YFA Articles

We are so excited to announce our partnership with Yoga International.  This course is available for free to existing Yoga International members or free with a new monthly membership HERE.

More than 50 million Americans—including 50 percent of adults over 65—are living with arthritis.

How can yoga help?

In this workshop, Yoga for Arthritis founder and director Steffany Moonaz explains how yoga benefits people with arthritis and provides an educational, practice-based resource for yoga teachers and students who want to learn more about an adaptive yoga practice.

Steffany explains that “Arthritis is a whole-person disease. It’s a musculoskeletal condition that affects the joints, but also the whole person and aspects of life that go beyond the physical.”

Yoga is a whole-person practice. And when approached in a safe and supportive way, it can be an accessible, natural tool for easing the discomfort that arthritis causes.

In this workshop you will learn:

What it means to have arthritis and what people with arthritis experience.

How yoga can help alleviate pain during arthritis flares.

How yoga can help improve physical health, psychological health, and quality of life for people living with arthritis.

Signs yoga teachers can watch for in class as potential indicators of arthritis and how to respond to them.

Gentle asana sequences that can be practiced lying down, seated, and standing every day or when experiencing pain and stiffness.

How pranayama (breathwork) can provide relaxation for people with arthritis.

How props such as chairs, blankets, and bolsters can support the joints and help create feelings of ease during yoga practice.

How practicing yoga can help people with arthritis become more attuned with their bodies, allowing them to implement self-care even at the earliest sign of a flare.

Let this course be your opportunity to better understand arthritis, and to bring more ease into your life and the lives of others living with arthritis.

Get the course HERE from Yoga International.

Carmen refers to her Yoga profession as a "calling," a calling which has taken her on an extended journey on many levels: experiential, physical and spiritual . Currently, she resides on Maui and has been teaching there since 2003. 

Maui is a magical place for healing and recovery, in Carmen's case, from a painful divorce. In a single year, her life was completely transformed from dejection and disillusionment to happiness and companionship. 

But in 2011 Carmen was  diagnosed by a rheumatologist with Sjøgrens, an endemic autoimmune disease, which affects every cell in the body, particularly, the moisturizing glands, from the skin to the gums, muscles and joints, digestive tract, the salivary glands of mouth, --even the hair follicles--resulting in excruciating, unpredictable flare-ups that for Carmen resulted in the wasting away of muscle, listlessness and ultimately depression. 

Sjøgrens is a not a well-known auto-immune disease. She first heard about it when world tennis champion Venus Williams' public announced she had the disease and dropped out of the circuit until recently making a come-back.  In hindsight, Carmen suspects her mother also had the disease but was never diagnosed. Stress is the indisputable trigger. 

Carmen experienced symptoms, I.e., extreme dryness of the eyes and vagina, lassitude, indigestion, constipation and diarrhea years before the diagnosis.  Although she bravely continued with her active life, she had to cut back on her strenuous practice that accelerated weight loss to 112 lbs.  

She then decided to revert to the classical form of yoga comprised of gentle stretching, breathing and meditation. She also turned to Restorative Yoga for relaxation and passive stretching.

Within three years, Carmen transformed the ravages of a debilitating disease into a positive experience, thus giving   her hope for full remission and possibly full recovery. Eventually, through nutrition and exercise she has regained her muscle strength and weight. She manages her disease successfully by paying close attention to her diet and is able to recognize early-on signs and symptoms before they erupt, thus, bringing mindfulness to her daily life--all thanks to Yoga.  

The upside to all this physical, emotional and mental suffering is  the empathy and depth of experience she has gained. On a spiritual level, Carmen has gained even more determination to help others. She looks forward to her  Level 2 Yoga for Arthritis certification so that she can pursue this practice as a full-time career. 

We are so excited to announce a new affiliate partnership with Sara Gorman Pillbags.

Unfortunately, dealing with arthritis and autoimmune conditions requires medications, sometimes several.  When you travel it can difficult to keep them all straight.  Airplanes suggest you carry them with you, but for a short trip three pills in a pharmacy bottle takes up a lot of space.  Dumping multiple pills into one container is a recipe for disaster.  Those plastic pill containers from the drug store hold almost nothing, are hard to open even if you don't have arthritis, and will break nails.  So what do you do?

The search for a pill container that allowed me to organize medications and supplements in one place, that wasn't too huge, that allowed me to label it in someway so I could keep things straight and was not disposable was really hard and I despaired of ever finding anything.  I now understood why people go traveling with tupperware bins of pharmacy containers.

Being a lupus patient who doesn't know a lot of other lupus patients, I cruise the web looking for support and information.  One day I stumbled upon Sara Gorman's Despite Lupus blog and she runs a business making pillfolds and pillbags.  I finally found something that fit the bill!  

Since it's labeled, I can keep things organized by day and AM/PM.  Since it's see-though, I can stick little post-its notes in it for myself so I won't mix anything up.  Since it's fabric, I can wash it when it gets dirty.  Not to mention it's light and has super easy open zippers that any hands can use.  Happiness!

I've had mine for over two years.  It's held up great on multiple trips and busy work weeks and I even bought one for my sister for her birthday last year.  Last but not least, a portion of the sales goes to Lupus charities to support their important work.  While it might cost more up front than one of those dinky little drugstore things it represents a lot more value. 

Buy one for yourself or a friend at Sara's website HERE.

- Reviewed by Christa Fairbrother, YFA Program Director

Thanks to Karen Ray Costa, one our newest YFA teachers, for organizing an Instagram challenge for us.  

How to participate in this challenge:

Follow @yogaforarthritis and @karenraycosta.

Post a photo of yourself practicing these poses each day of the challenge.

Tag us and use hashtag #yogaforarthritis.

Prizes:

TWO general memberships to the Yoga for Arthritis website which includes amazing resources for both teachers and students.

Each post that meets the guidelines above will count as an entry. Winners will be chosen at random and contacted by July 5th.

Thanks for joining us on this challenge and helping us to spread the word that yoga is for everyone. Make sure to tag your friends and family members who are living with arthritis. Namaste and happy posting.

Date	Pose/Practice	Notes
6/1	Easy Seated	Show props
6/2	Belly Breathing
6/3	Neck Stretches
6/4	Sun Breaths
6/5	Namaste/Prayer Hands
6/6	Staff Pose
6/7	Leg Lifts
6/8	Mudra of your choice
6/9	Table	Any props
6/10	Cat/Cow	Any props
6/11	Downward Dog	Any props
6/12	Forward Fold	Any props
6/13	Lying Extended Leg
6/14	Mountain	Flag Day Show Chair
6/15	Warrior 1	Any props
6/16	Warrior 2	Any props
6/17	Warrior 3	Any props
6/18	Tree	Father’s Day
6/19	Bridge	Any props
6/20	Supine Twist	Any props
6/21	Baby Cobra	Any props
6/22	Chair on Wall
6/23	ADL in the kitchen	Reaching Taking a break while cooking for shoulder rolls Sitting with long spine in front of meal Mindfulness while eating (one thing at a time)
6/24	Plank Variations
6/25	Seated Head to Knee	avoid “jumbo shrimp”
6/26	Bound Angle	Any props
6/27	Child’s Pose	Any props
6/28	Legs up the wall	Any props
6/29	Breathing practice
6/30	Corpse Pose	Any variation

About Karen:

Karen Costa is a writer, yoga teacher, coach, and educator living in Massachusetts. Her teaching is focused on gentle, restorative, and accessible yoga. She is passionate about helping students from all walks of life, at all levels, to connect with the powerful practice of yoga.

Karen leads various yoga workshops on topics such as meditation and personal growth. She completed her 200-hour teacher training with Frog Pond Yoga Centre in Princeton, Massachusetts, is certified in Reiki 1, and recently completed Level I training with Yoga for Arthritis studying under Ann Swanson. 

Karen has worked in higher education for over a decade and holds a master's of higher education and a certificate of advanced graduate studies in educational leadership. Her higher education work is focused on helping first-year, non-traditional students, to achieve academic success. She is a staff writer at Women in Higher Education and calls Central Massachusetts her home. Her ideal day starts with a cup of coffee and is spent at home with her husband and son, playing board games, reading, and writing. Two of her favorite places on Earth are Long Beach Island, New Jersey, and the amazing Kripalu Yoga Retreat Center in Western Massachusetts. 

Learn more about her work at www.thecoreofyourcore.com. You can find her on Facebook at https://www.facebook.com/thecoreofyourcore/. Follow Karen on Twitter @KarenRayCosta and on Instagram @KarenRayCosta.

I remember the moment that my chronic back pain moved from a one on the pain scale to a ten.  It was July 2016 while taking a walking tour that involved hills, starts and stops for conversation, not much time to complain and no time to sit down.  When I got to my car I was in tears. 

But the journey to this place of extreme pain started years before, if not at the beginning of my life.  In 2010 I was diagnosed with a level 2 spondylolisthesis at L5 – L6 (transitional vertebra) which is the forward or anterior displacement of one vertebra over another. I may have been born with it. In 2014 I learned that back bending too far could break my back and from that time on I was always very careful. In 2015 I experienced a traumatic event to my back and my spirit that probably accelerated the degeneration in my back, at this point my pain went from infrequent to chronic but moderate. Then, a little over a year later, on the walking tour, my back finally said “UNCLE!”

I wasn’t sure what to do.  I started with my family doctor. MRI showed Degenerative Disc Disease with an extruding disc.  I was told to select a neurosurgeon.  This process took months, all the while I was in pain.  To cope I began researching what I could do to help myself. I could go to a pain doctor for injections, but I was still going to need surgery, so I decided against that expense.  As a Yoga Therapist, C-IAYT, I reached out to my community of colleagues.  After much trial and error, I came up with a routine that worked for me. As part of my research I became a Level 1 Yoga for Arthritis Teacher. I also consulted with books, doctors, friend and associates that suffer with back pain too.

The routine I eventually came up with takes 15 minutes of Yoga Therapy Poses and 15 minutes of meditation and breath work each day.  I went from not being able to walk even 1/8 of a mile in September to walking up to ½ mile before the surgery in December.  Since surgery I have walked as much as 8 miles without sitting down! But I still have my routine that I am slowly integrating back into my day.

Beth’s Routine for Chronic Low Back Pain:

• -          Lay on a mat or carpet supine with feet touching the wall knees bent.  Take one knee and hug it into the chest.  Straighten the other knee perhaps all the way to a toe point on the wall.  This uses the friction of the mat/carpet below to gently massage and warm up the back. Change legs. (Krentzman)
• -          Core work: engage the pelvic floor (Kegel), move the abs to the middle, tuck low ribs in and push back into floor, and move the belly button towards the spine.  Hold and release. (Sullivan)
• -          Wrap the hands around the back of the head letting the elbows drop forward, thus providing a cradle/sling for the head, which should relax. Engage the core as above and lift from the core, gently crunch. (Pilates)
• -          Supine Figure 4 Pose – knees bent feet on floor.  Bring one foot up and rest it on the opposite knee.  Let the knee of the leg that is up drop open.  Take your hands and hold on to the back of the knee that is on the down leg. Gently pull that knee in toward your chest.  Optionally use your elbow to open the knee of the up leg. Switch sides.
• -          Happy Baby pose: hands hold feet or knees to chest, roll around massaging low back
• -          Bridge Pose: feet and shoulders on ground, knees bent, engage glutes and hamstrings, lift hips only to neutral, not beyond
• -          Roll over
• -          On good days only – Plank pose (upper pushup) for a few seconds moving into one very slow chaturanga (lower pushup), followed by pushups. Belly button to spine the whole time, focus on core. On a bad day – wall pushups.
• -          Prone Decompression pose – extend arms finger tips on ground, tuck toes, squeeze knees together and breathe – 4-5 breaths allow the head to rise just a little, the tiniest backbend.  Feel a lengthening in the spine. Adapted from Foundation Training, only the part that starts at 1:30.
• -          Birddog Pose - Hands and knees, engage core, center of the back may arch up. Extend one leg back and up off the ground keeping hip level with the opposite hip. Extend the opposite arm too.  Keep the core engagement. Exhale bring the knee and elbow together, inhale extend, repeat 10 times, change sides, follow this with up to 5 bird dog holds in the extended pose for 4 breaths on each side alternating sides
• -          Goddess pose/squats: standing, toes can be down, knees bent. It’s important to do a pose in neutral after a one-sided pose to avoid pain – Yoga for Arthritis
• -          Low lung, try to get the knee off the ground focus on the quads, change sides
• -          Mountain pose: simple standing to move back to neutral
• -          Tree pose: Standing foot to opposite leg, focus on core stability, try to upset the balance to engage the core more. Change sides. (If it is too much to get the foot to the opposite leg then just lift the knee in front of you)
• -          Squat walk to meditation spot.
• -          Meditation consists of focusing on the breath and adapting this simple Relaxation Response meditation by Peg Bain . This video uses a word on inhale and a different related word on exhale.  I added my own words, happy-back, strong-back, pain-
• free, anxiety-free, om-shanti, peace-peace.  Add your own, whatever you need…
• -          Inversion (not on the head) of some sort. To get out of gravity. Down dog with a sling (Krentzman), Hand Stand, or Inversion Table, etc.

I was honored not long ago to be a guest blogger for the Cochrane Collaborative. Their mission “is to promote evidence-informed health decision-making by producing high-quality, relevant, accessible systematic reviews and other synthesized research evidence. [Their] work is internationally recognized as the benchmark for high-quality information about the effectiveness of health care.”   Cochrane was releasing a systematic review of studies on the use of yoga to treat non-specific low back pain which showed yoga as promising.  Unfortunately, there wasn’t room to include my daily routine, I’m so glad to share it above.  Since writing the blog post for Cochrane the  American College of Physicians have published a new guideline for the treatment of low back pain which lowers the use of opioids and increases the use of complementary therapies, including yoga therapy. 

I’m so thankful for yoga therapy. It has truly saved my life.  To find a certified yoga therapist in your area go to the International Association of Yoga Therapist’s website. Please reach out to me if the routine above is confusing.

Links:

http://www.cochrane.org/about-us/our-vision-mission-and-principles

http://www.cochrane.org/CD010671/BACK_yoga-treatment-chronic-non-specific-low-back-pain

https://cochranecam.wordpress.com/2017/01/12/yoga-for-low-back-pain/

https://www.acponline.org/acp-newsroom/american-college-of-physicians-issues-guideline-for-treating-nonradicular-low-back-pain

www.arthritis.yoga

http://www.iayt.org/search/custom.asp?id=4160

Relaxation Response Meditation Video:

https://www.youtube.com/watch?v=gAIYm6wpzw4&feature=youtu.be

Prone Decompression Video:

https://www.foundationtraining.com/videos_and_blog/prone-decompression/

Book and Thanks to:

Yoga for a Happy Back by Rachel Krentzman, C-IAYT

Core work adapted from the work of Marlysa Sullivan, C-IAYT

Bio: Beth Novian Hughes, MS Yoga Therapy, C-IAYT,eRYT500 is a yoga therapist in Rome, Georgia. Learn more about Beth at her website  www.romega.yoga or contact her at novianhughes@gmail.com

 

For as long as I can remember, I’ve been interested in the mind/body connection. 

From age 7, I knew I wanted to be a communicator and use my gifts as a singer and performer. Even then, I was fascinated by the writings of Abraham Maslow and his theory of self-actualization. In high school, I began meditating and dabbling in many of the modalities I now teach, but that was many years before I would return to serious study.

After earning a BFA in Music and Theater, I pursued my performing goals all the way to Carnegie Hall, earning a Bistro Award for my one-woman show, recording a CD and receiving other accolades.

Some twenty years later - after many years of performing - I felt called again to my high school interests and redirected my focus. Interestingly, I was specifically called to therapeutic yoga. This was many years before the advent of Yoga Therapy as a profession in the west. I immersed myself in an eclectic array of studies including Gentle and Therapeutic Yoga, Ayurveda, Pranayama, Anatomy, MBSR, Raja Yoga and Sacred Mantra.

I began a private practice in NYC, which quickly grew.  At the same time, I was invited to teach a chair yoga class at a metropolitan Guild for the Blind where I ultimately taught for 6 years. In fact, that time remains one of my most cherished teaching experiences.  The work involved a steep learning curve. Since the students had physical and emotional challenges that required attention, much concentration to detail and precise languaging was required. I learned as much - or more - than I taught.

After some time, I founded Resilience for Life®, the business under which I now offer a variety of services aimed to educate and motivate people on their own path towards wellness.

I’ve been blessed to be mentored by extraordinary women like Tao Porchon-Lynch (who will be 99 years young this August) and Judith Lasater, with whom I traveled and assisted for four years. It’s one of the primary reasons I’m now thrilled to be a mentor of the Yoga for Arthritis Level I graduates, as I firmly believe in ‘passing the torch.’

I became a Senior Faculty and co-presenter for the Stress Management Teacher Training program through the Integral Yoga Academy. For the past 10 years, I’ve had the opportunity to teach people from all over the world and provide mentorship to many of the students.

More recently, my connection to Integral Yoga and my work as a Stress Management Trainer led to my being hired by Dr. Dean Ornish, working as an Ornish Faculty on his Program for Reversing Heart Disease.

As a stress management trainer, I’ve long understood the connection between stress and disease. Stress can have a significant and negative effect on arthritis, which is now the leading cause of disability in the US. Becoming a Yoga for Arthritis certified teacher seemed a logical progression. I’d also heard wonderful things about Dr. Steffany Moonaz and her team.

Arthritis has touched my own family.  My father and grandmother were both personally impacted by the condition. My Dad had an affected knee from his college football injuries. My grandmother’s swollen knuckles caused her horrible pain and made it increasingly difficult for her to write, open mail or perform the simplest activities. Their experiences shaped my understanding of the devastating effects of arthritis and are a driving force behind my work today.

It excites me to now have the multitude of tools I’ve learned in the Yoga for Arthritis training and to be of service to not only my students but to offer support to my family. I’m equally committed to taking care of my own health as I age so that I can continue to be vital.

In the past several years, I forged a relationship with the Northern California Arthritis Foundation and have presented Resilience for Life Stress Reduction Workshops for Arthritis at their EXPOs. Most presenters at the EXPO deliver a straight lecture; mine is one of the only experiential programs, and, consequently, the feedback has been very high. Given the opportunity to be exposed to the useful practices we offer opens windows of possibility to arthritis sufferers. It gives them hope, and it improves the quality of their lives.

Finally, in the past 9 years, I’ve added coaching to my toolkit and am now a licensed HeartMath provider and also New Life Story Wellness Coach.  A highlight for me in 2014 was the inclusion of a client case study in the publication Successful Life Story Transformations: Using the ROADMAP System to Change Mind, Brain, and Behavior, edited by one of my teachers, Dr. David Krueger. This fall, I’ll be sitting for the first National Board Certified Health & Wellness Coach (NBC-HWC) accreditation, from ICHWC.org.

I’m grateful to be a part of the Yoga for Arthritis community. Deep bows to Steffany for planting the seed and creating it!  I look forward to continuing to share Yoga for Arthritis with groups, individuals and as a mentor, supporting those seeking the Yoga for Arthritis certification.

________________

Jaymie is the founder of Resilience for Life®. She's a licensed HeartMath provider, Health & Wellness Coach, C-IAYT yoga therapist and Ayurveda Health Educator. In practice for nearly two decades, Jaymie is passionate about helping people learn how to reduce stress, increase resilience and enjoy healthy aging. She has presented at the National Institutes for Health, IBM, Panasonic, and the Arthritis Foundation, among others. Jaymie believes the mind, body, and heart have much to teach us about our internal - and often untapped wisdom. Learn more at: www.resilienceforlife.com

Thanks to Livvie Mann and the extraordinary team at Integral Yoga NYC for sharing their yummy snacks with us.  Enjoy!  A printable PDF version of this is available to YFA members of all levels in the members only content area. If you're not a member, consider joining us in the patient's or teacher's section.

Amy Welden, YFA Certified Instructor, submitted this great idea for the holiday season. Since she was generous enough to share, if you use these resources, please give her credit.

Since the seasons of celebration are soon here, I thought I would share something I have done with my students that other yoga teachers might like to do for their classes. I gave these things to my students at my last Yoga for Arthritis class:

1. A Completion Certification with the Yoga for Arthritis Logo
2. On the back of the Certification, the 8 Limbs of Yoga and how they could apply to Yoga for Arthritis.
3. Yoga Gingerbread Cookies with Yogi Teas
4. Amy’s Life Lessons from a Yoga Cookie

I had the cookies on table with the certificates and clipped a couple Yogi teas (Calming/Bedtime) to each certificate. Everyone loved reading the 8 Limbs info and those Gingerbread Yoga People are just too cute. I made over 100 and you can see that is frosting on my black shirt!!  I just wanted you to see how adorable these cookies are.

Amy’s Life’s Lessons from a Yogi Gingerbread Cookie

Cookie Dough is like life…

• When it gets too sticky, just “chill” for awhile and it gets easier to handle

• If it is too difficult to handle – change the recipe and start over

• Be mindful to honor time or you might get burned

• Adding something sweet usually makes things more palatable

• A smiling face will cover for many mistakes

• Even when not perfect, you can still be appreciated and charming!

Om Shanti, Shanti, Shanti!

Copyright 2016 Amy Welden, MAed, RYT-200, Certified Yoga for Arthritis Instructor

The Eight Limbs of Yoga

(Some examples of applying to living with Arthritis & Chronic Pain)

1. Yama – Five practices of restraints:

Ahimsa – applying non-violence to every part of your life. Not harming yourself or others. Being mindful to listen to your body and paying attention. Avoid negative self-talk.

Satya – Truth or living according to your own truth. Accepting what your body can or can’t do today.

Asteya – non-stealing.  Avoid taking someone else’s peace.

Brahmacharya – abstinence.  Accept what you are able to do and avoid comparing what someone else can do and you can’t in asana practice.

Aparigraha – Non-hoarding/non-possessiveness. Have boundaries that honor your self

1. Niyama – five essential self-observances.

(Saucha, Santosha,Tapas, Swadhaya, Ishwara pranidhana)

1. Asana – yoga “poses”. In Sanskrit, it means, “seat”.
2. Pranayama – life force. Prana, in Sanskrit means breath/energy/vitality. Ayama = to stretch.
3. Pratyhara – to withdraw from the senses, going inward to find calm.
4. Dharana – concentration
5. Dhyana – meditation
6. Samadhi – Sama means, “equal”. Dhi=thinking. What can happen when all seven limbs are practiced with earnest, without break for a long time.

Next Classes: Mancos Library      10:00 – 11:15ish ;)

March 10

March 17

March 24

March 31

Namaste!    Amy

You can order the gingerbread yogi cookie cutters from the Baked Ideas website.

This is the recipe that Amy uses.  With a little added chocolate cocoa as her secret ingredient.

Directions for decorating the cookies can be found on Youtube HERE.

This book, by Harry D. Fischer, M.D. and Winnie Yu, is a book written to help people who are diagnosed with rheumatoid arthritis (RA). Co-authored by a medical doctor and a health writer, this text is practical in content, and written in straight – forward, understandable language.

The 14 Chapters include definitions, the importance of creating a medical team, use of self-help, traditional and non-traditional methods when treating RA. It also provides a glossary of terms, a list of resources and a bibliography. Each chapter ends with a case study from a person who has RA and how they applied the topic of the chapter to his or her life.

Chapter 6, Exercising with RA, doesn’t specifically address using yoga for Arthritis, but it does support the idea that the medical experts now agree that when treating RA, there needs to be a balance between exercise and rest.

A person who is diagnosed with RA or a Yoga Therapist helping clients with RA would find it a useful resource.

However, this book is already twelve years old; therefore, some of the medicines and research may not be up to date.  Also, although the authors include a bibliography, they do not cite specific sources in their text. It would be up to the reader to delve further.

Reviewed by Amy Welden, M. Ed., RYT-200, Certified Yoga for Arthritis Instructor

You can purchase the book through Amazon HERE.

Predictors of Fatigue in Rheumatoid Arthritis Patients in Remission or a Low Disease Activity State

Fatigue is a very common and often debilitating symptom in patients with rheumatoid arthritis (RA). Research shows that fatigue is a problem even for RA patients who are in remission or a low disease activity state1. This article expands upon the investigation of this type of lingering fatigue in RA patients, and the relationship between fatigue and other factors such as disease-activity measures, physical functioning and demographics.

This study looked at data from patients enrolled in a large, 11-year, Norwegian study (The Norwegian Disease-Modifying Antirheumatic Drugs Register). From the larger sample of 1.5 million patients, researchers first selected 2,193 patients who had been treated with Methotrexate only or Methotrexate in combination with biologics. They then looked more closely at the 32% who were in remission or a low-activity disease state after 6 months of treatment.

More than one in four (28%) of these patients continued to report high levels of fatigue in spite of having low disease activity.

Results show that greater pain and poorer physical functioning were both predictors of fatigue. Other notable factors associated with fatigue include being female, being younger and having a greater number of tender and swollen joints.

Interestingly, patients taking the combination of medications showed greater reductions in fatigue in comparison to those taking just Methotrexate. However, as the authors point out, these results should be interpreted cautiously as the patients in the combined therapy group initially reported greater pain and disease activity in comparison to the Methotrexate only group.

While this article offers a glimpse into factors associated with fatigue, more research is needed on ways to reduce this lingering and debilitating symptom beyond what is offered by pharmacologic treatment alone. Preliminary research appears to support a combination or integrative approach to RA-disease management that includes coping-skill management, physical activity, and mindfulness-based training.2

Yoga, which has previously been shown to reduce pain and improve physical function3, also promotes mindfulness and some of the other skills mentioned above. With an individually tailored approach, yoga, in conjunction with conventional medication, may have the potential to be particularly helpful in addressing the pervasive effects of fatigue for those living with RA.

LINK to the full article.

Submitted by Dana Halkowski

1. Curtis JR, Shan Y, Harrold L, Zhang J, Greenberg JD, Reed GW. Patient perspectives on achieving treat-to-target goals: a critical examination of patient-reported outcomes. Arthritis Care Res (Hoboken) 2013;65:1707–1712.
2. Cramp F, Hewlett S, Almeida C, Kirwan JR, Choy EH, Chalder T, et al. Non-pharmacological interventions for fatigue in rheumatoid arthritis. Cochrane Database Syst Rev. 2013;8:CD008322.
3. Moonaz SH, Bingham CO 3rd, Wissow L, Bartlett SJ. Yoga in Sedentary Adults with Arthritis: Effects of a Randomized Controlled Pragmatic Trial. Journal of Rheumatology, 2015 Jul:42(7):1194-202.doi: 10.3899/jrheum.141129.