Thursday, May 3, 2012

Lupus, stress and alternative health care

One of the hardest things to deal with when having lupus is stress.  It seems like the stress from the disease itself is hard enough, and then adding normal life stressors, or big stressful incidences, makes having lupus almost impossible to bear.  There are many things that can be done either at home or outside the home that can help us deal with our overwhelming stress.  Meditation, massage, support groups either online (here is mine or through the LFA, listening to or playing music, exercising, writing, or drawling.  Those are just a few, I hope you can find what works well for you and pass on your knowledge to help others.

Coping With Stress After a Lupus Diagnosis

What are the effects of stress on lupus symptoms? Find out how to cope with stress if you have lupus, to keep your symptoms from getting worse.

Medically reviewed by Pat F. Bass III, MD, MPH
If you've been diagnosed with lupus, you may have noticed that many of your symptoms are made worse by stress. Studies show that daily stress, stressful life events, depression, anger, and anxiety can all make the symptoms of systemic lupus worse.
Kathleen LaPlant of Eastham, Mass., was diagnosed with lupus four years ago. "I used to accept a certain amount of stress as a normal part of my life but I have learned that as my stress level builds up my lupus symptoms start to flare up," she says.
Living with a chronic disease like lupus is stressful. Lupus affects all physical, emotional, and social aspects of a person's life, and since lupus is most commonly diagnosed among women in their twenties and thirties, it affects them earlier and longer than most other chronic diseases.
In addition to emotional stress, physical stress such as surgery or infection can also make lupus symptoms worse. Long-term stress can cause a flare of lupus symptoms. This can be a vicious cycle because a lupus flare itself is known to increase stress.
How Does Stress Make Lupus Worse?
Lupus occurs when an abnormal immune system makes antibodies that attack normal cells in your body. Stress has been shown to decrease your body's control over your immune system. When the immune system gets too active, lupus symptoms get worse.

When you are under stress, your body releases a stress hormone called epinephrine. Research has found that epinephrine allows lupus antibodies to pass into areas of the brain that cause lupus symptoms like headache, confusion, and fatigue.
How Can You Cope With Lupus-Related Stress?
The following tips can help:
  • Know your limitations. Many people with lupus learn to limit their exposure to stress by avoiding situations that are likely to cause mental or physical stress. "I don't push myself like I used to. I have had to relearn what my emotional and physical limits are," says LaPlant.
  • Understand your disease. Learning to recognize the warning signs of a lupus flare can help you take steps to limit its effects. Common symptoms of a flare include being overtired, increased joint or muscle pain, and the development of a fever, rash, or headache.
  • Stick to a structured routine. Schedule your activities to include regular exercise, maintain a good diet, get plenty of rest, and see your doctor regularly. "I have learned that getting overtired increases my stress, so I keep to a routine. If I'm reading or watching TV and it's getting late, I turn off the lights and go to bed. No more late nights," LaPlant says.
  • Find the right stress management techniques. Relaxation techniques, like meditation or deep breathing, have been shown to be excellent methods of reducing stress. You may have to try several things before you find what works for you. "When I start to feel stressed, I relax by playing the piano for awhile. I have also found that keeping a journal helps. Activities that quiet my mind prevent stress buildup," says LaPlant.
  • Use your support system. Your support system might include family and friends, or a more structured lupus support group. The Lupus Foundation of America can help you find support groups in your area and can be a good resource for information and advice. The foundation provides support groups and patient education through a nationwide network of chapters and branches.
  • Be your own advocate. Studies show that people with lupus who take an active role in their treatment and learn about their disease experience fewer symptoms and require fewer doctor visits.
"Having a lupus diagnosis isn't always fun but you can learn to live with it. People should know that they need to be their own best advocate. Learn to listen to your body and learn how to take good care of yourself. You can go on leading a full life," LaPlant says. People with lupus can and do lead active and productive lives. Managing stress by making appropriate lifestyle changes, getting support, and understanding your disease can help.

Preventing a Lupus Flare

Flares are an unfortunate part of living with lupus, but lifestyle changes can reduce your risk of flares. Eating a healthy diet, exercising regularly, avoiding stress, and staying out of the sun will help.

Medically reviewed by Lindsey Marcellin, MD, MPH
One of the hardest things about living with systemic lupus is coping with unpredictability; if you have lupus you will go through periods when your disease seems to be quiet and periods when your it's active and your symptoms worsen. These periods of feeling worse are known as lupus flares. Although there is no way you or your doctor can completely predict or prevent a lupus flare, you can identify and try to avoid known triggers to reduce your risk of flares. Making appropriate lifestyle changes can also help to reduce your risk of getting hit with a lupus flare.
"Some of the common triggers in systemic lupus are sunlight, infections, and stress," says Anita Bishnoi, MD, a rheumatologist at Henry Ford Hospital in Detroit, Mich. Other common triggers include being overtired, starting or stopping medications, becoming pregnant, or undergoing any physical stress such as surgery or an injury.
Lupus Flares and Lifestyle Changes
"The best thing you can do is just live a healthy lifestyle," says Ellen Ginsler, MD, professor of medicine and chief of rheumatology at the State University of New York Downstate Medical Center, in Brooklyn, N.Y. "Stay active, eat a healthy diet, stay out of the sun, and don't smoke."

Other things you can do include:
  • Visiting your doctor regularly. To maintain your health, make sure you stick to scheduled doctor visits and let your doctor know if symptoms seem to be getting worse.
  • Getting plenty of rest. Manage your schedule to avoid becoming overtired or overworked.
  • Watching out for stress. Some stress is unavoidable and having a chronic disease is stressful in itself, but it's important for lupus patients to avoid putting themselves in stressful situations when possible. Learn some techniques that help you manage your stress. Meditation is an excellent way to reduce stress and decrease your risk for a lupus flare.
  • Avoiding physical stress. Regular exercise is a great way to stay strong and fit. If you need to undergo a procedure that will require recuperation time, schedule it when your lupus is not active. It's best to wait to get pregnant until your doctor clears you for it, for the same reason.
  • Avoiding sunlight whenever possible. If you have to be in the sun, use a sunscreen with a high sun protection factor (SPF 15 to 30) and wear protective clothing. Remember that halogen and florescent lights also give off ultraviolet light, so avoid prolonged exposure to them as well.
  • Taking your medications as prescribed. Never start or stop a medication without checking with your doctor first. Many medications, including some over-the-counter drugs, can trigger lupus flares. Ask your doctor or pharmacist for a list of these medications so that you can avoid them.
What Should You Do If You Sense a Lupus Flare Coming On?
Many people with lupus eventually become tuned into their body's rhythms enough to sense when a possible flare is coming. At these times you can rest and use stress management techniques, but once actual symptoms of a flare begin you shouldn't try to handle it on your own. Some common flare symptoms include:
  • Increased fatigue
  • New or worsening rash
  • Joint and muscle pain
  • Headache or dizziness
  • Stomach ache
  • Fever
  • Any new symptoms
When you think a flare is starting, it's best to see your doctor as soon as possible.
The best way to manage lupus and avoid flares is to learn as much about your disease as you can and to follow these simple guidelines: Listen to your body, learn what your own triggers and early warning signs are, stick to your lupus treatment plan, and take good care of yourself.

Controlling Stress Helps Fight Chronic Diseases Such As Lupus

ScienceDaily (Aug. 2, 2007) — Lupus is an autoimmune disease which produces antibodies causing injuries to the body’s cells and tissue. It makes the immune system go out of control and the organism attack healthy cells instead of the germs on them. This pathology, which affects more than 5 million people around the world, is more developed in women of fertile age between 15 and 44 years old.

A study conducted in the Department of Medicine at the University of Granada determined that daily stress (which occurs in circumstances of little importance but of high frequency) could exacerbate the symptoms of patients suffering from lupus. In other words, controlling the stress level of those suffering from this disease allows the determination of its negative effects, such as inexplicable loss of weight, feeling of fatigue, continuous fever or pain and inflammation in joints.
This study, carried out by Dr. Nuria Navarrete Navarrete and led by researchers Juan Jiménez Alonso and María Isabel Peralta Ramírez, aimed to check the effects of stress treatment in patients suffering from lupus and with high levels of stress. A team of psychologists from the University of Granada applied a therapy to fight stress in a group of 45 patients suffering from lupus to teach them how to manage their stress to reduce the negative effects of this disease.
Results showed that patients who received psychological therapy signifcantly reduced their levels of stress, anxiety and depression, achieving levels even lower than those of the general population. Furthermore, they significantly improved their quality of life both at a physical and psychological level and presented fewer skin and musclar skeletal symptoms, which usually appear in patients suffering from lupus.
Managing daily stress
Nuria Navarrete explains that lupus is a chronic disease whose course is unpredictable. Patients alternate periods of clinical stability with others in which there are symptoms and signs showing that the disease is active. In addition, there are certain factors such as stress which may cause crisis and, therefore, worsen the prognosis of the disease.
Daily stress is very common in patients suffering from lupus. Apart from the usual circumstances which produce anxiety in a healthy population, other effects include knowing that your body suffers from a chronic disease which is controllable but incurable and of uncertain prognosis that requires chronic treatment (in some cases for the rest of their life) and which have important secondary effects.
The results of this study highlighted the importance of dealing appropriately with patients suffering from lupus and, by extension, from other chronic diseases. “According to our results, attention on other psychological aspects is essential to achieve an effective global treatment of the patient”, says Navarrete.
In other words, the treatment of daily stress, together with the usual pharmacological treatment, is a useful weapon when treating patients suffering from lupus. “We think that this treatment could be useful from the moment in which the disease is diagnosed, as patients may require help to manage their stress and minimise its negative effects,” says researcher Navarrete.
Part of the results of this study were published in the journals “Psychosomatic Medicine” and “Revista Clínica Española”.

Massage Therapy as a Lupus Treatment Tool

From Jeri Jewett-Tennant, MPH, former Guide Health's Disease and Condition content is reviewed by our Medical Review Board
Description: Massage Therapy as a Lupus Treatment Tool
Mark Webber of Australia and Red Bull Racing receives a massage from his personal trainer Roger Cleary following qualifying for the Bahrain Formula One Grand Prix at the Bahrain International Circuit on April 5, 2008 in Sakhir, Bahrain.
Where one method of treating systemic lupus erythematosus will work for one individual, it may have little affect on another. Thus it is common for someone suffering from lupus to explore various ways to treat the symptoms of the disease, notably pain caused by inflammation, a hallmark of the disease.
Some methods, like massage therapy, are considered complementary and alternative medicines (CAM), defined as a group of diverse medical and health care systems, practices and products that are not presently considered a part of conventional medicine. These approaches come as novel to some and completely familiar to others. Massage therapy, for example, is a time-honored method of pain and stress relief.
It is important to note, however, that the Lupus Foundation of America does not recommend medications, products or methods not approved by the U.S. Food and Drug Administration or the American College of Rheumatology, further stating on its web site, “remedies that have not undergone the scrutiny of scientific investigation, lack the crucial information and data necessary to enable physicians to make sound recommendations regarding substances.”
Before exploring any new treatment option, then, it is best to talk with your healthcare provider.

Massage Therapy

The use of massage therapy as pain management tool continues to gain popularity in the United States. One survey found that 5 percent of 31,000 participants had used massage therapy in the previous year and nearly 10 percent had engaged in therapy at least once in their life. And, increasingly, healthcare providers are discussing massage therapy with their patients as a way to complement their conventional medical treatment (another survey found that 63 percent of massage therapists received referrals from healthcare professionals).
There are dozens of massage therapy methods, but all follow the same basic principles and practices: pressing, rubbing, and manipulating the body’s muscles and soft tissues, in an effort to relax the patient and decrease his or her physical pain. This is achieved by increasing the flow of blood and oxygen to the massaged areas, warming and relaxing them.
Massage therapy is performed by a licensed therapist who may use a number of different techniques. Long strokes and friction on the muscles is the hallmark of a therapist who prefers Swedish massage. Patterns and deep pressure applied by individual fingers to the knotted muscles and muscle layers is part of a therapist’s deep tissue arsenal. And a therapist who applies varying, rhythmic pressure from the fingers to zones on the body corresponding with the body’s vital flow of energy is engaging in shiatsu massage.

The Role of the Massage Therapist

Professionals who provide massages to patients are called massage therapists. They work in a variety of settings, from office locations to house calls and workplace visits.
If you are considering massage therapy, chose a licensed and trained practitioner. Your healthcare provider should be able to refer one to you. And in some cases, conventional medical professionals might also be licensed to perform massage therapy.
Most therapists attend a school or training program and, as stated, a fair number of massage therapists also practice medicine in another capacity, such as a nurse. Study typically covers subjects such as anatomy and physiology, kinesiology, therapeutic evaluation, massage techniques, first aid, legal issues, and hands-on practice.

Treatment, Benefits and Risk

A standard massage therapy session typically lasts a half hour to an hour, but can be shorter or longer. The atmosphere should be relaxed and the patient comfortable.
The therapist may use oil or powder to reduce friction on the skin and employ ice, heat and fragrances as part of the therapy. You should feel free to discuss the techniques he or she will use prior to the therapy session.
And while there are few risks and side effects associated with massage therapy – temporary discomfort, bruising, swelling or an allergic reaction to massage oils are the most common – there are some people who should not receive massage therapy, emphasizing the need to talk to your healthcare professional prior to starting any regime. Those that should not receive massage therapy – or should consult their doctor before getting massage therapy – include:

The Benefits of Exercise in Lupus Management

Exercise can improve your quality of life when you have lupus by helping to prevent fatigue. But be aware of your limitations and how exercise may specifically affect your condition.

Medically reviewed by Lindsey Marcellin, MD, MPH
If you have systemic lupus, one of the best things you can do to manage the disease is to become as physically fit as possible.
Studies show that physical exercise can lower the risk of heart disease in lupus patients and is also beneficial in decreasing the risk of osteoporosis. Exercise can also be helpful in managing fatigue and pain and improving overall quality of life for people with lupus.
How Does Exercise Help Lupus Patients?
Here are a few ways that exercise can benefit people with lupus:
  • Fatigue. "Being physically active helps prevent fatigue, a major symptom of lupus," says Amita Bishnoi, MD, a rheumatologist who treats lupus patients at Henry Ford Hospital in Detroit. Studies have shown that lupus patients who participate in an aerobic exercise program are able to reduce their level of fatigue and have more energy throughout the day.
  • Cardiovascular benefits. Heart disease is the leading cause of death for people with lupus. If you have lupus, you're at risk of getting heart disease up to 20 years sooner than the general population. Regular exercise, especially aerobic exercise like walking or biking, can decrease your risk of heart disease.
  • Obesity. Obesity is a common problem in people with lupus. Obesity can increase your level of pain, put more strain on inflamed joints, increase your risk of heart disease, and make your fatigue worse.
  • Osteoporosis. Women with lupus are especially vulnerable to osteoporosis. Loss of bone mass has been reported to be as high as 46 percent in these patients. Weight-bearing physical exercise is an important part of osteoporosis prevention.
  • Sleep disturbances. People with lupus have more problems sleeping than the general population. This can add to lupus fatigue and stress. Many studies show that aerobic exercise is one of the best ways to improve sleep.
  • Quality of life. Because lupus is a chronic and unpredictable disease, it can produce stress and anxiety. Aerobic exercise has been found to reduce depression in people with lupus and improve their overall sense of well-being.
What Kinds of Exercise Work Best?
"Exercise regimens that focus on muscle strengthening and improving endurance are best. Some examples are swimming, walking, low impact aerobics, and bicycling," advises Dr. Bishnoi.
  • Muscle training. Muscle strengthening exercises include isometric exercises where you contract your muscles without movement and and isotonic exercises where you include movement, as in weight training.
  • Be flexible. Flexibility exercises are important in maintaining the full range of motion of your joints. Exercises that stretch your muscles and increase flexibility include Pilates and yoga.
  • Movement therapies. These exercises combine physical movement and techniques to calm the mind. They have been shown to increase flexibly and help relieve pain. Yoga can also be included here, as well as tai chi and qigong.
  • Aerobic exercise. These are activities that increase your heart rate and help build endurance. For aerobic exercise to benefit your heart, you want to get up to about 30 to 50 minutes of exercise at least three times per week.
Avoiding Exercise Risks
Each person with lupus will have different levels of exercise ability. "It may also be appropriate if you are unsure what type of exercise is best for you to consider a consultation with a physical therapist," says Bishnoi.

Another option is to take part in an organized exercise program. This can be a good way to socialize, become active in your treatment, and get support and encouragement. People who exercise in groups often see better results and stay with their exercise program longer.
The level of exercise that's safe for you may change if your lupus symptoms become more active. If you have a flare of your lupus symptoms, you may need to reduce or stop your exercise activity to prevent damage to inflamed joints and muscles and to avoid fatigue. Although exercise can help prevent fatigue, too much exercise can trigger a lupus flare-up. You'll need to find the right balance and avoid pushing yourself too hard. Always check with your doctor to see what level of exercise is best for you.

Meditation for Combating Fatigue and Stress
Nanette Greene hasn’t always been a Zen guru. “I became interested in Eastern philosophies in my twenties, but didn’t know much about it,” says the Easton, Conn., yoga and meditation instructor, now 44. But then one day her lupus flared badly—and a happy accident occurred. She was in too much pain to see her own doctor in New York, so she visited a local doc who ended up teaching her how to meditate.
“As I lay flat on the floor, he showed me how to visualize the sun moving over me, healing me,” says Greene, who admits she was a little lost at first. But she repeated the routine every day and, ultimately, her symptoms subsided.
Best of all, meditation profoundly changed her outlook on life. “I felt a shift in the way I perceived my own healing. I learned to treat my body with compassion,” she says.
Mainstreaming Meditation
Nanette is not alone. Many people with chronic illnesses are finding that meditation helps them cope better. And many more doctors are prescribing the ancient Eastern practice.
“It is part of a holistic approach to treating patients, where we address both their physical and mental states,” says Oscar Gluck, M.D., of the Arizona Rheumatology Center in Phoenix, Ariz. “Meditation is extremely useful in treating chronic illness because it can decrease stress levels and increase the level of endorphins.”
Research conducted at the Center for Women’s Healthcare, at Weill Medical College of Cornell University, has found that endorphins encourage white blood cells, those foot soldiers of the immune system, to enter the blood stream. Endorphins also can improve a patient’s perception of pain.
“There’s a strong association between the perception of pain and the way [lupus] occurs. Meditation gives patients some control over their emotional response, which can alleviate symptoms like depression, anxiety and insomnia,” Gluck says.
There are physical benefits, too. The Mind/Body Medical Institute at Harvard University recently reported a 36 percent drop in clinic visits by patients with chronic pain who practiced meditation for at least two years.
Learning to Let Go
Meditation was first studied in the U.S. during the 1960s. One of its investigators was Herbert Benson, founder of Mind/Body Medical Institute. In his book Relaxation Response, Benson studied our instinctive response to stress—that panicky decision to battle an enemy or run away (think “fight or flight”). His assertion: when practiced properly over time, meditation can help quiet the savage human beast.
Though times have changed, our response patterns haven’t. Instead of fighting wild animals and natural disasters, we stress over deadlines and rush-hour traffic.
For people with lupus, long-term stress can instigate or exacerbate a flare. This is a dangerous cycle, because lupus flares can also raise a person’s stress levels. For some people, meditation can help get them off that roller coaster.
“Meditation is the act of experiencing your feelings as they come, then letting them go,” says Greene. “You realize that even pain is impermanent, and that initial panic dissipates.”
Living in the Present Tense
So the goal is clear: free your mind and the body will follow. But it often takes practice to engage your spiritual side and kick negativity to the curb.
The first rule of thumb: forget about yesterday—and tomorrow, for that matter—and focus on the here and now.
“Most of the time, our brains are like a tumultuous waterfall—always worrying and obsessing,” explains Joe Arak, a meditation instructor at the Shambhala Meditation Center in Hadley, Mass. “Meditation helps to quiet that mental overactivity.”
Meditation should be a peaceful experience. But, believe it or not, some novices get stressed out over it.
“People become obsessed with doing it right,” says Greene, who offers meditation workshops at the LFA, Connecticut Chapter, where she also serves as program chair.
Her advice: “Don’t think of it as meditation. A lot of times I just call it breathing, because you’re learning to become aware of your body’s natural rhythms, including inhaling and exhaling.”
“It definitely takes focus and dedication,” adds Arak. “Think of meditation like going to the gym or brushing your teeth. You might see results right away, but it’s not meant to be a quick fix. The real benefits come over time.”
Playing Devil’s Advocate
Still, it’s important to note that most of the evidence supporting meditation is anecdotal—and it has its skeptics.
“We still don’t understand a whole lot about the mind-body connection,” says Neal Birnbaum, M.D., of San Francisco–based Pacific Rheumatology Associates. “Alternative therapies may help people, but patients should be careful when they’re committing to a new program.” He recommends setting a timeframe, whether six weeks or six months, so you can judge for yourself whether meditation is right for you.
And, of course, meditation is just one possible element of a well-rounded self-care plan.
“I strongly believe in combining Eastern and Western approaches. I still have flares, and traditional medicine helps cure the symptoms,” says Greene, who strongly believes that meditation has helped lessen her symptoms—and given her a new attitude.
“I’ve learned that I am not my illness,” she says. “I now treat myself with compassion and joy, rather than fear and anxiety.”
Finding Your Inner Mindfulness
Meditation is easy to learn—and most anyone can do it. But some experts suggest that first-timers work with an instructor.
If you prefer to go it alone, here are a few tips that may help:
RSVP for enlightenment. Reserve a good time to meditate, so you won’t be worrying about other appointments and obligations. Find a quiet space where you can be alone. And sit however you feel most comfortable: cross-legged, on a chair or on a cushion.
Take baby steps. Begin by focusing on your breathing. Concentrate on inhaling, filling your nose and belly. Then exhale, and feel your body relax. Start with three minutes of breathing each day for one week. Increase to at least 10 minutes a day.
Let distractions happen. It’s normal for your mind to wander. If you lose your concentration, don’t judge yourself. Just take note of the distraction, and return to your rhythmic breathing. If you get frustrated with frequent distractions, consider meditating with an audiotape or DVD. “Mindfulness Meditation” by Jon Kabat-Zinn comes highly recommended. You also can search the Internet to find information on various methods of meditation.
Be consistent. Try to practice at the same time every day, and don’t give up after a couple of tries. Consistency is an important part of discipline.

Imagine Your Way to Peace

Use guided imagery to relieve stress and promote relaxation.
A little stress is good because it keeps us sharp, focused, and alive. Unfortunately, more is not better. Chronic stress depletes us and can negatively impact our health. If you are experiencing chronic, overwhelming stress, you know how vicious the cycle can be—and how difficult it is to hop off the stress merry-go-round. It’s frustrating when people tell you, “Don’t stress,” or “Just relax” because it’s not that simple—but what if it could be?
Our brain perceives whatever we feed it—real or imagined—as real, and our body actually responds physiologically to the images that play in our brain. Guided imagery is a simple relaxation technique that can help you achieve a relaxed and focused state. It turns out that daydreaming might be good for us after all.
What is Guided Imagery?
The mind-body connection has been well documented. Guided imagery is a technique that utilizes all of your senses to help you engage in a vivid imagery exercise that allows you to feel like you are experiencing something simply by imagining it.
Guided imagery is different than daydreaming because it is more directed and focused. In fact, there are several guided programs and audios available to navigate people through guided imagery sessions. During a guided imagery session, you may imagine yourself in a place—and then imagine the sights, sounds, smells, feelings, and even taste you would experience in such a location.
Guided imagery can be used for many purposes. Athletes use it to visualize the desired outcome of their performance. It is also helpful for overcoming phobias (such as the fear of public speaking) or achieving goals (such as weight loss). Guided imagery is an excellent tool for stress relief and has been shown to reduce blood pressure and promote relaxation. Imagining yourself in a peaceful setting can help you to relax and de-stress.
Using Guided Imagery
Guided imagery is safe, effective, and easy to learn. You may choose to use an audio program or engage the help of a therapist or instructor, but you can easily follow your own script to create your own peaceful session.
1. Set aside 10-15 minutes of uninterrupted time in a place where you’ll be free from distraction.
2. Get into a comfortable position, either sitting or lying down.
3. Take a few deep, cleansing breaths.
4. Begin to envision yourself in a peaceful, relaxed setting. For some people, this might be a tropical beach and for others, it could be sitting around a campfire telling stories. Choose what feels peaceful and wonderful to you.

5. As you begin to envision your peaceful place, start to engage all of your senses to complete the picture. If you’re at the beach, you might hear the sound of the surf, feel the sand in your toes, smell the ocean breeze, and taste the tropical fruit. Or, if you’re snuggled into a winter cabin, perhaps you can feel the warmth of the fire, hear the crackling logs, and taste the sweet hot chocolate. Get specific as you imagine your scene. Focus on the details.
6. Stay in your “happy place” as long as you wish. Relax and sink into the peaceful feelings your imagery evokes.

Acupuncture: A Treatment Tool for Lupus?

From Jeri Jewett-Tennant, MPH, former Guide Health's Disease and Condition content is reviewed by our Medical Review Board
Description: Acupuncture: A Treatment Tool for Lupus?
Acupuncture is an ancient form of treatment to alleviate pain.
Getty Images
Treatments for systemic lupus erythematosus vary by patient and by healthcare practitioner, as one method can work well for one individual and have little affect on another. So, it is not uncommon for someone to explore various ways to treat her symptoms -- especially pain caused by inflammation, a hallmark of the disease.
Some of these methods, such as acupuncture, are considered part of complementary and alternative medicine (CAM). They have been used by various cultures for many generations. CAM is defined as a group of diverse medical and healthcare systems, practices and products that are not presently considered a part of conventional medicine.
It is important to note, however, that the Lupus Foundation of America does not recommend medications, products or methods not approved by the Food and Drug Administration or the American College of Rheumatology, further stating on its website, “remedies that have not undergone the scrutiny of scientific investigation lack the crucial information and data necessary to enable physicians to make sound recommendations regarding substances.”
Before exploring any new treatment option, it is best to talk with your healthcare provider.


Many Westerners’ first encounter with acupuncture is by way of popular culture. But the actual discipline and the seriousness with which professional practitioners approach the method is very serious.
The practice originated in China more than 2,000 years ago and continues to grow in popularity in the United States and abroad. Although most equate acupuncture with the insertion of hair-thin needles into the skin, the term actually describes many procedures involving the stimulation of specific points on the body (acupoints) to help improve health and well-being.
Some of those techniques include stimulation with heated herbs, magnets, mild electrical current, manual pressure (acupressure), and low-frequency lasers.
Acupuncture is based on the ancient Chinese theory that an essential life energy called qi (pronounced "chee") flows through the body along invisible channels, called meridians. When the flow is blocked or out of balance, illness or pain results. Stimulation of acupoints is thought to correct the flow and restore balance, optimize health, and block pain.
The science behind acupuncture suggests that acupuncture may be associated with neurotransmitter activity in the muscles, spinal cord and brain that trigger the body's release of endorphins ("feel good" chemicals.)
An interesting side note: Researchers studying acupuncture's affect on patients with migraine headaches discovered that patients who underwent clinical acupuncture and those who underwent "sham acupuncture," in which needles are placed randomly on the body, reported similar outcomes. Both groups reported a reduction in headaches. Those researchers attributed the outcome to "nonspecific physiological effects of needling, to a powerful placebo effect, or to a combination of both." The research was conducted by the Centre for Complementary Medicine Research and reported in the May 2005 issue of the Journal of the American Medical Association.


Research studies have shown that acupuncture can reduce nausea and vomiting after surgery and chemotherapy, as well as relieve pain, particularly that associated with osteoarthritis and fibromyalgia. It also reportedly helps ease depression and irritable bowel syndrome connected to arthritis.
Important to lupus patients, however, is a 1997 meta-analysis of 17 studies that discovered that acupuncture seems to be less effective at relieving pain associated with inflammatory diseases such as lupus, rheumatoid arthritis, and local and progressive systemic scleroderma.

Get the Right Help

On the flip side, the body of research on the topic suggests that acupuncture relieves pain for some. If acupuncture is something you're interested in trying, speak with your healthcare provider before starting treatment. It's important, too, that you seek acupuncture treatment from a professional; the treatment is safest when performed by a reputable provider using sterile, disposable needles.
The American Board of Medical Acupuncture certifies clinician acupuncturists, and the National Certification Commission for Acupuncture and Oriental Medicine certifies non-clinician acupuncturists. Certification comprises passing a standardized exam and a demonstration of adequate training.
The FDA regulates acupuncture needles for use by licensed practitioners, requiring that needles be manufactured and labeled according to certain standards. Needles must be sterile, non-toxic, and labeled for single use by qualified practitioners only.

Getting Treated

Acupuncture needles are metallic, solid, and very thin. Those that have undergone acupuncture report experiencing little or no pain from needle insertion. Others report feeling energized during the procedure; still others say they are calmed and relaxed. Your experience will likely vary from that of a friend.
Most complications related to acupuncture are due to inadequate sterilization of needles and from improper delivery of treatments. Practitioners should use a new set of disposable needles taken from a sealed package for each patient, and they should swab treatment sites with alcohol before inserting needles. Make sure your practitioner follows these guidelines.
Your healthcare provider should be able to refer you to a licensed practitioner. If not, websites and professional associations can direct you to an appropriate acupuncturist. Try the American Academy of Medical Acupuncture website. It has a wonderful search function that allows you to find a skilled medical acupuncturist in your area.
Safety Guidelines for Acupuncture
Acupuncture is generally safe, but as with any therapy, you should be cautious. The following guidelines are adapted from the Arthritis Foundation's Guide to Alternative Therapies:
-Get a diagnosis from a medical doctor before undergoing acupuncture to make sure you don't have a condition requiring prompt medical attention.
- Don't stop your medications without consulting your doctor. Acupuncture can work with, rather than instead of, conventional medicine.
- Tell the acupuncturist about all health conditions, including pregnancy. Stimulating certain acupuncture points, particularly those on or near the abdomen, can trigger uterine contractions and could induce premature labour and possibly miscarriage.
- Tell the acupuncturist about all medications you are taking. Some herbs, nonsteroidal anti-inflammatory drugs, and, of course, anticoagulants, can cause you to bleed easily even when thin acupuncture needles are inserted. You should also consult your physician before having acupuncture is you are on such medication.
- Don't take muscle relaxants, tranquillisers, or painkillers right before acupuncture because acupuncture can intensify the effects of these drugs.
- Because you have a compromised immune system, be sure the acupuncturist uses disposable needles.
- Electrical stimulation of acupuncture needles, which is sometimes used to stimulate acupoints, could cause problems for people with pacemakers (as can magnets).
- If you have diabetes, the practitioner should insert needles into your limbs only with extreme caution. Even a small skin cut in a person with diabetic neuropathy can turn into a severe infection.
- Tell the practitioner right away if you experience pain. Acupuncture shouldn't hurt after a possible initial sting with the needle's insertion.
- Do not automatically take herbs offered by traditional Chinese medicine practitioners. They can interact with prescription drugs.
Taken from "New Hope for People with Lupus," used with permission.
Finding an Acupuncturist
Ask your doctor for a referral to a practitioner or contact one of the national acupuncture organisations for a referral. Check if they are certified by the national acupuncture organisation, e.g. National Certification Commission for Acupuncture and Oriental Medicine in the US.
For a list of accredited acupuncturists, contact the following organisations:
National Certification Commission for Acupuncture and Oriental Medicine
Phone: (703) 548-9004
Website -
American Academy of Medical Acupuncture
This organisation offers a list of medical doctors and osteopathic physicians.
Phone: (800) 521-2262
Website -
British Medical Acupuncture Society
Website -
British Acupuncture Council
Website -

Cognitive Behavioral Therapy Benefits People with Lupus

What is the topic?

Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that explores the role of thinking in people’s well-being. One previous study investigated the effects of this treatment on stress in people with lupus. That study found that CBT, along with biofeedback, reduced pain and improved coping in people with lupus for up to nine months after the study was conducted.

What did the researchers hope to learn?

The researchers hoped to learn whether CBT could help people with lupus cope with stress, anxiety, and depression, all of which may co-occur with a chronic illness. They wanted to see if they could confirm the results of the previous study and whether benefits could be seen over a longer time period. 

Who was studied?

45 people with lupus, who were found to have a high level of chronic stress by use of a measurement called the Cohen Perceived Stress Scale, participated. The study was conducted at the Systemic Disease Unit in Granada, Spain. People were not included in the study if they were seen for less than a year, or if they were unable to read and write, attend therapy sessions, or receive treatment for a psychiatric condition.   

How was the study conducted?

The lupus patients were interviewed and asked to complete the Perceived Stress Questionnaire to rate their daily stress level. The people with the highest stress levels were randomly divided into two groups. 
This study lasted 15 months, during which time one group received CBT and the other group (called the control group) were not offered any special intervention. Patients in the control group received standard medical care, as well as encouragement to participate in moderate exercise, eat a balanced diet, and get plenty of rest. The therapy group had CBT sessions lasting 1.5 – 2 hours once a week for 10 weeks. About six and nine months later, patients in the therapy group participated in “booster sessions” in order to strengthen their newly learned psychological skills.  

The patients were studied at the time of enrollment, as well as at 3, 9, and 15 months later, with measures of disease activity, psychological parameters, and quality of life.

What did the researchers find?

People in the therapy group improved in both the perception of stress and vulnerability to stress, as compared to the control group, at months 3, 9, and 15.
People in the therapy group also had lower levels of anxiety and depression at months 3 and 15 than they did upon entry into the study, but this was not the case for people in the control group.

People in the therapy group showed improvement in multiple measures of quality of life at some point throughout the study period.

Lupus disease activity (measured by the SLEDAI) was not different in people in the CBT group compared to the control group. Similarly, there was no difference in the number of flares in either group during the year after therapy compared to the year before therapy.

People in both groups were similar in age at lupus diagnosis, duration of illness, level of education, gender, and lupus manifestations.  

What were the limitations of the study?

The number of people who participated in the study was small, which may somewhat limit the applicability of the results. Also, the time at which the “booster” therapy sessions were initiated, as well as their frequency, may not have been ideal in order to optimally observe effects of the therapy sessions, especially after the 10 therapy sessions were complete. 

Editor’s note: “This study suggests the possibility that this type of psychotherapy may be helpful to people with chronic stress, but it is still possible that the extra time spent with the patients in therapy or the special relationships developed with the study doctors were what actually made the difference in their lives.”

What do the results mean for you?

This study suggests that CBT might reduce stress, anxiety, and depression, and improve the quality of life, in people with lupus.

Lupus - Managing Stress & Depression

By Melba Newsome
Reviewed by Jennifer Monti, MD, MPH
Extreme fatigue. An adverse reaction to the sun. Constant joint pain. Living with lupus means never knowing precisely what the day will bring. The unpredictability of the disease can cause depression and other mental health problems, such as stress and anxiety. This is known as reactive depression. Chemical or clinical depression is characterized by feelings of hopelessness and loss of interest in things you once enjoyed. It is a debilitating and prolonged state caused by a chemical imbalance in the brain and requires prompt professional attention.
“Everyone who has a chronic disease experiences depression of one degree or another,” says Patty Dunn, who has lived with lupus for 40 years and has learned ways to cope with the inevitable depression and sadness. Studies have found that between 15 and 60 percent of people with a chronic illness will experience clinical depression. The good news is that there are effective treatments and lifestyle changes that can help combat depression and the symptoms.

Join a Support Group

Whether it is in-person or virtual (online), a support group can help beat back feelings of loneliness and isolation by connecting you with others who share your diagnosis. Support groups are also a great resource for learning coping skills and finding out what’s new in research and treatment. Since joining the Piedmont chapter of the Lupus Foundation of America nearly a decade ago, Patty has shared her experience and strength with hundreds of lupus patients and drawn upon their support during her rough patches.

Be Open With Friends and Family

An erratic disease for which there is no cure can be a strain on any relationship. Many lupus symptoms are not readily visible, so it’s up to you to tell your loved ones how and what you are feeling and what they should expect. Involve them in your care, and tell them what they can do to help.

Meditate on It

Recent studies have found that meditation is a powerful tool for treating depression. It also decreases stress levels and increases the level of endorphins, chemicals in the brain that causes feelings of euphoria. Best of all, meditation can be done almost anywhere at any time.

Be Wary of Drug Side Effects

Corticosteroids are prescribed to counter lupus-related inflammation, but they can also make you more emotional and increase the risk of depression.

Seek Counseling

A recent study found that cognitive behavioral therapy (CBT)—a type of psychotherapy that explores the role of thinking in people’s well-being—is an effective treatment for lupus patients with high stress levels. CBT significantly reduces the incidence of psychological disorders associated with lupus and helps to improve and maintain quality of life. Psychotherapy, alone or in conjunction with medication, can help you better cope with your emotions and illness.

Consider Medication

Antidepressants can help ease the effects of depression, whereas anti-anxiety medicines reduce anxious and fearful feelings. Ask your doctor if they may be right for you. These medications have side effects and may heighten symptoms associated with lupus, such as increased dryness in the mucous membranes. Keep your doctor informed about any physical changes you notice.

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