Transcript Chronic Fatigue Syndrome (CFS)

A self-management model for
Fibromyalgia Syndrome
(FMS)
Chronic Fatigue Syndrome
(CFS).
Fibromyalgia Syndrome (FMS)
3 months of fatigue and pain
over a widespread area of the body
with numerous sensitive points.
Chronic Fatigue Syndrome (CFS)
• Myalgic Encephalomyelitis
• Persistent exhaustion for six
months or more.
• 60% following glandular fever,
Ross River virus or severe flu.
Common features
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sleep disturbance,
environmental sensitivity with allergies,
depression,
muscle weakness and tightness,
deconditioning
poor posture.
fibromyalgia
chronic fatigue syndrome
PAIN
FATIGUE
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Causal factors for FMS and CFS.
• Autoimmune diseases, such as lupus and
rheumatoid arthritis.
• Chronic pain.
• Traumatic injuries.
• Chronic stress.
• Sleeping disorders.
• Viral or bacterial infections.
• Major hormonal events
• develop without any apparent cause.
• sensitisation of the central nervous system
Following an eight-week yoga
program.
• In the Journal of Pain (November 2010)
• a randomised controlled study of
fibromyalgia sufferers showed significant
improvement in:
• pain,
• fatigue,
• mood
• coping strategies
The self-management model.
• complex, chronic conditions
• gradual improvement in symptoms over
months or years..
• treat as an individual.
• the chronic pain or fatigue end of the
spectrum,
• a mixture of both.
Yogic Approach
• disturbances in the energy flow and
balance in the body.
• symptoms of increased sensitivity to
touch.
• increase in vital physical pranic energy
(sympathetic output)
• a decrease in mental pranic energy
(parasympathetic) .
Yoga physiology
• prana in a muscle or joint is blocked or
deficient
• the supply of blood and lymphatic fluid
becomes sluggish
• muscles and joint circulation grow stagnant.
• cellular metabolism build up,
• Acidic wastes and toxins irritate the sensitive
nerve fibres, causing pain and stiffness.
• the structure of the muscle and joint itself
begins to degenerate.
Ida
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Ida represents,
parasympathetic nervous system activity,
right brain,
mental activity,
the left nostril,
introversion and calmness.
Pingala
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Pingala represents,
sympathetic nervous system activity,
left brain,
physical activity,
the right nostril,
extroversion and dynamism.
Brain physiology
• The more you use a body part
• the larger the representational area in the
brain will become
Brain physiology
• With disuse, the area of the brain
representing parts of the body can become
smaller .
• nerve is injured and your brain computes
that more sensitivity is required to protect
the body,
• more stress sensors are made by the nerve
cell and put into its membrane.
• stress states can increase nerve sensitivity.
• Research has shown that practising normal
pain-free movements normalise the input
from the brain.
Yoga treatment
• Yoga asanas, regularly practised,
begin to normalise body movements,
therefore re-establishing normal brain
physiology.
Yoga treatment
• With pranayama practices we
experience a greater sense control
over the nervous system allow it to
become stronger and more balanced.
Telencephalisation
• Breathing controlled from the primitive
brain stem.
• pranayama, we shift control to the more
highly evolved cortex.
• This shift of control from unconscious to
conscious levels will have profound effects
on our well-being.
kumbhaka (breath retention)
• train the nervous system to tolerate higher
levels of carbon dioxide in the body
• blood capillaries in the brain lie dormant
• increased carbon dioxide levels stimulate
capillaries to dilate.
• improves cerebral circulation.
Hyperventilating pranayama
techniques
• bhastrika is a vitalising pranayama and
can be used effectively in chronic fatigue.
• The rapid muscular effort and increased
metabolic rate
• purifying and healing effect on the body
and mind.
Lack of awareness
• In FMS and CFS thoughts are often
scattered and there is difficulty in focusing
the attention on the present moment
Thoughts focused on the past
• individuals often keep thinking of the
golden past, prior to their injury.
• This makes it difficult to move on,
• a complete cure is the only way of
reclaiming the past.
Thoughts focused on the Future
• Expectations of the future can also cause
pain, anxiety and fear.
• they may never work again,
• that their condition will worsen
• they will lose the support of friends and
family.
• Swami Niranjan states that “expectations
in life are bondage”.
Physiological effects of thoughts
• thoughts can activate alarms signals
inside the brain which can augment the
experience of pain.
• The thoughts trigger the release of stress
chemicals such as adrenaline
• leave the person feeling anxious and
fatigued.
Yoga psychology.
• Awareness
• In the practice of yoga we seek to intensify
our conscious experience.
• Awareness is recognising our
experiences.
• Yoga practices aim to increase our
awareness, to focus our consciousness
and allow us to be in the present moment.
The positive effects of focusing the
mind
• someone competing in a world championship
may be unaware of the pain of an injury.
• mind is focused, a powerful internal pain control
system kicks in.
• Pathways coming down from the brain meet the
rising pain impulses and damp down the pain
signals.
• This is approximately 60 times more powerful
than any drug you can inject or ingest. It allows a
flood of chemicals (happy hormones) such as
endorphins (opioids) and serotonin to be
released.
Simple practices for focusing the
mind
• Simple practices such as abdominal
breathing (vertical breathing) have been
shown to release endorphins into the
bloodstream, these are potent neuromodulators which help us to cope with
pain and anxiety.
Physiological effects of
diaphragmatic breathing
• improves circulation to the heart and lungs
on top of the diaphragm, and the liver,
spleen, stomach and pancreas
immediately beneath it and attaching to it.
• The vagus nerve, a parasympathetic
nerve, connecting to the abdominal organs
heart and lungs to the brain is also said to
be massaged and toned.
Treatment
• If there is low energy and lethargy,
• stimulating practices
• full yoga breathing and yoga energy locks
(bandhas).
Fatigue Paradox
• In chronic fatigue some people can suffer
the paradoxical situation
• they feel fatigue
• also feel agitated and anxious reflecting
heightened sympathetic response.
Physical effects
Deconditioning
and
muscle weakness
Muscle tightness and
tension
Poor
fitness,
less
endorphins
Poor posture or postural
pain
Strategies
strengthening postures
Yoga stretches and relaxation
Aerobic activity
Postural reversal exercises,
ergonomic assessment and
advice.
Weight gain or weight loss Diet and exercise
Sinus congestion and Yoga sinus cleansing (Neti)
allergies
Abdominal bloating and Nauli (abdominal massage),
nausea
stomach locks
Psychological
effects
Stress,
confusion
anxiety
Strategies
yoga relaxation, breathing and
and meditation
Depression and Psychology
counselling.
mood swings
Training in the practices of
being in the moment, and
witnessing.
Functional consequences
Strategies
Unable to perform paid work
Work
conditioning,
pacing strategies
Return to modified
part-time duties
Begin small and easy
tasks at home. Pacing
strategies
Unable to perform house work
Socialising,
friends
relationship
Intimate relationships
with Expand
networks.
Visit the ashram.
Family
counselling
and support.
Yoga practices
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Yoga Nidra
Pranayama
Meditation
Hatha Yoga kriyas
Bandhas
Asanas
Diet
Fasting