Arthritis - treating arthritis with yoga

I have a personal interest in arthritis.

I developed OA (osteoarthritis) thumb and it's a good, although painful way to understand more about a health condition.

After I inadvertly overstretched my right wrist, I developed a sore thumb joint causing wrist pain which refused to get better. I resting the joint, cooled it, was careful with it and supporting it, but it continued to feel sore as though bruised. I had weakness in gripping and twisting movements and aching after using my hand. Most annoying was the nagging hot pain in my wrist, noticeable at night. In my yoga practice – I had great difficulty managing large flexion through the wrist in upward facing dog pose, ūrdhva mukha śvānāsana, and to some extent in downward facing dog pose, adhomukha śvānāsana.

So here are some steps. If you have osteoarthritis in your hands, do look through, try them out and see if they work for you.

Step 1 - know something about the condition

I found the book Yoga for Arthritis by Loren Fishman and Ellen Saltenstall helpful. There's a description of arthritis developing through a process of uneven distribution of pressure through the joint. This disrupts the cartilage and the bone substance beneath it. This seemed likely in my case. The cartilage is undergoing a constant process of degeneration and repair but as arthritis continues, the repair can’t keep up with the degeneration and the underlying bone with increasing pressure reacts by laying down new deposits in the area of greatest stress. "Unfortunately, as the cartilage becomes thinner the underlying bone changes shape, altering still further the patterns of stress for which the joint was originally so well adapted.” Yoga for Arthritis.

I had experienced the inflammation of my carpometacarpal joint for most of a year so I decided I had nothing to lose in finding a new strategy as it wasn't getting better on its own.

Step 2 - look at the major symptom The most disturbing symptom was the heat and discomfort in my wrist due to inflammation in the joint. Cooling the joint gave short term relief but didn't solve it. I decided to change the level of my internal inflammation and took a course of turmeric capsules. I found this helpful in reducing some but not all of the inflammatory pain. (It may be advisable to see a nutrition therapist or medical herbalist for investigating this and also look at the option of altering diet to reduce foods causing inflammatory responses.)

Step 3 - careful observation

I carefully observed both my hands looking for differences in normal positioning and range of movement. I wanted to work out why I had OA thumb in one hand and not the other and to see if this was related to joint positioning. I could see differences in my hands for both position and movement. The hand with OA was tighter around the thumb joint, with slightly less range of movement and ability to place my hand into a completely flat plane – probably relating to being right-handed and using it frequently, gripping all kinds of objects, typically a pen.

Step 4 - set up a manageable practice.

Intelligently choose postures/movement to reduce symptoms and monitor and adjust over time. I decided to use stretching through the joint. The process of repair of cartilage is ongoing but is reduced by damage to cartilage with reduction in joint space eventually getting caught in a spiral of bone changes beneath the cartilage. My course of action was to create more space in the joint.

The Yoga for Arthritis book gave me initial ideas and I developed these through a process of adjustment and personal experience of the effects. I began regularly stretching the thumb out to create more space between the first metacarpal bone of the thumb and the trapezium bone of the wrist. I also stretched my hand in the thumb area to achieve similar ranges of movement in both hands. The differences were not big between hands/thumbs, but I think were significant. Some of this stretching felt uncomfortable – not painful but pressing to the limit of the thumb movement. After a time (thinking back this was around 6 weeks), I felt that the pain was diminishing and the inflammation was reducing. This was a big step forward given that I’d had this heat and pain in my thumb for a year.

Step 5 - Reduce the underlying causes I gradually built up strength in my hand, wrist and arm through yoga postures, specific movement and also just by doing the tasks I’d stopped doing before. Twisting was a movement which used to be very painful. Strengthening the joint area is protective in supporting the joint when weight bearing through it.

Now I regularly stretch my hands, wrists and in particular this thumb joint as on-going maintenance. Part of the OA thumb and reduced movement was an affect into the muscles of my arm and stiffness in the wrist overall. On-going maintenance covers massage of the arm muscles below the elbow and extending wrist range of movement. It includes developing and maintaining wrist strength through non-weight bearing movement. This has allowed me now to place my arms where the wrist is in full flexion, upward facing dog pose, ūrdhva mukha śvānāsana, as long as I don't overdo it.

Image credit Maartenv, CC BY-SA 3.0 https://creativecommons.org/licenses/by-sa/3.0, via Wikimedia Commons