ROLE OF YOGIC PRACTICES IN THE MANAGEMENT OF PATIENTS WITH CHRONIC BACKACHE PROBLEMS WITH PARTICULAR REFERENCE TO ACTIVITY RELATED EFFICIENCY (1999-2003)

Dr. N. V. Vaidya MS, DNB (Ortho) ATLS (USA)
Dr. M.V.Bhole  Yogacharya ,MD (Physio

ABSTRACT:

A research project sanctioned by Indian system of homeopathic and medicine, Government of India, was undertaken by Lokmanya medical research centre titled “Role of Yogic Practices in the Management of Patients with chronic backache problems, with particular reference to activity related efficiency.” With an aim to access the impact of Yogic practices & techniques on Activity related efficiency. And to assess the impact of Yogic practices on relief of Backache in conservatively treated & surgically intervened backache patients.

Several educational lectures titled “Back School” were conducted for motivating workers and Simultaneous free checkup camps were organized for selecting patients in surrounding industrial units and government organisations.

950 patients were selected for the study, however in the subsequent two years there was 23.26% drop out was seen. So the actual sample size for the study was 729.Further for statistical convenience and for equal pairing between the study and control group the data was randomly reduced to 444 patients. Comprising of 196 patients each in conservative group and 26 each in surgically intervened group.

This study demonstrated that the problem assumes greater significance with industrial workers being increasingly prone to spinal problems. Back pain is perhaps the most common medical condition that cuts across all age groups and the leading cause of reduced work related efficiency and increased absenteeism. The symptoms complex appears to be most prevalent in individuals during their prime productive period. In addition, it was seen that the sedentary workers had more back problems. About 86.04% patients were suffering from backache in between moderate to more severe pain

The symptom appears to be increasing in frequency, despite our advancing knowledge of its pathogenesis and management. Like many research our study also proved that objective test (Viz radiological / Laboratory analysis) of back pain have limited value when it comes to final outcome of the treatment.

There are numerous studies that have indicated that inspite of inadequate fusion or progression of the existing pathology on X-rays or C.T.Scan; the patient may get excellent symptomatic relief. Our study goes in accordance with these findings in respect of relief from pain; symptomatic improvement and ultimate satisfaction of the patient had no correlation with radiological status.

Since one of the main objective of the study was to see the effect of different treatment modalities i.e. physiotherapy or yoga on backache, activities of daily life and work related efficiency.

Patients who were given yoga showed better symptomatic pain relief (as compared to control group) and a good change toward positive side when their personality was assessed.

Positive change was seen in personality factors viz. shift from emotionally unstable to stable, tensed to relaxed, group dependent to self sufficient and undisciplined to controlled. Further the patients who were given yoga showed better work related efficiency and reduced absenteeism as compared to those not given yoga.

This project also gave us a chance to highlight a need to establish yoga diagnosis to make yoga therapy to become complete in itself. Dr.Bhole’s approach of “Yoga Health Education and Practice (Abhyasa)” has become one of the important highlighting features of this project in this respect.

 

INTRODUCTION:

Back pain is perhaps the most common medical condition that cuts across all age groups. The symptoms complex appears to be most prevalent in individuals during their prime productive period. In addition, the symptom appears to be increasing in frequency, despite our advancing knowledge of its pathogenesis and management. Conventional treatment of back problems, whether through surgery or manipulation, treats only the symptoms. This leaves the underlying cause of back problems untreated - hence the saying "Once you have backache you always have backache.”

For ages, Yoga is looked upon as system of Spiritual culture, Education and Practice in India as well as abroad.  Kundalini Yoga belonging to “Prana Samyam Yogas” (popularly called as Hatha Yoga) gives emphasis on working in the region of the Vertebral Column (Merudanada) with a view to arouse the dormant spiritual energy called as Kundalini.  The practices are centered around the Vertebral column to achieve the desired goal and results.

Without psychophysical health and balance, one cannot proceed on spiritual lines. Therefore it was postulated that working in Kundalini yoga should take care of the vertebral column in a positive way. Thus, it was postulated and hypothesised that these techniques could and should prove useful in the Self-management for the patients of chronic backache.

This study has demonstrated that Yoga Health Education and Practice (Abhyasa) can offer significant help in relieving pain and can bring the symptomatic & clinical improvement. Leading to reduced absenteeism, improvement in work related efficiency and can perform activity of daily living easily and without pain.

 

OBJECTIVE:

LONG TERM

To investigate various determinants in patients with chronic backache problems who are conservatively and or surgically treated and to assess the impact of Yogic practices and approaches on activity related efficiency.

SHORT TERM

To study etiological factors and Psychological determinants in chronic backache patients, who are advised conservative or surgical line of treatment.

-   To assess the impact of Yogic practices and approaches if any on relief of backache in patients treated conservatively.

-  To evaluate the effects of Yogic practices and approaches if any on surgically intervened backache patients.

-To assess the level of efficiency in work life situation in chronic backache patients who were advised conservative treatment or surgically intervened group.

 

RESULTS:

 

In short the socio-economic observation were as follows, out of 444 patients, 259 (58.33%) were male & 185 (41.66%) were female. Majority of the backache patients i.e.63.96% belong to age group of 30-50 years a very active & working class people. All most 90.76%of the selected patients were married.85.36% patients were educated in Secondary to Graduation level. 66.44% patients belong to middle to higher middle class group. Most of the selected patients were engaged in light duty & sedentary type of work.

The radiological observations were as follows, 62.16% patients were having normal weight. 60.81% were having spondylosis & 39.18% reported with other backache related problems of them 54.05%of patients reported with lumbar pain & 32.65% patients with cervical pain. 69.14% patients were suffering from pain for more then a year. 86% patients were suffering from backache in between moderate to most severe pain.

A significant change is observed in Comparison of year I & III findings in radiological assessment of patients, about 253 (56%) patients were totally relieved from backache due to yoga.. further while assessment of clinical improvement, of the 444 patients examined in 282 patients (63.51%) Excellent improvement is seen. 127 (28.60%) patients show satisfactory improvement, indicating that 92.11% of patients have shown significant improvement.

41.67% patients show improvement in doing domestic activity, work related efficiency is improved in both groups, Sexual behavioral problem & absenteeism is reduced in Study group of conservatively & surgically treated groups.

Until now there is no universal answer to this problem of back pain, which has large impact on health sector both in terms of resources and finances involved. Due to absenteeism and reduced work related efficiency there is a large impact on the economic growth of corporate sector. We definitely at the end of this meticulously done study say that yoga can be a very important tool in management of back pain with special emphasis on improving work related efficiency.

To conclude we can say yoga is effective in reducing pain scale, improving activity of daily life & work related efficiency. Further reducing sexual behavioral problem & absenteeism in Study group of conservatively & surgically treated groups.

Acknowledgement: 

Dr.V.G.Vaidya, Dr. Meenal Rathod, Mr. Shrinivas Pattar,  Dr. Ram sakhalkar, Ms.Sangeeta Bhole, Dr. Yargattikar, Dr. Anupriya Salvi, Mrs. Uma. Mahajan and Mrs Veena Borkar.