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Yoga and Lupus

Baxter Bell offers a yogic prescription for sufferers of the autoimmune disease lupus.

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Several years ago, I wrote something for Yoga Journal about using yoga as an intervention for lupus, or Systemic Lupus Erythematosus (SLE). Since then, I get the occasional question about yoga’s role in helping to manage this difficult illness, and just last week, I got both an email from a student, as well as a new student in class with lupus, so I thought it was a good time to revisit this issue for anyone suffering from or teaching someone with lupus or any other autoimmune condition that can negatively impact joint health and flexibility.

Here’s what I had to say back then:

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 30’s and 50’s. 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 (or an Anusara-style class, or any other alignment-focused 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.

These recommendations still stand. And in terms of new mainstream treatments, not much has changed. In fact, the given line is that there is no cure for SLE, and the goal of treatment is to control symptoms of the disease. The main “tools” that Western physicians typically prescribe are nonsteroidal anti-inflammatory medications, like ibuprofen, for arthritis and lung symptoms; topical steroids creams for skin rashes; and stronger antimalaria drugs and oral steroids for skin and arthritis symptoms that worsen. And they recommend talk therapy to deal with ensuing depression and mood changes that often arise as the illness progresses.

Well, a lot of yoga practitioners with lupus have something to say about their experiences in how the practice can help manage the disease. Blogger Daisy Seale-Barnes, who writes Living Well With Lupus, even stated simply and eloquently that yoga lowers her stress levels, and less stress has meant fewer lupus symptoms for her!

The main areas of benefit of yoga on SLE include the following:

Improved flexibility and mobility

Improved physical energy

Stress management

Pain management

Improved mood and coping

Lupus is a variable disease, meaning it affects each patient differently, making yoga a near perfect intervention since the practice can be individualized for the array of symptoms each person is dealing with. Developing a home practice and finding a good public class that is right for you can go a long way in making a difficult illness more manageable.

A 2009 study on the potential benefits of yoga for rheumatoid arthritis patients showed reduced joint pain and swelling after an eight-week yoga program modified to accommodate their reduced flexibility and other symptoms.

Since lupus patients often develop arthritis on top of their chronic whole body inflammation, a reasonable correlation could be made that yoga might have the same benefit for SLE that this study found for arthritis. Also, in addition to the recommendations I made in 2006, I’d add yoga nidra to the list of restorative practices that can be particularly beneficial for lupus folks for almost any of the symptoms that happen to arise on any given day.