammation. Continuous pain ‘for a long time usually reduces the amount of exercise we take and the muscle of the body becomes weak. Slowly even the efficiency of the heart and lung will also suffer.

It is not only necessary to plan exercise after rest but it is important to do exercises of right kind and proper duration. Wrong exercises and doing them too much will be very harmful. It will produce exhaustion and increase the intensity of pain. It will further frustrate the patient and reduce his will power to start it again. When the patient starts exercises in the beginning, he is normally enraged and feels further frustration as during exercise he feels pain but slowly as the muscles are strengthened the pain is reduced and he gets confidence. The exercise works as a painkiller.The mobility of a joint is key to managing pain, resumingnormal activity and finally to rehabilitation. Exercise stimuates the production of endorphins in the bloodstream and increases body’s capacity to cope with pain.

In order to maintain the maximum mobility of joints, yogic exercises are the best. In this section we shall discuss about yogic exercises and their correlation with different arthritic disorders. During the practice of yogic exercises(asanas), there should not be rapid movement of the body and limbs and the breathing process should be normal. The mind should be at peace and should be withdrawn from all thoughts.

In yogic exercises, there is harmonious development of all muscles of body, internal, organs and the nerves. The movements are gentle and rhythmic and there is minimum wastage of energy. In order to derive maximum, the following instructions should be followed.

1. Asanas should be done on empty stomach in the morning or 3 to 4 hours after taking food.

2. Spread a folded blanket on the floor and practice yogic exercises.

3. Before doing yogic exercise mind and body both should be relaxed.

4. In the beginning, each asana should’,be practiced for a few seconds and gradually increase the duration.They should be done slowly.

5. Asanas should be practiced in well-ventilated room where there is free movement of clean air.

6. In order to derive the maximum, be regular.

7. Limitations mean asanas not to be done in those disorders & benefits mean asanas to be done in those disorders.

Some Important Yogic Exercises.

Yogic Exercises To Facilitate Bowel Movement

Drink two glasses of lukewarm water in the morning with or without a little salt in it and do the following five exercis,es 8 – 10 times. These exercises help in controlling constipation.

[a] Tadsana (Palm Tree Pose)

Stand straight with feet at a distance of 4-6 inches apart. Raise the arms above your head with palm upwards. See towards your hands. Now raise your heels and stretch the body fully in the upward direction. Balance your weight on fingers and slowly bring the heels to the ground. Repeat it 8 – 10 times.

Inhale while stretching upwards arid exhale while coming down.

[b] Triyak Tadasna (Curved Palm Tree Pose)

Stand as in Tadasana with heels raised and body stretched in the upward direction. Curve the body.from the back first in the right direction and then in the left direction. Do this asana 10 times in each direction and then stand on your feet.

In the beginning, it is difficult to balance the body weight on fingers. Hence, initially this exercise can be done by balancing the weight on the toes. Inhale while standing straight and exhale in curved movement.

[c] Kati Chakrasana (Circular Movement of Back)

Stand on feet with feet 2-3 feet apart. Spread the arms at the height of the shoulders on both sides. Upper part of the body is moved in a circular movement on right side such that left hand comes to right shoulder right hand circles round the back. Repeat the exercise on the other side. Repeat it ten times.

[d] Triyak Bhujangasana (Curved Cobra Pose)

Lie on the ground with forehead touching the ground. Place your palms on the floor below the shoulders and spread the legs 2-3 feet apart. Press in the palms against the floor,inhale and slowly raise the upper part of body bending the vertebrae one by one until body from naval downward touches the floor. Curve the head and back in one direction and see the heel of other foot. Exhale in this position. Repeat this exercise in opposite direction.

Repeat the above exercise ten times in each direction.

[e] Crow Movement

Sit on your toes. Put your palms on the knees. Walk like a crow touching the knee on the ground on each step. Slowly do this exercise without tension for a minute.

Yogic Exercises Useful In Gastric Troubles

These exercises help in getting rid of gastric troubles. These are also helpful for persons suffering from indigestion and constipation. The following exercises are very useful.

[a] Rotating the Legs

Lie on your back with hands straight and on both sides of the body. Keeping your right leg straight, lift it above the ground and rotate it 5-10 times in clockwise direction and 5-10 times in anticlockwise direction. Repeat this exercise with left leg.

During this exercise the body along with the head should be touching the ground. After finishing this exercise take rest till breathing is normal.

[b] Cylcling

Lie on your back. Lift the right leg and rotate it like cycling. Do it 5-10 times in one direction and 5-10 times in opposite. Repeat it with left leg.

Practice cycling with both legs 5-10 times in one direction and 5-10 times in another.

During this exercise the body along with the head should be touching the ground. After every part of exercise take rest till breathing is normal.

[c] Bending the Legs

Lie on your back. Bend your right leg and bring the thigh near the chest. Press the knee with your both hands and exhale. Now try to touch the nose to the knee raising the head and the upper portion of the chest. Come to lying position inhaling slowly. Loosen the body. Repeat it 5-10 times. Repeat this exercise with the right leg.

Now bend both the legs and circle your arms around the knees. Repeat all actions as above. Breathing should be in harmony with the body movement.

[d] Boat Exercise .

Lie on your back with hands on both sides of the body and palm towards the ground. Inhaling, lift hands, arms, head and torso above the ground. Head should not be more than one foot above the ground. Arms should also be on the. same height and fingers of feet should be straight, Keep yourself in this position as long as it is comfortable. Exhaling come to ground slowly. Relax. Repeat this exercise 5-10 times.

Yogic Exercises for Joints

These exercises are very useful for joints and related body parts.

[a] Curling The Fingers of Feet

Sit with legs stretched and support your body with the hands by bending backward. Keep hands straight and do not curve the elbows. Curve the fingers of foot backward and forward. Repeat ten times.

[b] Bending The Toes (Feet Stretch)

Sit in the position of exercise [a]. Bending from ankle move your toes away from yourself. Now bending at the ankle, bring the toes towards yourself as far as possible. Repeat it ten times.

[c] Rotating The Ankle

Sit in the position as in exercise [a]. Keep some distance between the feet. Keeping heels on the ground rotate each ankle first in clockwise and then in anticlockwise direction. Repeat ten timeso

[d] Bending The Knees

Sit straight with legs stretched. Bend the right knee and keep both hands tied behind the right thigh. Keeping hand below the right thigh near the knee, straighten the leg. The heel should not touch the floor. Bend the right leg from knee as far as possible and bring heel near right hip. Repeat it 10 times.

Similarly repeat this exercise with left leg.

[e] Bending The Vertebrae

Sit straight with legs fully stretched and 2-3 feet away from each other. Keeping hands straight bring the right hand near the toe of the left foot and stretch the left hand to the back side. Both arms should be in straight line. Bending the neck keep your sight towards the left arm.

Now do the exercise in opposite direction. This will constitute one frequency. Now repeat it 5-10 times.

[f] Clenching The Fist

Stand straight. Spread the arms at shoulder level parallel ~o the floor. Spreading fingers of both hands, produce tension In it. Keeping the toe inside, clench the fist. Again spread the fingers and produce tension. Repeat it 10 times.

[g] Bending The Wrist

Take positions as in exercise [f] with fist open. Bend the palm from the wrist in the upward direction keeping fingers straight. Now bend the palm from the wrist in the downward direction. Repeat it 10 times.

[h] Rotating The Wrist Joint

Take position as in exercise.[f]. Clench the fist of the right hand. First rotate in clockwise direction and then in anti clockwise direction. It should be repeated ten times. Repeat it with left hand. Exercise should also be repeated with both hands simultaneously.

[i] Bending of Elbow

Take positions as in exercise [f] with the fist open and the palm in the upper side. Bending the arms from elbows, touch the fingers to the shoulder. Then straighten the arms at shoulder level. Repeat it 10 times.Straighten the arms to the side and repeat the exercise 10 times.

[j] Rotating the Shoulders

Take position as in exercise [i]. Keeping the fingers at the shoulders, rotate the shoulders first in clockwise direction and then in anti-clockwise direction. Try to make the circle as large as possible and let the elbows touch each other in front of the chest. Repeat it 10 times.

[k] Bending, Curling and Rotating The Neck

Sit down with legs straight and hands on both sides of the thighs on the floor.

• Bend the head forward and backward 10 times.
• Keeping face straight bend the head sideways on right and on left 10 times each
• Rotate the head in as big a circle as possible first in clockwise direction and then in anti-clockwise direction. Repeat 10 times in each direction.

Vajrasana And Related Asanas

These exercises are very easy but very effective. These exercises are very useful in controlling the nervous system. They control sex glands and are also useful in digestion of food. Different exercises in this group are as follows.

[a] Vajrasana (Adamant Pose)

Sit kneeling, knees and toes together and heels apart. Sit between the heels. Body erect, hand on thighs and eyes closed. Breathing normal. Keep the spine and neck straight.

The body acquires stability in this pose. This posture strengthens the waist & muscles of legs, tones up the nervouS system, and helps in digestion of food. This is also a good asana for meditation and prayer.

Limitations: This exercise is not suitable for persons with gross osteo-arthritis of knees and other painful conditions of knees and ankles.

[b] Shashankasana (Rabbit Pose)

Sit in vajrasana with hands on knees. While inhaling lift hands above head. Keeping hands in line with torso, touch the floor with forehead and exhale in the process. For few seconds keep the breath out. Now inhaling slowly take the hands above the head in line of torso. While exhaling come to the initial position. Repeat it 10 times.

A variation of this exercise can be done by taking the hands to the back and holding wrist of the right hand with the left hand and vice versa.

Benefits: This asana exercises sciatic nerve and regulates adrenal gland. It also helps in proper development of breasts.

Limitation: This exercise is not recommended for persons with gross osteo-arthritis of knees and other painful conditions of knees and ankles.

[c] Marjari Asana (Cat Pose)

Sit in vajrasana. Kneel with hands straight just below the shoulders. Keep the spine in straight line with floor. Breathe in, hollow your back and raise your head. Breathe out, arch your back and bring the head towards the chest. Repeat it 10 times.

Benifits: This exercise is useful in gynaecological troubles. It makes neck, shoulder & spine flexible.

[d] Shashank Bhujangasana (Rabbit And Cobrapose)

Come in marjari asana and keep hands 45 cm apart. Without displacing hands take the chest forward touching the floor till it is in straight line with the arms. Touch the stomach on the floor and take the chest further forward till it is bow shaped. Now bend the head backward (snake pose). Now slowly take the back upwards, and taking the head and the entire body backward come to the postion of shashankasana (rabbit pose). Stay in this position for few seconds and return to marjari asana (cat pose)

Breathe normally in cat pose. Breathe in while going to snake pose and breathe out while returning to the rabbit pose.

Benefits: This exercise is useful in disorders of stomach, liver, sciatica and gynaecological troubles.

[e] Ustrasana (Camel Pose)

There are two variations of this exercise.

• Sit in vajrasana. Keep distance between the knees. Stand on knees. Turn the torso to your right and bending backward hold the heel of the left leg with your right hand. Raise your left hand over your head straight and look towards it. Now allow the weight of your upper body on the heel of the left leg. Repeat it in opposite direction. Breathe in while standing on knees. Breathe out while turning. Again breathe in while bringing torso in the middle.
• Come in position (a) of Ustrasana. Bend the neck and torso as far as possible in the backward direction. Come in the original position. Breathe in whilestanding on knees. Breathe out while bending backward.

Benefits: This exercise is very useful in digestion, gynaecological troubles and back pain.

Limitations: This exercise is not recommended for persons with gross osteo-arthritis of knees and other painful conditions of knees and ankles.

Eercise Of Bending Backward

These exercises are very good in diseases of back and spine. They are also very useful for the nervous system which passes through the spine. The most important asanas of this group are Bhujangasana (Cobra pose), Shalbhasana (Locust pose) and Dhanurasana (Bow pose).

[a] Bhujangasana ( Cobra Pose)

Lie on abdomen, legs stretched out. Place palms on floor by the side of the chest, forehead resting on ground. Loosen the body.

Slowly raise the head and shoulders and take the head backward as far as possible. Now try to curve the back in circular form till hands are straight.

Ensure that there is no undue stress on the spine. Raise the body above solar plexus. Stay in this position for some time. Slowly return to the original position.

Breathe in while raising the body. Keep breath inside during the last stage of exercise. Breathe out while returning to the original position.

Limitations: Root canal and central canal stenosis.

Benefits: Muscular back pain, Ankylosing spondylitis. Strengthening of cervical and lumbar spine.

[b] Salabhasana (Locust Posture)

(1) Lie flat on ground with face downwards. Keep hands on the side of the body with palms under the thighs. Rest the chin on the ground by raising the head.

Keeping one leg straight on the ground, raise the other leg as high as possible. Stay in this position for sometime and bring the leg down slowly. Repeat this action with the other leg.

Breathe in while lying on the ground. Hold the breath while raising the leg and holding it in that position. Breathe out while bringing the leg down. Repeat 5-10 times

(2) Keep hands under the thighs with the fingers clenched into fists. Rest the chin on the ground by raising the head. Inhale and stiffen the body by pressing the fists against the floor. Slowly raise the legs as high as possible. Keep the legs in straight line while two thighs, knees and ankles touch each other. Weight of the legs must be on body and hands. Retain the posture for sometime and return back to the original Position. Breathe in while lying on the floor. Hold the breath while raising the legs and holding it in that position. Breathe Out while lowering the legs to the floor.

Limitations: Peptic ulcer, hernia and acute heart disease, osteo-arthritis of spane. Server & acurate condition of pelvis and sacroiliac joint.

Benefits: Muscular back pain. Hip extension strengthening. Helps in controlling sciatica pain.

[c] Dhanurasana (Bow Posture)

Lie flat on the ground with face downward. Keep hands on your side. Stretch the arms backward and catch hold of the right ankle with the right hand and the left ankle with the left hand. Raise the head, body and knees by tugging the hands and legs so that the whole weight of the body rests on abdomen. Retain this posture for few seconds. Increase the duration up to one minute. Release the ankles, stretch out the legs and bring head, chest and legs in straight line on the floor.

Limitations: Patello ostreo arthritis of knees, hernia, peptic ulcer & disease of intestine and cardiac problems.

Benefits: Strengthens liver and helps digestion.Reduces fat and gives pressure to the sciatic nerve.

Exercise for Forward Bending

These exercises are useful for spine, back muscles and abdomen. Regular exercise of this group will make spine & back muscles flexible. In order to get maximum advantage, one should perform asanas of bending on one side followed by those with bending on the reverse side.

The important exercises of this group are:

[a] Paschimottanasana (Extreme Stretch of Back Pose)

Sit, stretch the legs fully with toe inwards. Breathe in. Breathing 0ut bend forward and touch the toes, with hands out stretched. Now touch the knees with the head, drop elbows.Retain this position for about 6 seconds. Inhaling, return to the starting position.

Limitations: Gross osteo-arthritis of knees, Acute disc prolapse.

Benefits: Stiff back and cramp in back muscles. Elasticity of spine is increased. The hamstring muscles behind knees are strengthened. It tones up kidneys and abdominal organs.

[b] Hastapadasana (Head and Foot Pose)

Stand erect, knees straight and feet together. Inhale for 3 seconds. Raise arms above the head till slightly backward. Breathing out for 3 seconds bend forward. H01d ankles with hands and head facing downward. Maintain this position for 6 seconds. Inhaling for 3 seconds return to the starting position.

Limitations: Resolving & acute disc prolapse and very painful spine and also in cardiac & severe abdominal problems.

Benefits: Ankylosing spondylitis and in resolved disc prolapsed.

[c] Konasana (Angle Pose)

Stand erect with feet approximately two feet apart. Keep left hand on waist. Turn head towards right. Keeping the back straight, bend towards the right in such a way that the right hand slides towards the right ankle and the left hand moves up towards the armpit. Repeat on the other side. Breathe normally while standing straight and exhale when bending. Breathe in while coming to normal position.

LIMITATIONS: Resolving and acute disc prolapse. Very painful back. Gross osteo-arthritis of spine and cervical area. Gross osteo-arthritis of knees. Vertigo, hypertension and severe cardiac problems.

Benefits: Muscular pains of shoulder girdle, lumbar and cervical. Ankylosing spondyilitis.

• Konasana – 2 (Angle Pose)

Stand erect with the two feet apart. Raise arm above the head touching the ear. Bend side ways to the left and bring right arm parallel to the ground. Slide left arm towards the ankle and remain in this position for sometime. Repeat on other side.

While standing breathe normally. Bending sideways breathe out. Inhale while coming to normal position. Limitations & benefits as in Konasana – 1.

[d] Hastapadangushtasana (Hand, Leg & Toe Pose)

Pose –1 Lie on back with feet straight. Inhaling for 3 seconds hold right arm up. Exhaling for 3 seconds raise right leg towards right hand. Hold this position for 5 seconds. Inhaling for 3 seconds return to the normal position. Repeat it on the other side.

Limitations: Gross osteo-arthritis of hip and acute disc prolapse. Hypertension, cardiac problems, pregnancy and hernia.

Benefits: Muscular pains, osteo-arthritis of knees and ankylosing spondylitis.

Pose – 2 Lie on the back with the feet straight,

keep arms in ‘T’ position. Exhaling take right leg side ways as far as possible till it touches the hand. Stay in this position for 6 seconds and come back to normal position inhaling. Repeat in opposite side.

Limitations: Gross osteo-arthritis of hip. Acute lumber disc prolapse.

Benefits: Muscular pains and all spine problems.

Pose – 3 Lie on right side. Inhale and raise the left hand. Now exhale and raise the left leg side way at 90 degree stay in this position for 6 seconds. Inhale and return to original position. Turn other side and repeat.

Limitations: Gross osteo-arthritis of the hip and acute lumbar disc prolapse.

Benefits: Osteo-arthritis of knees, problems of spine.

Surya Namaskar

Surya namaskar is a combined process of Yogasana and Pranayama (Yogic exercises and regulated breathing). This exercise reduces abdominal fat, makes limbs and spine flexible and increases breathing capacity. There are twelve spinal positions each stretching different ligaments and giving different movement to vertebral coluumn. It gives mild exercise to leg and arm muscles and ensures good circulation of blood. It is a boon to persons With stiff spine and limbs.

During different positions, movement of limbs and breathing must be very slow and rhythmical. Inhalation and exhalation in quick succession including retention of breath causing strain in lungs should be completely avoided.

Technique:

Step – 1 Stand erect with both legs together. Face the sun, fold the hands and keep the palms together touching middle of the chest with both the thumbs.

Step – 2 Slowly inhale and raise the arms over the head and bend backward.

Step – 3 Slowly exhale and bend forward till palms are flat in line with feet. Keeping the legs straight, touch your knees with your head. In the beginning legs may be bent but with practice legs could be kept straight.

Step – 4 Inhale slowly. Move the right leg away from the body, keeping hands firmly on ground. Now raise the hands and look forward.

Step – 5 Retain breathe and move left leg and keep left foot along with the right foot. Entire weight of the body should rest on the hands and toes.

Step – 6 Exhale and slowly, lower the body and let two toes, two knees, two hands, chest and forehead touch the floor. Abdomen is kept slightly raised.

Step – 7 Inhale and slowly raise your head and bend your spine backward as far as possible.

Step – 8 Exhale and slowly lower your head and raise the body with toes and hands resting on the floor as in step 5.

Step – 9 Inhale and bring left foot along the level of the hands. Right foot and knee should touch the ground. Look forward as in step 4.

Step – 10 Exhale and bring right leg also forward and come as in step 3.

Step – 11 Inhale and raise hands overhead and bend backward as in step 2.

Step – 12 Slowly bring your hands as in step 1. Exhale and relax.

Exercises For Prayer

[a] Padmasana (Lotus Pose)

Sit on floor with legs fully stretched out, keep spine and neck erect. Bend right leg at knee and place the foot on the left thigh with palm facing up. Now bend the left leg at knee and place the foot on right thigh with palm facing up. Place two hands with palm facing up on respective knee joints. Bend index finger and it should touch the middle portion of the thumb. Keep eyes closed and breathe normally.

Limitations: This exercise is not suitable for persons having gross osteo-arthritis of knees.

Benefits: It is a stretching exercise. It improves blood circulation in lower portion of spine and stomach.

[b] Sukhasana

Sit with legs stretched. Bend right leg and put it below the left thigh. Now bend the left leg and put it below the right thigh. Keep hands on your knees and keep the head, neck and back straight.

This is a simple exercise and is ideal for less experienced people.

Miscelleneous Exercises

[a] Ardha – Matsyendrasana

Sit down with feet spread in front. Bend left leg placing left foot besides right hip. Place right foot on outside of left knee, keeping foot flat on ground. Bring left arm and place it outside the right knee, elbow at knee and left hand grasping right foot circle the r’ight hand behind the back and twist the trunk towards right as much as possible. Hold this position for 6 seconds. Return to starting position and repeat in other direction.

Exhale while bending the back, Hold the breathe in the last stage. Inhale while returning to the starting position.

Benefits: General muscular pain and stiffness, It improves the functioning of pancreas and kidney.

[b] Sarvangasana (All Limb Posture)

Spread thick blanket on floor and lie flat over it with legs stretched out, heels and knees together and hands close to the side of the body, palm facing the floor. Slowly inhale and raise the legs without bending the knees. Slowly lift the trunk and support it with your hands bent at the elbow. Keep the spine vertical. The back of shoulders, neck and the back of the crown of head should touch the floor and chin should be pressed against the chest. Keep this position with normal breathing.

Exhale slowly lower the legs without jerk and release the position of head. Slowly slide down and lie flat.

Limitations: Cervical spondilytis. chronic eye disease.High and low blood pressure.

Benefits: During the practice of this asana every part of body is given exercise. Circulation of blood is direct~d to thyro.id and para thyroid glands. It strengthens muscles of cervical region. It also helps the persons with varicose veins.

[c] Halasana (PLOUGH POSTURE)

Lie flat on your back with arms on the side and palm resting on ground.Keep your legs together. Raise legs slowly without bending knees till they are at right angle with trunk. Keeping hand on ground raise hip and lumbar portion of the back and bring down legs to the floor beyond the head. Press the chin against the chest and breathe slowly. Remain in this posture for 6 seconds.Slowly raise legs and bring them gradually to the original position.

Limitations: Cervical spondylitis.

Benefits: The asana reduces excess fat from abdomen, thighs and hips. It cures various complications of back, spine and shoulders.

[d] Mayurasana (Peacock Posture)

Kneel on the floor with knees slightly apart and toes resting on ground. Bend the body forward, join arms together and rest the palms on the floor with two little fingers touching each other and all fingers pointing towards the feet.

Slowly bend forward and rest the abdomen on the elbows and chest on the upper part of the arms. Stretch the legs backward and keep them stiff. Balance your body parallel to the ground and remain in this position at least for 6 seconds. Release from the pose, first lower the head and then legs. Place the knees by the side of the hands and then release the position of the hands. Lie flat on the ground and relax.

Benefits: This asana strengthens forearms, elbows, wrists and removes. a number of abdomen diseases. It increases digestive power, tones up stomach, kidney & spleen.It is beneficial for those suffering from diabetes.