Importance
Of
Managing Stress

Dr.
Shriniwas Kashalikar


The only way of effective stress management is to understand the nature, causes, dimensions, mechanisms, effects and principles of management of stress. Basically this involves improvement in cognition, affect and conation. In other words, this involves improvement in our views, our feelings and our actions. In my book, �STRESS, UNDERSTANDING AND MANAGEMENT, A WAY TO TOTAL WELL BEING�, I have discussed these things.

But having studied the basics required in stress management one looks forward for greater efficiency.

For more effective management of stress, management of conceptual stress is essential and for that, further improvement in views, feelings and actions is essential. For this, it is imperative to study issues, which affect private as well as public life and especially those issues, which are pertinent to our fields.

Please remember, without evolving views, feelings and actions with respect to issues in individual as well as social life, pertinent to your field, stress in general and conceptual stress in particular can not be managed effectively.

Unfortunately many of us try frantically to manage stress [and conceptual stress], without this understanding and as a result, create and perpetuate misery for themselves and the society. All short cuts marketed under the disguise of stress management can at times be temporarily useful but ultimately prove useless and even counterproductive in personal and social life.

Now let us see why effective stress [and conceptual stress] management is essential.

Every one of us has stress. Thus a student may have stress of examination or competition and a doctor may have a stress of treating a difficult disease. A farmer may have stress of drought and a mill worker may have stress of lay off. A Prime Minister of a country may have stress of a crucial decision making such as nuclear testing, dealing with religious sentiments or flak from media etc.

It has to be appreciated that just as the causes of the stress vary, the implications of the stress also vary.

Thus the adverse effects of the ineffective management of stress in individual life as well social life vary. Thus the student may avoid appearing for examination, the doctor may shirk from his duty, the farmer may commit suicide and the mill worker rendered jobless may be forced into illegal underworld activities. The wrong decision of a Prime Minister may influence not only his life but also that of the generations after generations of one or more countries, in adverse ways.

This clearly illustrates that the adverse effects of stress are not restricted to one�s own body and one�s own family. The ineffective management of stress by political leaders, industrial leaders, union leaders, media leaders, religious leaders and in general people involved in decision making can adversely affect various walks of life and even the future generations directly or indirectly.

This is comparable to most dangerous and rapidly spreading pandemic infectious disease. The patient suffering from such infectious disease, if does not undergo proper treatment, then he/she would harm himself/herself as well as the others.

Effective management of stress [and conceptual stress] therefore, is vitally important for one�s own well being and that of the society as well!

Dr. Shriniwas Kashalikar

Meaning
of
Conceptual Stress

Dr.
Shriniwas
Kashalikar

Conceptual stress is not a separate entity. It is a part of over all process of stress. We can also call it intellectual chaos or stress, born out of various other causes, which may be physical, instinctual, emotional etc.

In modern life where the pace of change of life has become very fast, we are unable to understand the rapidly emerging new issues in life. Our conceptual framework gets shattered and we become helpless and miserable. This state of helplessness and misery and consequent deleterious effects on individual and social life, constitute conceptual stress and it has acquired menacing dimensions!

Morality, ethics, customs, traditions, conventions etc. i.e. guidelines of past in every sphere of life are being proved to a large extent; inadequate and also irrelevant.

To give a simple example, cancer phobia [excessive and unfounded fear of cancer] is nothing but a case of conceptual stress. Cancer phobia many times results from inappropriate views, feelings and actions [conceptual deficiency] about the phenomenon of cancer, its nature, its symptoms such as pain and its outcome.

What are the symptoms of cancer phobia?

A patient of cancer phobia may suspect that he/she has cancer, whenever he/she gets pain. If he/she gets repeated pain, in a particular organ then he/she starts suspecting cancer of that particular part! This leads to morbid fear, anxiety, worry, and sense of helplessness.

Conceptual stress involves defective or deficient perception, deficient ideas, inaccurate thoughts, disproportionate emotions, unreasonable instincts and unnatural physical needs, which are associated with abnormal electrophysiological interactions between various neurons in the brain. The secretion of different neurotransmitters, secretion of hormones and metabolic activities are abnormal and involve deleterious effects on personal and social health.

Conceptual stress is minimal or absent if you are totally ignorant and adjusted to a self centered, petty, indifferent, reflexive, passive, and stereotyped life style like a lower animal.

Conceptual stress is maximum; when your perspective assumes global dimension, your feelings reach out to the miseries of the millions and your thinking reaches out to the mysteries of millennia! Your conceptual stress magnifies when your heart starts bleeding for suffering in even the remotest part of the world and even to the suffering of animals!

Your conceptual stress worsens when you actually start searching for solutions as you come across conflicting opinions.

This stress gets further multiplied when you start coming close to the solutions and begin to encounter difficulty in expressing them.

This becomes more disturbing when you see every one turning away from you and your solutions being proved ineffective, though not inaccurate! Since you are not proved wrong, you do not find valid reason also; to abandon your views and mission! You land in an agonizing question, �Why you are ineffective if you are accurate?�

At this point the very foundation of your existence begins to shake and your existence almost gets uprooted!

Then gradually if and when you begin to see increasing matching, agreement, or harmony between your life and the universe [which in most cases would constitute changes in the direction of global welfare] your conceptual stress begins to get relieved simultaneously as that of the others!

It is true that we manage to ignore some questions, and rightly so e.g. mathematical problems need not as a routine, bother a biologist. Similarly, problems in one�s educational career are best dealt with in the text-books and guides of those subjects and or solved by the expert teachers in that particular field!

But there are issues which are a] unavoidable, b] are faced by most of us, c] affect our personal and family lives immensely and d] affect the well being of the society immensely.

These issues produce CONCEPTUAL OR INTELLECTUAL STRESS in almost every one!

One of the most practical and super-solutions provided by the seers and sages; is NAMASMARAN i.e. remembering your true self. One can give it a trial if one wishes and get the empowerment to get intellectual clarity and clues to act appropriately and satisfactorily and overcome conceptual stress.

SHRINIWAS KASHALIKAR

The basic concept, dream, pursuit and action towards welfare of all living beings are common.

But these are not explicitly understood, experienced and realized and hence they get manifested into subjective, superficial and petty perspectives, thinking and practical actions at different levels.

This disruption of an individual and the mankind can be overcome if every one including theists i.e. believers of God and atheists i.e. non believers of God grow from within to accommodate and understand the core of one another.

But this is not easy. This inner growth is not within one�s control or volition.

However it is possible through the practice of NAMASMARAN. This can ensure THE TRUE YOGA i.e. manifestation of inner enlightenment and God into every field of life and blossoming of all spiritually and materially i.e. from within as well as outside, i.e. inner as well as outer richness, i.e. profundity and prosperity!

You may try and verify this without blind belief!

BUT
WHAT IS
NAMASMARAN?

Namasmaran means; remembering the name
of God, Guru, great souls; such as prophets and holy objects such as planets and stars. It may be remembered silently, loudly, along with music, dance, along with breathing, in group or alone, either with counting by rosary (called SMARANI or JAPAMALA) or without counting. The traditions vary from region to region and from religion to religion.

However the universal principle underlying
NAMASMARAN is to reorient your
physiological being with your true self. In
fact while reorienting with true self you aim
to establish and strengthen the bond or
connection; between; your physiological
being; with your true self. You aim at
reunification with yourself!

Since remembering your true self is the
pinnacle of or culmination of individual
consciousness, and individual consciousness
is the culmination of every activity in life,
remembering any name of God or Guru (any
symbol of your true self) is equivalent to
opening the final common pathway for the
individual consciousness associated with
every possible activity to get funneled into or
unified with objective or cosmic
consciousness.

Thus NAMASMARAN is in fact the
YOGA of YOGA in the sense that it is the
culmination of consciousness associated with
every possible procedure and technique in
the yoga that you are familiar with. It is the
YOGA of YOGA because it is the
culmination of consciousness associated with
all the activities in the universe, which it
encompasses as well! It is YOGA of YOGA
because everybody in the world irrespective
of his/her tradition and the beliefs; would
eventually, ultimately and naturally reach it
it; in the process of liberation. Even so called
non believers also would not �miss� the
�benefit of remembering the true self
through one symbol or another�!


Just as NAMASMARAN is YOGA of YOGA
it is meditation of meditation also! It is the
natural and ultimate climax of every form of
meditation.

These facts however have to be realized with
persistent practice of NAMSMARAN and
not blindly believed or blindly disbelieved
with casual approach!

In short NAMSMARAN is super-bounty of
cosmic consciousness for every individual to
realize it (cosmic consciousness)! This is truly
a super-bounty because a person who
experiences it, rises above mercenary,
commercial and even professional and
charity planes and manifest super-
transactions in his or her life!

These are just few observations to give rough
idea about what is NAMASMARAN.
NAMASMARAN is an ocean of bliss. Its true
meaning is beyond description in words and
has to b experienced, most preferably, by
billions!

References:
Namasmaran: Dr. Shriniwas Kashalikar
Sahasranetra: Dr. Shriniwas Kashalikar
Holistic Medicine: Dr. Shriniwas Kashalikar
Stress: Understanding and Management: Dr.
Shriniwas Kashalikar
Conceptual Stress: Dr. Shriniwas Kashalikar

All available
for free download on
www.superliving.net
and
www.scribd.com

DR. SHRINIWAS KASHALIKAR

Low Back Pain

Dr (Maj) Pankaj N Surange
MBBS, MD, FIP
Interventional pain and spine specialist


Back pain is a problem which is very often faced by all the human beings at least once in their lifetime. This pain, if not taken seriously can turn in to a deadly disease which can put your life at stake.

Some Important Facts about back pain

� Low back pain is the most common musculoskeletal complaint, with potentially devastating consequences.

� 90% of patients with acute low back pain do not require surgery. Most specialists agree that non-surgical treatment should be tried first.

� Surgery as first line treatment is indicated only in few selected cases. These are medical emergencies such as a broken neck or if you have symptoms such as weakness in the legs that gets progressively worse and/or bladder and/or bowel incontinence caused by the back problem.

� The incidence of back pain is highest between the ages of 35 and 55.

� Disc is not always the culprit. Small joints of spine are the source of pain in majority of patients.

� The pain combined with depression and anxiety in long-term cases places sufferers at risk for suicide.

� People who work at sedentary occupations are at a higher risk of disk injury than those who do moderate amounts of physical work.

� Up to 85 per cent of persons with back pain can�t recall a specific incident that brought on their pain.

� Early interventional treatments in Back pain management have been found to return patients to work and regular activities more rapidly than past conservative therapies.

� Early intervention decreases unnecessary chronic pain, long-term treatments and disabilities.

� Heat and massage therapy cannot cure the disease. These do not provide long term solutions to the problems of back. These are mainly used for managing pain during the recovery period.




Important Causes of back pain

The most common causes of low back pain are:
� Injury or overuse of muscles, ligaments, facet joints, and the sacroiliac joints.
� Pressure on nerve roots in the spinal canal. Nerve root compression can be caused by:
o A herniated disc, often brought on by repeated vibration or motion (as during machine use or sport activity, or when lifting improperly), or by a sudden heavy strain or increased pressure to the lower back.
o Osteoarthritis (joint degeneration), which typically develops with age. When osteoarthritis affects the small facet joints in the spine, it can lead to back pain. Osteoarthritis in other joints, such as the hips, can cause you to limp or to change the way you walk. This can also lead to back pain.
o Spondylolysis and spondylolisthesis, vertebra defects that can allow a vertebra to slide over another when aggravated by certain activities.
o Spinal stenosis, or narrowing of the spinal canal, which typically develops with age.
o Fractures of the vertebrae caused by significant force, such as from an auto or bicycle accident, a direct blow to the spine, or compressing the spine by falling onto the buttocks or head.
o Spinal deformities, including curvature problems such as severe scoliosis or kyphosis.
� Compression fractures. Compression fractures are more common among postmenopausal women with osteoporosis, or in men or women after long-term corticosteroid use. In a person with osteoporosis, even a small amount of force put on the spine, as from a sneeze, may cause a compression fracture.
Less common spinal conditions that can cause low back pain include:
� Ankylosing spondylitis, which is a form of joint inflammation (arthritis) that most often affects the spine.
� Bacterial infection. Bacteria are usually carried to the spine through the bloodstream from an infection somewhere else in the body or from IV drug use. But bacteria can enter the spine directly during surgery or injection treatments, or as the result of injury. Back pain may be the result of an infection in the bone (osteomyelitis), in the spinal discs, or in the spinal cord.
� Spinal tumors, or growths that develop on the bones and ligaments of the spine, on the spinal cord, or on nerve roots.
� Paget's disease, which causes abnormal bone growth most often affecting the pelvis, spine, skull, chest, and legs.
� Scheuermann's disease, in which one or more of the bones of the spine (vertebrae) develop wedge-shaped deformities. This causes curvature of the spine (rounding of the back, or kyphosis), most commonly in the chest region
Newer Developments and Better Understanding in Management of Back pain
A wide range of treatment is available for low back pain, depending on what is causing the pain and how long it lasts. Most people find that their low back pain improves within a few weeks. Chances are good that your pain will go away soon with some basic self-care.
� If you have recently developed low back pain, stay active and consider taking over-the-counter pain medicines .
� Staying active is better for you than bed rest. In fact, staying in bed more than 1 or 2 days can actually make your pain worse and lead to other problems such as stiff joints and muscle weakness.
� If your low back pain has lasted longer than 3 months, you will probably benefit from more intensive treatment.
� Must visit Interventional pain and spine specialist :-
� if you have moderate to severe low back pain that lasts more than a couple of days;
� if you have back or leg symptoms that have gotten worse;
� if your symptoms have not gone away after 2 weeks of home treatment;
� or if improved symptoms flare up again.
� A physical examination by pain specialist and possibly an imaging(x-ray/MRI) test may produce new information about your condition and help direct your treatment decisions.
� Physical Therapy: TENS, Ultrasound, Heat and Cryotherapy:
o These Modalities should always be considered an adjunct to an active treatment program in the management of acute low back pain.
o They should never be used as the sole method of treatment.

Interventions: Minimally invasive non surgical procedures for management of Back Pain


For back pain sufferers, interventional pain management techniques can be particularly useful. In addition to a thorough medical history and physical examination, interventional pain management physicians have a wide array of treatments that can be used including the following:

Epidural injections (in all areas of the spine):

The use of anesthetic and anti-inflammatory medications injected into the epidural space to relieve pain or diagnose a specific condition.

Nerve, root, and median branch blocks:

Injections done to determine if a specific spinal nerve root is the source of pain. Blocks also can be used to reduce inflammation and pain.

Facet joint injections:

An injection used to determine if the facet joints are the source of pain. These injections can also provide pain relief.

Discography:

An "inside" look into the discs to determine if they are the source of a patient's pain. This procedure involves the use of a dye that is injected into a disc and then examined using x-ray or CT Scan.

Pulsed Radiofrequency Neurotomy (PRFN):

A minimally invasive procedure that disables spinal nerves and prevents them from transmitting pain signals to the brain.

Rhizotomy:

A procedure in which pain signals are "turned off" through the use of heated electrodes that are applied to specific nerves that carry pain signals to the brain.

Spinal cord stimulation:

The use of electrical impulses that are used to block pain from being perceived in the brain.

Intrathecal pumps:

A surgically implanted pump that delivers pain medications to the precise location in the spine where the pain is located.

Percutaneous Discectomy / Nucleoplasty:

A minimally invasive day care procedure in which tissue is removed from the disc with the help of decompressor through a very minute hole ,in order to decompress and relieve pressure on the spinal nerves.


Ozoneucleolysis or Ozone discectomy:

Has emerged as an affordable, least invasive approach and costs 2/3 of the price of conventional surgery. Ozone injected inside the affected intervertebral disc under c- arm guidance, causes shrinkage of disc and thus reducing the volume and lessening the pressure on nerves.

Intradiscal Electrothermoplasty (IDET)
This procedure involves the insertion of a needle into the affected disc with the guidance of an x-ray machine. A wire is then threaded down through the needle and into the disc until it lies along the inner wall of the annulus. The wire is then heated which destroys the small nerve fibers that have grown into the cracks and have invaded the degenerating disc.

These techniques are exciting. They offer the possibility of treating low back pain and sciatica with much less trauma and risk than surgery.


Quick tips to a healthier back


� Following any period of prolonged inactivity, begin a program of regular low-impact exercises.
� Speed walking, swimming, or stationary bike riding 30 minutes a day can increase muscle strength and flexibility.
� Yoga can also help stretch and strengthen muscles and improve posture
� Always stretch before exercise or other strenuous physical activity.
� Don�t slouch when standing or sitting. When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced.
� At home or work, make sure your work surface is at a comfortable height for you.
� Sit in a chair with good lumbar support and proper position and height for the task. Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for a long period of time, rest your feet on a low stool or a stack of books.
� Wear comfortable, low-heeled shoes.
� Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface.
� Ask for help when transferring an ill or injured family member from a reclining to a sitting position or when moving the patient from a chair to a bed.
� Don�t try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body. Do not twist when lifting.
� Maintain proper nutrition and diet to reduce and prevent excessive weight, especially weight around the waistline that taxes lower back muscles.
� If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.