FACTORS PREDICTING PREVALENCE OF CAM IN SUBJECTS WITH MUSCULO-SKELETAL DISORDERS.

By

Dr.Deepu V

Literature Section-

CONCEPT OF VYÄDHI ACCORDING TO YOGA AND ÄYURVEDA

The science of Yoga today not only signifies its rich spiritual essence but also is a means of therapy that has become an answer to many of today’s ailments. In this regard, it is accompanied by another ancient medical wisdom of India- Ayurveda. Both these wisdoms of India have a holistic approach in treating the individual and not limiting him to the physical dimension of existence. Health is explained basically to be a state of balance and harmony in these various dimensions of human existence. Where yoga talks about the five-layered existence of man, Ayurveda talks about balance of the Tridosa, Sapta Dhatu, proper digestion and state of happiness.

Our ancient texts have detailed descriptions on the concepts of disease. A vast majority of today’s ailments are psycho-somatic in origin with stress as the root cause. This stress or the agitated emotional surges are termed as “Adhi” in the Yogic texts. It is the uncontrolled speed which arises at the mental or Manomaya Kosa level. Over a period of time this Adhi percolates to the Pranayama Kosa level and then to the grossest physical or the Annamaya Kosa level where in it is first manifested as altered digestion. The yogic concept stops at this level and explains that the badly digested food which settles down in the body amidst such commotion is transformed into incuable diseases.
And to explain the process through which this badly digested food causes disease, similar references in the science of Ayurveda is taken. In Ayurveda, this badly digested, unassimilated food is termed as AMA. This AMA flows in the srotas to cause constriction, blockages and vitiation of dosa which gets manifested as Vyadhi or disease.

This study has compiled the concepts of disease as highlighted in yoga and Äyurveda. The modern medical science has been able to establish cause and effect relation for various diseases through external laboratory investigations. The discovery of germs, antibiotics and vaccinations has helped gain mastery over communicable diseases. The more recent problem of non-communicable disease has posed the problem of establishing the cause and effect relation, although we know that these non- communicable diseases are traceable to lifestyle .We need a conceptual frame work as to how disturbed lifestyle results in diseases. This study was a attempt to unravel the concepts of Yoga and Äyurveda texts that have detailed description about the understanding of health and disease. The concept is that the lifestyle is disturbed because of the wrong notion of happiness. This deals to agitated emotional surges which are called “Ädhi”, this Ädhi is uncontrolled Vega at Manomaya koça, this Vega percolates over a period of time as Vega at the Präëamaya koça level. The Präëa imbalance which are comparable  to the concept of doça according to Äyurveda that results in disturbance  in Agni or  Mandägni leading to the  formation of ÄMA , this ÄMA flows in srotas to cause constriction and blockages which is manifested as VYÄDHI or disease. The following comparative flow chart depicts the summary of this study.

Experimental Sections

Factors predicting the prevalence of CAM in subjects with Musculo-Skeletal Disorders

Background:  A greater proportion of patients taking recourse to CAM are those suffering from painful musculoskeletal conditions. In this cross sectional study we evaluated patients perceptions and disease characteristics which influence their choice for CAM treatments.
Method: We conducted a cross sectional survey among patients visiting rheumatology clinics, naturopathy, ayurveda and yoga centers for joint complaints. We evaluated their perceptions, expectations, attitudes and concerns regarding CAM and conventional treatments using a set of questionnaires. We also assessed their health staus using the Short Form 12 questionnaire and Rheumatology Attitudes Index. Results: According to this survey it was found that a significant proportion (48.1%) of patients in rheumatology clinic had used CAM in one form or other of these 71.1% had used Ayurveda and 46.3% had used homeopathy. Disease characteristics such as younger age (<48 years), longer illness duration, greater severity of disease such as swollen joints, Ritchie score and early morning stiffness had preponderance to allopathy use. Lower income patients had more access to Ayurveda than other therapies. Significant proportion of patients with degenerative joint diseases used CAM therapies. A significant proportion of patients with Back pain resorted to yoga intervention. The main reasons for using CAM was attributed to patients expectation to “control pain”, followed by the knowledge that the “treatment has helped someone with the same condition”. The reasons for not using CAM among those visiting the rheumatology (allopathy) treatment center was the knowledge that “CAM treatment to take long time to act” and “CAM treatments are prolonged”. A significant proportion of patients on CAM were overburdened with disease and had poorer mental health compared to those visiting the rheumatology center. Conclusion:  In conclusion it can be said that patient’s preferences for CAM are driven by both their clinical disease condition, disease burden and mental state. Popularity of these systems in Indian setting is an important factor that cannot be ignored in the present scenario. Larger trials are needed to assess the benefit finding and risk these interventions pose in rheumatology practice.

In summary we have studied a clinically representative sample from both outpatient rheumatology clinics, as well as hospital set ups using Ayurveda, Naturopathy and Yoga as the main line of treatments. This has helped us to evaluate the differences and compare the reasons for CAM preferences and usage in populations that subscribe to each of these therapies. This would be beneficial to assess the factors that drive patients to each of these therapies. we have also collected information on physicians diagnosis to examine relation between specific diagnosis and CAM Although many studies have described prevalence of CAM use in patient with arthritis, few studies provides insights on the association between CAM use and other important clinical and psychological factors.
In conclusion it can be said that patient’s preferences for CAM are driven by their clinical disease condition, disease burden and mental state. Popularity of these systems in Indian setting is an important factor that cannot be ignored in the present scenario.

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