The lifestyles people live largely influences the health domain of the US healthcare system. According to Fahey (2018), Chronic pain can be defined as pain that exceeds three months. Chronic pain is a devastating public health issue that has affected over 1.5 billion people globally (Fahey, 2018). In fact, more than half of this population end up disabled. In the US, chronic pain has also had adverse economic impacts where treatment costs have reached $635 billion (Fahey, 2018). Traditionally, according to Lee et al. (2014), chronic pain management involved “prescription medications or provider-based, behavioral, or interventional procedures which are often ineffective, may be costly, and can be associated with undesirable side effects” (p.21). Likewise, with the increasing concerns opioid crisis, pain management treatment plants are evolving to nonpharmacologic therapies. Facilities are using more patient-centered models that enhance the biopsychosocial approach in pain management. Among the new approaches taken by practitioners include mind-body medicine (complementary and integrative medicine (CIM) therapies), which has encouraged the patients to take an active role in their treatment (Rudaz et al., 2017). Mind/body medicine “focuses on the interactions among the brain, mind, body, and behavior, and the powerful ways in which emotional, mental, social, spiritual, and behavioral factors can directly affect health” (Rudaz et al., 2017 p.27). This enhances an individual’s ability to participate in self-care. The article aims at proposing complementary and integrative medicine (CIM) therapies that may be used to treat patients with lower back pain, hypertension, and diabetes mellitus. The objectives are:
To propose the use of Tai Chi Therapy in reducing chronic lower back pain.
To propose the use of Yogic interventions to manage hypertension and diabetes type II.
Tai Chi Therapy in Reducing Chronic Lower Back Pain
Low back pain (LBP) affects people of all ages. According to Qin et al. (2019), LBP has a recurrent rate of 33% in a span of one year from the last recovery episode. Likewise, LBP has been the leading cause of disability, consequently leading to social and economic problems. Every year in the US, there are over 2.6 million ED visits due to LBP (Qin et al., 2019). Further, patients with LBP record higher depression rates and are at a higher risk of LBP recurrence (Qin et al., 2019). Moreover, people with chronic conditions also have higher chances of suffering from LBP (Qin et al., 2019. Therefore, given the adverse impacts of LBP, this condition needs to be addressed in a cost-effective way to minimize the disease burden in the future.
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In the last three decades, clinical guidelines have emphasized the need to use nonpharmacological therapies instead of costly pharmacological therapies. These guidelines recommend “maintaining active, education, exercise therapy, and cognitive behavior therapy as first-line treatments, and spinal mobilization, massage, and acupuncture, etc. as second-line treatments” (Qin et al., 2019, p.2). Among the nonpharmacological therapies used is Tai Chi, which has characteristics that align with the clinical guidelines. Tai Chi involves the use of “slow and relaxed physical movements combined with deep breathing” (Qin et al., 2019, p.8). Tai Chi, as compared to other general exercises, has a lower energy metabolism but yield the same benefits. In fact, according to Qin et al. (2019), Tai Chi ranks third among the most used complementary and integrative medicine (CIM) therapies in the US. Therefore, to investigate the effectiveness of Tai Chi in reducing LBP, Qin et al. (2019) conducted a systematic review of the literature. Seven electronic databases were used to find literature for review. The authors used the Physiotherapy Evidence Database (PEDro) scale to evaluate the Randomized Control Trials' quality in the research. The authors found that Tai Chi helped alleviate pain and improved the functional disability of LBP patients. Thus, the authors concluded that Tai Chi therapy could help LBP patients manage pain safely and cost-effectively.
The nurse in treating Mr. Yakisoma can use this therapy. The patient reports that he cannot exercise due to the pain. As discussed, Tai Chi involves slow and relaxed physical movements instead of general exercises; it may help improve his musculoskeletal strength. This could help him to start exercising progressively. Thus, the nurse could book Mr. Yakisoma for one-hour Tai Chi sessions thrice a week, increasing the hours as the patient regains strength and joint stability.
Yoga in Managing Hypertension and Diabetes Mellitus
Type 2 diabetes occurs when the body becomes insulin resistant or cannot produce insulin at the required level. This also causes other cardiovascular complications, such as hypertension (Raveendran et al., 2018). By 2017, there were over 425 million diabetic people globally, and projections showed that this number would hit 629 million by 2045 (Raveendran et al., 2018). Among the risk factors causing diabetes include unhealthy dietary patterns. Likewise, psychological stress increases the severity of the condition. Further, lack of physical exercises also aggravates the condition. According to Murray & Wilson (2018), hypertension ranks third as a cause of increased US mortality rates. There are over 76.4 million American adults diagnosed with hypertension (Murray & Wilson, 2018). Consequently, the US spends over $48.6 billion every year to treat this condition. This is an economic burden to the nation, and alternative methods are required. This has called for the use of Complementary and Alternative Medicine (CAM) therapies. Among these therapies is Yoga, which originated from India (S et al., 2019).
Effective management of hypertension and diabetes type II requires the patient to make lifestyle modifications such as dietary control and exercise. According to Raveendran et al. (2018), “Yoga practice is a complex intervention with various components, including cleansing processes ( kriya ), postures ( asana ), controlled breathing ( pranayama ), meditation, relaxation, chanting mantras, yogic diet, code of conduct, philosophy, and spirituality” (p.308). These characteristics of Yoga correlate with the lifestyle modifications required to manage Hypertension and Diabetes type II. To assert this, Saha et al. (2018) conducted a Randomized Controlled Trial in two old age homes to investigate the effectiveness of a 12 weeks yogic intervention in regulating blood sugar. Twenty elderly women were recruited for the study and divided into two: the intervention and control groups. The intervention group was subjected to Yogic interventions while the control groups were not. Blood sugar BMI was measured during weeks six and twelve in both groups. The authors found that the intervention group recorded a decrease in postprandial blood sugar while no significant results were obtained from the control group. Thus, the authors concluded that Yogic intervention is effective in managing diabetes type II.
On the other hand, Murray & Wilson (2018) conducted a systematic review to investigate the yogic intervention's effectiveness in managing hypertension in adult patients. The literature to be review was obtained from medical databases where articles published between 1993 and 2017 were considered. The selection criteria yielded eleven articles with 957 participants. The analysis revealed that Yoga assists patients with hypertension decrease blood pressure. Thus, Murray & Wilson (2018) concluded that Yoga, nonpharmacological method, impacts the physical and emotional well-being of patients with hypertension positively.
The nurse may refer Mr. Yakisoma to a qualified yoga professional. Yogic interventions are complex and entail numerous practices. Some of these styles are fast-paced, while others are conducted in slow motion. Thus, professional guidance is needed to determine which exercises suits the individuals best. For instance, beginners are discouraged from engaging in extreme practices. Therefore, during yogic sessions, the trainer could tailor the interventions to suit the patient’s unique needs. This will allow the patient to participate actively in the intervention leading to optimal outcomes.
References
Fahey, R. L. (2018). A Novel Approach to Using Mind-Body Therapies for Chronic Pain . Www.reliasmedia.com. https://www.reliasmedia.com/articles/142141-a-novel-approach-to-using-mind-body-therapies-for-chronic-pain
Lee, C., Crawford, C., & Hickey, A. (2014). Mind-Body Therapies for the Self-Management of Chronic Pain Symptoms. Pain Medicine , 15 (S1), S21–S39. https://doi.org/10.1111/pme.12383
Murray, A., & Wilson, K. (2018). Yoga and Hypertension: A Systematic Review. Journal of Yoga & Physical Therapy , 08 (02). https://doi.org/10.4172/2157-7595.1000289
Qin, J., Zhang, Y., Wu, L., He, Z., Huang, J., Tao, J., & Chen, L. (2019). Effect of Tai Chi alone or as additional therapy on low back pain: Systematic review and meta-analysis of randomized controlled trials. Medicine , 98 (37), e17099. https://doi.org/10.1097/MD.0000000000017099
Raveendran, A. V., Deshpandae, A., & Joshi, S. R. (2018). Therapeutic Role of Yoga in Type 2 Diabetes. Endocrinology and Metabolism , 33 (3), 307. https://doi.org/10.3803/enm.2018.33.3.307
Rudaz, M., Ledermann, T., & Witt, C. (2017). Mind-body medicine and the treatment of chronic illnesses. Zurich Open Repository and Archive . https://doi.org/10.5167/uzh-148692
Saha, S., Mondal, S., & Kundu, B. (2018). Yoga as a therapeutic intervention for the management of type 2 diabetes mellitus. International Journal of Yoga , 11 (2), 129. https://doi.org/10.4103/ijoy.ijoy_74_16
