—Dee, via e-mail
Baxter Bell's reply:
Systemic lupus erythematosus (SLE) is a chronic autoimmune illness (that is, one in which the body attacks itself). It's sometimes likened to rheumatoid arthritis, except that the inflammation of SLE can affect not only the joints but almost every other bodily system, including the skin, heart, lungs, and kidneys.
It affects women by a ratio of 10 to 1 over men; they commonly develop it between their 30s and 50s. It is considered a progressive illness, meaning it gradually worsens over time, and it alternates between periods of remission and flare-ups. Studies examining the relationship between arthritis and exercise have found that moderate aerobic exercise can be beneficial, so you might assume the same would be true for SLE.
My recommendations for an asana practice depend on whether you are in a symptom-free or flare-up stage. To improve joint health when symptom-free, you should focus on proper alignment of the joints, creating maximum space in the joint, and putting the joints through a full range of motion. A beginning-level Iyengar-style class would be ideal, along with a gentle vinyasa practice for range of motion.
Things shift dramatically during flare-ups, when most sufferers experience profound fatigue. It's good to move to a more restorative practice during those periods. When you have pain, joint inflammation, and a skin rash, your body needs help to shift from the high-alert focus of the sympathetic nervous system to the quiet, immunity-supporting role of the parasympathetic nervous system.
A regular yoga practice can also help the mind observe itself during the stress of pain and physical limitations. The limbs of yoga most helpful in this regard are pratyahara (sense withdrawal), dharana (concentration), and dhyana (meditation). I've witnessed patients completely change their relationship to their chronic illnesses through the application of these ancient methods.
Baxter Bell, M.D., teaches public, corporate, and specialty back-care yoga classes in Northern California, and lectures to health care professionals around the country. A graduate of the Piedmont Yoga Studio's Advanced Studies Program, he integrates the therapeutic applications of yoga with Western medicine.