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MANAGEMENT OF STRESS

So how do you avoid stress?

Repetitive Stress Injury / Computer Related Injury

Ayurveda Treatments for Stress

Panchakarma for Stress management

Rejuvenation Therapies

Rasayana Therapies for Stress Management

What are the causes of RSI?

Is there treatment in Ayurveda for RSI and CRI?
 
 
Stress can be described as a mental or emotionally disruptive condition that generally occurs in response to some adverse external or internal influence. These are truly stressful times we live in. Body, mind, heart and spirit are all subjected to the ravages of day-to-day stress. Worries about security, economic difficulties, emotional trauma-stressors like these can take a toll on health and longevity if not addressed in a timely fashion. It is the greatest threat to the well being of people and ultimately affects the physical health, manifesting itself in the form of increased heart rate, raised blood pressure, irritability, anger, fear or depression.
Your optimum health and peak performance depend on remaining calm under pressure. Most debilitating types of stress, called negative stress or distress, generally occur when you view change and pressure as burdens and rising demands as threats. You feel a sense of isolation, frustration and helplessness. This results in disease, disorder, and dissatisfaction.

The idea that prolonged exposure to stress could be harmful was first formalized by a Canadian researcher called Hans Selye in the 1930s. He divided the experience of stress into three stages - the alarm stage, the resistance stage and the exhaustion stage.
    1. The alarm stage denotes the physiological changes we undergo when preparing to deal with a threat.
    2. The resistance stage refers to our initiation of the chosen course of action.
    3. The exhaustion stage is the period when the adverse effects of sustaining our course of action are making the body vulnerable to disease or collapse.

In terms of disease the exhaustion stage may be reached when a person begins to develop a stomach ulcer, or has a heart attack. In order to prevent the more serious consequences of stress you should know the symptoms and consult our doctors if you feel you have an ongoing problem with stress.

Repeated or prolonged negative stress can trigger complex physiological reactions involving multiple chemical changes in the body. These lead to an exhaustion of mental, physical and emotional energies, thus increasing your susceptibility to disease. Research shows that stress raises blood cholesterol and blood pressure, and lowers immunity. It destroys brain cells, lowers IQ, and impairs memory and thinking. Cancer, heart disease, immune-deficiency diseases, and even the common cold are related to stress.

Now it is a known fact that free radicals (the reactive oxidizing molecules that can destroy the cells internally, causing mutations in the nucleus and destruction of mitochondria) can cause damage to cells when the body attempts to defend against stress. Free radical damage results in less energy, and causes deterioration of the organs and systems of the body. Free radicals are causative factors in most of the degenerative diseases and hasten the aging process.
 
So how do you avoid stress?
Our experience of stress depends principally upon our reaction to conditions outside ourselves. For this reason stress management and self-awareness are extremely useful tools for someone who feels they are run ragged. They are geared towards changing a person's reaction to stressful circumstances and so reducing the level of anxiety a person may feel. On the other hand some people experience stress positively, finding that during times of extreme pressure the characteristics of stress such as anxiety provides the motivation for increased activity - certain individuals respond to deadlines in this manner. However when stress is exacerbated by negative feelings such as an underlying fear of failure or of loss, the negative experience of stress is likely to be ongoing unless a patient is encouraged to address their own mental causes for anxiety. Stress-related illness comes about through continued exposure to our own physical changes during stressful times. We become more vulnerable to stress-related illness when we have an ongoing psychological issue that may perpetuate stress such as low self-esteem or a fear of failure.
To be effective in treating stress, it is important to be individualistic. The Ayurvedic approach is to target the causative factors and then bring that area into balance.

There are three different manifestations of stress from the perspective of Ayurveda— mental, emotional, and physical. Each requires different solutions and therapies.

Mental Stress

Mental stress, according to Ayurveda, is caused by an overuse of the mind. For instance, if you perform intense mental work many hours a day, or if you work long hours on the computer, it can cause an imbalance in Prana Vata, the mind-body operator concerned with brain activity, energy and the mind. The first symptom of Prana Vata imbalance is losing the ability to handle day-to-day stress. As the person becomes more stressed, it impacts mental functions such as dhi, dhriti, and smriti-acquisition, retention, and recall. The person's mind becomes hyperactive, yet the person loses the ability to make clear decisions, to think positively, to feel enthusiastic, and even to fall asleep at night.

To address day-to-day mental stress, it is important to begin by managing mental activity. Secondly, you can take measures to pacify Prana Vata, for example, by:

  • Favouring Vata-balancing foods, such as sweet, sour, and salty tastes.
  • Favouring warm milk and other light dairy products
  • Performing a full-body warm oil self-massage ksheerabala tailam or dhanwantari tailameveryday

It is important to get plenty of rest, and if you are having trouble falling sleep, avoid stimulants like caffeine and sip on herbal tea instead. Relaxing aromatherapy and meditation can help calm the mind.

Emotional Stress

Emotional stress can be caused by a problem in a relationship, the loss of a relative, or any situation that might hurt the heart. Emotional stress shows up as irritability, depression, and emotional instability. It affects sleep in a different way than mental stress - it can cause you to wake up in the night and not be able to go back to sleep.

Emotional stress disturbs Sadhaka Pitta, the mind-body operator concerned with the emotions and functioning of the heart. To balance emotional stress, you need to favour Pitta-pacifying foods and routine, such as:

  • Eating lots of sweet juicy fruits
  • Favouring Pitta-pacifying foods such as the sweet, bitter and astringent tastes.
  • Drinking a cup of warm milk with cooling Gulkand (rose petal preserve) before bedtime
  • Cooking with cooling spices such as cardamom, coriander, cilantro, and mint
  • A daily self-massage with a cooling oil such as coconut oil or Chandanaadi tailam.
  • Going to bed before 10:00 p.m.

Physical Stress

Physical stress is caused by misuse or overuse of the body, such as exercising too much or working for extended periods at a job that is physically taxing. This can cause a person to experience physical fatigue, along with mental fogginess, difficulty in concentrating, and dullness of the mind.

Excessive physical strain causes three sub-doshas to go out of balance: Shleshaka Kapha, the subdosha concerned with lubrication of the joints and moisture balance in the skin, Vyana Vata, which governs the circulation, nerve impulses and the sense of touch, and Tarpaka Kapha, which governs the neuro humours.

Another reason for physical stress can be too little exercise, which results in a sluggish digestion and the formation of ama, the digestive impurities that clog the channels. In either type of physical fatigue, the process of regenerating cells slows down, and thus the cells themselves become physically tired.

The solution is to balance Vata and to support Kapha to make the body more stable and nurturing, for example, by:

  • Getting adequate rest and moderate exercise
  • Following a Vata-Kapha pacifying (invigorating and energetic) diet
  • Performing the full-body warm oil self massage everyday
  • Dhara treatment, an exclusive Ayurvedic pre-panchakarma therapy is proved to be beneficial.

Certain foods are natural stress busters according to Ayurveda. These include walnuts, almonds, coconut, sweet juicy, seasonal fruit such as pears, apples (cooked if possible), milk, and fresh cheeses such as paneer or ricotta.

If you build your resilience to stress through natural methods, you can begin to experience stressors more as a challenge or a positive opportunity for growth. If you learn to evoke the 'stay and play' rather than the 'fight or flight' response, you can truly live a stress-free life of self-actualization, and become a 'spiritual being' in human form.

Ayurveda Treatments for Stress

Ayurvedic treatment for stress includes changing life style, changing diet, herbal medicines and therapies, especially Panchakarma Therapy. Since, the accumulated toxins in the body also aggravate the condition; the person should go for treatments which detoxify and purifies the body.

Ayurveda has two major treatments for stress, the Panchakarma and the Rasayana therapies. While the Panchakarma is meant to flush out the toxins from the body, the Rasayana therapies are meant to nourish the body.

Panchakarma for Stress management

Panchakarma therapies loosen the toxins, speed up the circulation and make the body ready to release wastes. Following are some of the many methods that are usually adopted in the treatment of stress management.

Sirodhara: In this method, lukewarm herbal oil is poured in a continuous stream onto the forehead, while performing a gentle massage. This activates the brain cells and nervous system and gives relief to nervous disorders.

Snehapanam: In this therapy, medicated ghee is given to the patient on an empty stomach. The common ingredients are Malabar nut, wild snake gourd, sweet flag, sandalwood, neem, Cassia fistula(amaltas, Golden shower tree, Indian Laburnum), asparagus, ginger, mustard, gooseberry etc.

Thailadhara: This means continuous showering and massaging of the whole body with warm medicated oil to stimulate perspiration. The oil is a mixture of highly effective herbs like deodar, white leadwort, Malabar nut, nutmeg, liquorice and sesame oil, castor oil and milk.

Rejuvenation Therapies

After removing the toxins from the body and balancing the Doshas–the three basic constituents of the body, the person has to go through the rejuvenation therapies to balance the body and mind.

Rejuvenation procedures include:

  • Abhayangam: Body massag. It rejuvenates body and mind.
  • Sirodhara: Pouring medicated oil over the head. It calms the mind by relaxing central nervous system
  • Pizhichil: Medicated oil bath. It helps increase blood circulation
  • Elakkizhi: Massage done with herbal leaves. This is good for back pain and rejuvenating the body
  • Njavarakizhi: Massage done with Njavara herbal rice. Halts ageing and rejuvenates the body.

Rasayana Therapies for Stress Management

These therapies are body nourishing therapies that rejuvenate the body and mind after the Panchakarma treatments. Rasayana treatments for Stress Management include oral medicines and diet regulation.

Oral medicines: Oral medicines for stress management are mostly the extracts of pure medicinal herbs, leaves, spices etc. They are prepared specifically to restore the balance and provide the needed inputs to reduce stress. The most common medicines are Sarawastharishtam, Pathyadi Kashyam, Manasmitra vatakkam and Brahmi Gritham

Diet Regulation: Stress Management patients are advised to follow a pure, natural and wholesome diet, which is low in fat and cholesterol. They are advised to strictly avoid alcohol, salt, sweets, tobacco etc. A diet of natural foods, germinated wheat, raw root vegetables, whole wheat bread, cheese, butter, honey, and raw milk are recommended. Also, juice of fresh fruits and vegetables should be consumed in large quantities.

It is very important to get rid of stress so that you can lead a healthy and happy life. Ayurveda makes sure that you become stress free not only while you are undergoing treatment, but for the rest of your life as well.

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Repetitive Stress Injury / Computer Related Injury
In the last decade, hundreds of thousands of otherwise healthy individuals have developed a painful, debilitating and sometimes disabling condition known as Repetitive Stress Injury (RSI). Repetitive stress injuries are conditions caused by placing too much stress on a joint, and they vary in type and severity. Most RSIs are linked to the stress of repetitive motions at the computer or overuse injuries in sports. RSI in kids may occur from heavy computer or video game use, playing musical instruments, or the repetitive motion of sports like tennis. RSI affects the neck, upper back, shoulder, upper and lower arm, elbow, wrist or hand, or a combination of these areas, which leads either to impairment or to participation problems.

RSI is not a modern problem. In 1713 the Italian physician Bernardino Ramazzini recorded that the incessant hand movements of clerks caused “maladies”. In the 1840’s there was an epidemic of writers’ cramp among service clerks in London. The term RSI was introduced in Australia in the 1970’s with the introduction of visual display units in the workplace.

RSI is also known as Work Related Musculoskeletal Disorder (WRMSD), Cumulative Trauma Disorder (CTD), Computer Related Injury (CRI), Work Related Upper Limb Disorder (WRULD), and Occupational Overuse Syndrome (OOS).

The following professions / groups are prone to RSI:

  • Children
  • Check-out clerks
  • Computer Users
  • Hairdressers
  • Health Professionals: Surgeons, Dentists, Nurses, Massage Therapists
  • Housewives
  • Laboratory workers
  • Manual Labourers, Assembly Line Workers
  • Musicians
  • Sportspersons
  • Teachers

 Prevalence

  1. 15-25% of all computer users worldwide (both vocational and recreational) are estimated to have RSI. By this estimate, over 5 million Indian computer users (out of an estimated 28 million) may already be having RSI.
  2. In USA, in 1999, RSI accounted for 66% of all work-related illnesse.
  3. A survey of 500 software professionals at Hyderabad in 2000 revealed that over 50% had symptoms of established RSI.
  4. Preliminary results of our ongoing prospective study among over 35,000 Indian computer professionals (2001-2008) found that over 75% reported musculoskeletal symptoms. This is the largest study ever undertaken to identify the prevalence, causes and results of treatment of Computer Related RSI
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What are the causes of RSI?
RSI arises due to the following factors:

  • Prolonged repetitive, forceful, or awkward hand movements
  • Poor posture
  • "Static loading" or holding a posture which promotes muscle tension for a long period
  • Poor conditioning of the heart and lungs, and poor muscle endurance
  • Direct mechanical pressure on tissues
  • Cold work environment
  • Poorly fitting furniture
  • Basic inadequacies of keyboard, monitor and workstation design
  • Work organisational and psychosocial issues
A brief description of what causes RSI of the hand

Restricted blood flow is often the culprit. Lack of blood to the muscles, tendons and nerves can cause or aggravate a host of conditions, even, perhaps, arthritis. When you tense a muscle to just 50% of its ability, the blood flowing through the capillaries in the muscle can be completely shut off. Tensed muscle fibres pressure the capillaries thereby restricting the blood flow. As the muscle is continually tensed and no fresh blood is supplied, it switches from aerobic (with oxygen) to anaerobic (without oxygen) metabolism. This produces by-products such as lactic acid which can build up and cause cell damage and pain. Subsequently, the neighbouring muscles work harder to help carry the load, but because they are not designed to do the job as efficiently, those muscles fatigue (anaerobic) even faster.

Muscle tension, therefore, restricts blood flow and restricted blood flow causes more tension in other muscles. If the muscles are not allowed to relax, cellular degeneration can rapidly increase as a vicious cycle takes hold. The tensed muscles also pressure surrounding nerves which causes tingling, numbness, and more subsequent injury. In addition, the lack of blood increases the likelihood of degeneration and inflammation throughout the system and, of course, retards healing. And though the cycle may stop when you rest your hands, by the time you feel any symptoms, the damage has already started. Consequently, it will take less stress to bring on symptoms in the future.

Repeated tensing of the hand can cause the fibres of the tendons running through the carpal tunnel to separate or break. This causes friction between the tendon and its sheath (tenosynovium) and ultimately tendonitis. Tenosynovitis occurs when the sheath cannot properly lubricate the tendon it surrounds due the repetitive hand movement and the sheath itself becomes inflamed. Tightly gripping something for too long and forceful movements can lead to problems as well.

The two most common forms of RSI are Carpal Tunnel Syndrome and Tendon Injuries

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Should you be bothered about RSI?
  1. You could be at risk! It does not matter whether you are a week old in the industry or whether you are the CEO.
  2. RSI can seriously disrupt work and domestic life. There have been instances of employees being declared unfit and losing their jobs due to advanced and neglected RSI.
  3. RSI is not a compensable occupational illness in India, even though billions of dollars are spent worldwide annually as a consequence of RSI. There are no protective laws once workers get injured and are unable to work productively. The onus of RSI prevention is entirely on you.
  4. If RSI is not diagnosed and treated correctly and at an early stage, it can lead to a dreaded and crippling complication called Reflex Sympathetic Dystrophy.
 
Conditions that are the result of RSIs include:
  • Carpal tunnel syndrome: Swelling inside a narrow "tunnel" formed by bone and ligament in the wrist; the tunnel surrounds nerves that conduct sensory and motor impulses to and from the hand, leading to pain, tingling, and numbness
  • Cervical radiculopathy: Disc compression in the neck, often caused by repetitive cradling of a phone on the shoulder
  • Epicondylitis: Elbow soreness often known as "tennis elbow"
  • Ganglion cyst: Swelling or lump in the wrist resulting from jelly-like substance that has leaked from a joint or tendon sheath
  • Reflex Sympathetic Dystrophy: A condition characterized by dry, swollen hands and loss of muscle control; consistently painful.
  • Tendonitis: Tearing and inflammation of tendons connecting bones to muscles

You can help prevent RSI by taking preventive measures and redesigning your home computer environment.

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How can you avoid RSI?
In today's working environment the number of people working on PCs has increased rapidly. Computer power allows workers to increase productivity. However, this also tends to increase monotony, muscle strain and fatigue. In addition, computers make it possible to cut the work breaks and increase the pace of work leading to injuries, associated with computer use, becoming more pronounced.

We still do not know the full, long term consequences of a working lifetime on computers because computer technology has not yet been around long enough. What we do know is that users are suffering from a range of injuries associated with computer use and that they are all preventable

Computer related injuries cover a wide variety of health problems caused by or contributed to by computer usage. These can be broadly divided in to three groups.

1) Repetitive Strain Injury (RSI)
2) Back Problems
3) Eye Strain & Discomfort

Other Major Computer Related Injuries

Back Pain

Musculoskeletal back problems are the largest cause of disability amongst people of working age. 30% of adults become chronic sufferers. The highest incidences of back pain are found in workers whose jobs are entirely sedentary or entirely manual.

The human body is not designed to remain in a sedentary position for long periods of time. Unfortunately most visual display unit users do occupy sedentary positions for the majority of their working day. The sedentary position occupied whilst using a computer is not good for a users back and many office workers suffer from back pain. The problem is exacerbated if the user has a low general level of fitness.

There is a common misconception that it is only secretary’s and data entry clerks that suffer from back pain through sitting at their desk for too long. Back pain does not discriminate and there are sufferers throughout the office hierarchy.

Eye Strain & Discomfort

People who use visual display units (VDUs) for extended periods of time can suffer from tired eyes, discomfort and headaches. Staring at a computer screen can lead to a drop in blink rate causing dry eye. Undertaking more demanding tasks with your eyes can cause headaches and users may become aware of an eyesight problem they had not noticed before.

There is no evidence that using VDUs causes permanent damage to eyes. The impact of any serious injury caused at work creates a dramatically negative effect on the overall performance of the company itself. Pain experienced at work immediately affects both the morale and the productivity of employees. Loss of morale on the part of the injured employee in the workplace linked to working practices often creates a ripple effect throughout the company resulting in a discontented work force.

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Is there treatment in Ayurveda for RSI and CRI?
Ayurveda today, has found the answers to RSI and CRI related problems and an effective regimen has been designed to treat people suffering from RSI and CRI. Ayurveda Clinics has a comprehensive programme called Nava Tejas for RSI / CRI.

Treatment Includes: 

1.    Lifestyle corrections

2.    Internal herbal remedies

External Ayurvedic therapies like Abyangam, Pichu, Thalam, Pizhichil, Dhara, Kizhies (bundle massage with leaves, herbal powders and medicated rice), Sirovasthy, Greevavasthy, Netratarpanam etc. help to mitigate the effects of RSI and CRI. Advanced detoxifying Panchakarma therapies would also be suitably incorporated to prevent recurrence of these problems.

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