Ankylosing Spondylitis (AS) is an inflammatory autoimmune spinal condition whereby our immune system is defective and attacks healthy tissue around the spine. Because of this, people affected with AS commonly present with inflammation of the neck, back and pelvis joints causing pain and stiffness, pain in tendons and ligaments and reduced spinal mobility. AS affects 1 in 200 individuals and there is a stronger prevalence in males compared to females.
Currently medical practitioners and researchers do not know the exact cause of AS but it is thought to be due to genetic factors and not by strenuous activity. Furthermore, there is currently no cure for AS and unfortunately no current treatment options have been shown to induce remission5.
Despite this, it is important to seek help as early as possible if any symptoms are present as there are many effective treatments to help manage the pain and improve quality of life. These include both physiotherapy including hydrotherapy (exercises in water) and medical treatments such as analgesics (pain relief), non-steroidal anti-inflammation drugs and anti-rheumatic drugs. However before one takes these medications, it is important to be fully aware of the potential side effects of these. Additionally to these two treatment strategies, research has shown the successful effect of acupuncture in relieving pain and preventing future relapses in people affected with AS.
1 Better Health Channel (2018, July) Ankylosing spondylitis. betterhealth.vic.gov.au/health/conditionsandtreatments/ankylosing-spondylitis
2 Department of Health – Healthy WA. Ankylosing spondylitis. healthywa.wa.gov.au/Articles/A_E/Ankylosing-spondylitis
3 Royal Australian College of General Practitioners (2013, November) Ankylosing spondylitis – An update. Rheumatology Vol 42 (11) 780-784
4 Arthritis Australia. Ankylosing spondylitis. arthritisaustralia.com.au/types-of-arthritis/ankylosing-spondylitis/
5 Brown, M, Bradbury, L (2017, March 20). New approaches in ankylosing spondylitis. Med J Vol 206 (5) 192-194. doi: 10.5694/mja16.01111
6 Zhao et al (2015, November). A case report of ankylosing spondylitis treated by acupuncture. European Journal of Biomedical Research Vol 1 (2) 18-22. doi: 10.18088/ejbmr.1.2.2015.pp18-
What is Arthritis?
The word arthritis means ‘inflammation of the joints’ - a condition involving pain, swelling, heat, stiffness and sometimes redness of a joint. Arthritis is so widespread that an entire chapter in Professor Yoland Lim's book 'Your Body is Your Doctor' is dedicated to this non-discriminatory and ancient chronic crippling disease. It affects multiple levels of society, traditionally including Egyptian pharaohs, through to others in their, and our society.
Professor Yoland Lim states that whilst climatic conditions of 'dampness' and changing weather in the world may be contributing to the high incidence of arthritis, in his opinion diet is a greater cause. The optimal diet for arthritis should be curated to avoid obesity whilst maintaining good healthy nutrition. Professor Yoland Lim's management program has treated a number of patients over the last nearly 50 years.
This program consists of three steps:
The elimination and cleansing process is the most important. The body becomes a storehouse of junk which has been deposited in the cells. It is vital that your body has a 'clean' foundation to build on. Through time, whether it be from dietary factors, or chronic overuse, or a genetic component, just like a building, our foundations must be strong. The cleansing process initially involves a calm mental approach.
The building up process may incorporate physical and breathing exercises, which are known to improve circulation, increase oxygen intake thereby bringing more nutrients to the cells for repair and dissipate unwanted metabolites. The building up process involves a positive physical and mental approach to health. A nutritious fresh food diet may be prescribed along with other medications.
Professor Yoland Lim Health Care's medical approach (Fong Yang Therapy) is to work in conjunction with fellow medical practitioners and specialists with a general medical holistic patient centered approach to help co-ordinate and integrate care of the patient, including wellbeing, stress, and mental health in addition to acupuncture.
Doctors who are up to date with medical research in the benefits of acupuncture, know there is a famous and well respected Vickers Trial from Europe, which was a "Systematic review...with a total of 17,922 patients analysed. Conclusions: Acupuncture is effective for the treatment of chronic pain".
Arch Intern Med. Author manuscript; available in PMC 2013 Oct 22.
Published in final edited form as:
Arch Intern Med. 2012 Oct 22; 172(19): 1444–1453.
Acupuncture for chronic pain: individual patient data meta-analysis
Andrew J. Vickers et al
There are no ‘miracle diets’ for arthritis. A balanced, nourishing diet is advised and designed to keep the body strong and at its proper weight. Certain kinds of arthritis may involve special dietary considerations. Some people with rheumatoid arthritis may feel ill, stop eating and lose weight.
People with osteoarthritis tend to become inactive because of joint pain and thus gain weight. A sensible reducing diet (not a sudden crash program) may be required. Patients with gout may have to cut back their intake of certain meats, shellfish or alcohol.
It depends on the kind of exercise, and the kind of arthritis.
In active rheumatoid arthritis, the painful stiff joints tend to freeze up. They must not be allowed to do so. Each affected joint should be mobilised and if possible through its complete range of motion, at least twice a day – with the aid of another person if necessary.
Professor Yoland Lim Health Care has developed gentle exercises which will be tailored for your treatment. Walking and swimming also may form an important part of the treatment.
Relieving the joints of unnecessary work is an important part of treatment, but these joints must not be allowed to be totally immobile.
Arthritis treatment program may involve:
Professor Yoland Lim Health Care also recommends:
i) Balanced fresh food diet
ii) Eliminating sugar, flour, chicken and tinned and pre-packaged food from the diet while
iii) Increasing daily consumption of fresh vegetables.
A positive calm mental approach, exercises, and physical and breathing exercises may be advised to improve circulation and increase oxygen distribution.
CREST syndrome is a condition comprised of several ongoing medical issues. It is also known as limited scleroderma, and is a widespread connective tissue disease characterised by changes in the skin, blood vessels, skeletal muscles and internal organs.
As an autoimmune disorder it understood that in CREST syndrome the immune system is producing too much collagen ultimately impairing the function of the skin and internal organs. CREST is an acronym for the clinical features that are seen in affected patients and at least two of the five features must be present to be diagnosed with CREST syndrome:
- C – Calcinosis- formation of calcium deposits under the skin on the fingers
- R – Raynaud’s phenomenon- the spasm of blood vessels in the fingers or toes in response to cold or stress
- E – Esophageal dysmotility- difficulty in swallowing
- S – Sclerodactyly- the tightening of the skin
- T – Telangiecyasia- the dilation of vessels on the skin
There is currently no cure for CREST syndrome and current treatments and strategies are aimed to relieve signs and symptoms and prevent complications.
 National Centre for Advancing Translational Sciences (January 2018) CREST syndrome rarediseases.info.nih.gov/diseases/12430/crest-syndrome
 Lupus Research Alliance. Glossary: CREST Syndrome lupusresearch.org/glossary_of_terms/crest-syndrome/
Gout, also known as Gouty Arthritis, is an abnormality of monosodium urate (Uric Acid) crystals which abnormally deposit in joints. With proper treatment, good symptomatic control of the disease can occur although the underlying condition is incurable. Uric Acid is a natural chemical waste product in our body.
It may be caused by too much alcohol, starvation and certain prescription medications (such as diuretics). When predisposed patients consume too much seafood, cheese, beer and wine, the precursor for uric acid, purines are in excess. When uric acid can’t be metabolised sufficiently in our body nor excreted in our urine (some people have ‘inborn metabolic errors’ preventing this) it results in excruciatingly painful joints, predominantly, but not limited to the big toe of our feet. Up to 8% of men get this, and are usually in their 40s-50s. Treatment of gout requires medicines to fight inflammation and get rid of the excess uric acid.
Diet to contain a liberal intake of milk, fruit and vegetables (except those listed below 'to be avoided'). Meat and fish should only be taken in the quantities listed. Ample fluid is to be taken between meals. Any tendency to overweight should be avoided, and hence sugars and starchy foods reasonably restricted and adjusted according to individual requirements. Since it is believed that fat is liable to hinder the excretion of uric acid, avoid cream or fried foods.
Foods to be Avoided
Osteoarthritis (OA) is the commonest arthritis and is a degenerative joint disease occurring in 10% of the adult population with 50% of over 60 year olds having it. Sooner or later, if you live long enough, you are likely to encounter this. It affects both men and women equally. For some it is only a minor, occasionally disabling irritation but for others it may be a continual source of distress.
Unlike RA, OA joint involvement is not necessarily symmetrical. Pain and stiffness gets worse by the end of the day and worse with activity. It feels better after resting and worse in cold and damp conditions.
Professor Yoland Lim Health Care may advise on daily range-of-motion exercise, such as its Fong Yang Therapy Exercises but vigorous exercise is cautioned against as this may do more harm to already damaged joints. Since many people with OA simply can’t engage in regular exercise, weight control becomes even more important. But a 'crash diet' that may harm the rest of the body is not advisable. What is needed is a balanced nutritional diet including fresh fruits and vegetables, lean meat or other protein and some non-sugary cereal foods and dairy products in small enough quantities to achieve a gradual consistent weight loss.
Osteoporosis (meaning ‘porous bones’) is a common condition that causes bones to become thin, weak and fragile resulting in a greater risk of breaks and fractures. There is a myth that some people think it causes discomfort- this is not true, it does not directly cause pain, but rather the more fragile bones result in this greater fracture risk, which if it does happen, then will cause pain.
The cause of thinning of the bone is primarily due to an imbalance in the amount of minerals in bones – that is, the bones lose more minerals such as calcium more quickly than the body can replace them.
Like much of the human body, bone is constantly being broken down and renewed. During the early years of life, more bone is made than broken down and by about 25 to 30 years of age, peak bone mass is achieved. Although affecting anyone, osteoporosis is more prevalent in women and even more common in older women with 1 in 4 women aged 75 years and older. This is because sex hormones such as oestrogen and testosterone have a fundamental role in maintaining bone strength and the reduction in oestrogen during menopause results in accelerated bone loss.
Key risk factors for osteoporosis are:
In almost all cases, osteoporosis is asymptomatic meaning there are usually no signs of symptoms of the condition. Because of this, many individuals do not realise they have osteoporosis until a fracture happens, typically as a result of a minor fall. Most common fractures occur at the spine, wrist and hip.
Strategies which can be implemented into lifestyle choices to prevent weakened bones include:
If a substantial amount of bone density has been lost, medications are available to help slow down bone loss or assist in rebuilding bone.
 Osteoporosis Australia (2014, February) What is it? osteoporosis.org.au/what-it
 Better Health Channel (2019, March) Osteoporosis betterhealth.vic.gov.au/health/conditionsandtreatments/osteoporosis
 Australian Institute of Health and Welfare (2019, August) Osteoporosis aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoporosis/contents/what-is-osteoporosis
 American College of Rheumatology (2019, March) Osteoporosis rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Osteoporosis
 National Institute on Aging (2017, June) Osteoporosis nia.nih.gov/health/osteoporosis
 Health Direct (2019, October) Osteoporosis healthdirect.gov.au/osteoporosis
Although the ‘big three’ – rheumatoid arthritis, osteoarthritis and gouty arthritis account for the vast preponderance of arthritis, there are also other forms. An example is that there are several forms of juvenile (child) arthritis, different from the adult form, which can commence from infancy through to late adolescence, and beyond.
Polymyalgia rheumatica (PMR) is a relatively common disorder in individuals over 65 years old. With preponderance in females, PMR is characterised by:
1. Widespread aching
2. Stiffness, and
3. Flu-like symptoms.
Symptoms usually begin fairly abruptly with the shoulders, hip and neck being common areas to be affected. Additional symptoms of PMR include:
The exact cause of PMR is as yet unknown and there is substantial research to suggest PMR is not a result from side effects of medication. As the symptoms of PMR are typically abrupt there is reason to believe the aetiology may arise from an infection. Furthermore, genetics as well as the aging process are thought to play a role in the onset of PMR.
Patients who are not treated often feel unwell and have an impaired quality of life. For this reason, management typically involves medications to help ease signs and symptoms. For example, it may consist of low doses of an oral corticosteroid combined with physical therapy to reduce and relieve muscle stiffness. As PMR is hard to diagnose, visiting your medical practitioner is strongly encouraged.
 Mayo Clinic (2018, June) Polymyalgia rheumatica mayoclinic.org/diseases-conditions/polymyalgia-rheumatica/symptoms-causes/syc-20376539
 Arthritis Foundation. Polymyalgia Rheumatica arthritis.org/diseases/polymyalgia-rheumatica
 National Organisation for Rare Disorders. Polymyalgia Rheumatica rarediseases.org/rare-diseases/polymyalgia-rheumatica/
 American College of Rheumatology (2019, March) Polymyalgia Rheumatica rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Polymyalgia-Rheumatica
 Ameer and McNeil (2014, June) Polymyalgia rheumatica: clinical update racgp.org.au/afp/2014/june/polymyalgia-rheumatica/
Raynaud’s phenomenon is a condition induced by the cold and stress where there is a short-term interruption of blood flow to our extremities (fingers and toes) as the body redirects blood from the extremities to the internal organs.
Raynaud’s phenomenon can also affect other body parts, such as the nose, lips and ears. There are two kinds of Raynaud’s phenomenon:
1. Primary Raynaud’s phenomenon- whereby the underlying cause is unknown and generally happens sporadically
2. Secondary Raynaud’s phenomenon- arises as a product of other medical conditions, typically autoimmune disorders.
Due to the narrowing of blood vessels as a result of the redirection of blood, the most common symptom is the extremities turning a white, then blue colour leading to a stinging/tingling pain and numbness, followed by a change to a red hue.
Treatment includes keeping your body and extremities warm and avoiding exposure to the cold. In more severe cases, prescribed medication can be issued to improve circulation and widen the blood vessels. Alongside these treatments, a study published in the Journal of Internal Medicine has highlighted the positive effects of acupuncture in treating patients with Raynaud’s syndrome with all treated patients showing a decreased in the frequency of Raynaud attacks.
 Better Health Channel (2019, August) Raynaud’s phenomenon. betterhealth.vic.gov.au/health/conditionsandtreatments/raynauds-phenomenon
 Musculoskeletal Australia. Raynaud’s Phenomenon. msk.org.au/raynauds-phenomenon/
 John Hopkins Medicine Raynaud’s Phenomenon hopkinsmedicine.org/health/conditions-and-diseases/raynauds-phenomenon
 Health Direct (2018, August) Raynaud’s phenomenon. healthdirect.gov.au/raynauds-phenomenon
 Appiah, R et al (2003, October) Treatment of primary Raynaud’s syndrome with traditional Chinese acupuncture. Journal of Internal Medicine Vol 241 (2). doi: 10.1046/j.1365-2796.1997.91105000.x
Rheumatoid Arthritis (RA) is considered the most serious form because of its long, chronic course and the severe disability it may cause. It affects three times as many women as men. Usually worse in the morning and has stiffness lasting up to several hours, but gets slightly improved with movement.
Typically RA progresses slowly affecting similar joints on both sides of the body simultaneously namely Metacarpophalangeal (knuckles) and Distal Interphalangeal (outer) finger joints, wrists and elbows. In the early stages, the joints grow puffy, painful and stiff. The inflammation soon begins to damage cartilage in the joints. Initially flare-ups of joint pain may quieten down for weeks at a time, but the inflammation usually always returns and finally becomes chronic.
After several months to years, it moves into a second stage. Hard nodules form under the skin near the affected joints. The acute inflammation may quieten down but joint damage may become progressively more sinister. Continuing muscle spasm may dislocate and twist the finger joints. Typical signs include ulnar deviation (outward) displacement of fingers, ‘Z deformity’ of the thumb and boutonniere and swan neck deformity of the fingers. Knees or hips (delayed in 50%) can become so crippled that they can’t bear weight or even be moved without extreme pain.
The disease may start immediately after some severe physical or emotional shock, such as an internal infection or a significant emotional event.
RA is an auto-immune reaction where the patient’s own natural immune defences attack the linings of the joints as if they were a threatening foreign body. Professor Yoland Lim Health Care may order pathology tests looking for ‘rheumatoid factor’ which is positive in 70-80% of patients and ‘anti-cyclic citrullinated peptide (anti-CCP) which is very specific fpr RA (positive in 96% of patients).
Scleroderma or systemic sclerosis is a chronic autoimmune connective tissue disease that affects many parts of the body and involves the thickening or hardening of skin and tissue. Patients with scleroderma commonly suffer from internal organ complications such as:
There are two major types of Scleroderma:
The severity of scleroderma varies from patient to patient but common symptoms include:
Although there are various drugs used in the treatment of scleroderma, a study from 2015 published by the US National Library of Medicine National Institutes of Health’s investigated the effects of acupuncture as a treatment and found beneficial results in patients who were not responsive to medication.
 Scleroderma Australia. What is Scleroderma? sclerodermaaustralia.com.au/about/about-scleroderma
 The Royal Australian College of General Practitioners (RACGP). Red flags in scleroderma. racgp.org.au/afpbackissues/2008/200810/200810Li.pdf
 Arthritis Australia. Scleroderma. arthritisaustralia.com.au/types-of-arthritis/scleroderma/
 Better Health Channel. Scleroderma. betterhealth.vic.gov.au/health/conditionsandtreatments/scleroderma
 Saliha et al (2015) Beneficial Acupuncture Treatment For Systemic Sclerosis which was Non-Responsive to Medications. Acupuncture & Electro-Therapeutics Research Vol 40 (3) 205-214. doi: 10.3727/036012915x14473562233021
Sjögren’s (pronounced “show grins”) syndrome is an autoimmune condition affecting the eyes and the salivary glands. Due to a malfunctioning immune system, instead of attacking ‘bad’ bacteria and viruses to keep the body healthy, the immune system attacks and damages the salivary and tear glands preventing them from working properly. As a result of this common symptoms of Sjögren’s syndrome include:
Commonly, Sjögren’s syndrome is diagnosed from assessing the symptoms as well as other medical tests (such as blood tests, Schirmer’s test and biopsies).
It is categorised as either:
1) Primary Sjögren’s syndrome, or
2) Secondary Sjögren’s syndrome.
In primary Sjögren’s syndrome, although typically more aggressive, there are no other autoimmune diseases present. Secondary Sjögren’s syndrome on the other hand typically presents when an individual has another autoimmune disease such as rheumatoid arthritis or lupus.
More prevalent in females than males, Sjögren’s syndrome is thought to be caused by a combination of genetic factors as well as possibly viral infections. Currently, treatment is designed to reduce the severity of symptoms and may include:
In addition to medical treatments, environmental and lifestyle changes are beneficial in preventing symptoms from worsening. For instance, avoiding dry and dusty environments and wearing protective glasses when outside in the wind and sun. Furthermore, avoiding drinks such as caffeinated beverages and alcohol may also be beneficial as these drinks can increase dryness of the mouth. As tooth decay and cavities are a common complication of Sjögren’s syndrome, regularly chewing sugar free gum can help stimulate saliva production to help prevent the risk of dental caries.
 Better Health Channel (2019, August) Sjogren’s syndrome betterhealth.vic.gov.au/health/conditionsandtreatments/sjogrens-syndrome
 Arthritis Australia. Sjögren’s syndrome arthritisaustralia.com.au/types-of-arthritis/sjogrens-syndrome/
 Herndon (2017, March) Sjögren’s syndrome healthline.com/health/sjogren-syndrome
 American College of Rheumatology (2019, March) Sjögren’s syndrome rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Sjogrens-Syndrome
 Musculoskeletal Australia. Sjögren’s syndrome msk.org.au/sjogrens-syndrome/
 Harvard Medical School (2019, March) Sjogren’s syndrome health.harvard.edu/a_to_z/sjogrens-syndrome-a-to-z
Systemic lupus erythematosus (SLE) is a chronic autoimmune condition affecting almost any organ or system in the body. The normal role of the body’s immune system is to fight off infections and diseases. In autoimmune conditions such as SLE our immune system mistakes healthy tissue as foreign bodies (such as bacteria and viruses) causing healthy tissue to be attacked.
SLE is more predominant in women and is more commonly seen and severe in:
The exact cause of SLE is unknown but it is thought a combination of genetic, environmental and hormonal factors may play a role in the onset of SLE.
Common symptoms of SLE include:
Moreover, individuals affected by SLE typically present with skin problems. The most typical being a flat red rash across the cheeks and bridge of the nose, called a “butterfly rash” but other skin problems that may occur include calcium deposits under the skin, damaged blood vessels and petechiae (tiny red spots on the skin).
There is currently no cure for SLE but different medications are available to help control and manage an overactive immune system. Medical practitioner led management involving lifestyle changes can help manage lupus, such as understanding what causes your skin flare ups, managing exposure to UV light and regular exercise.
 Arthritis Australia. Lupus (systemic lupus erythematosus) arthritisaustralia.com.au/types-of-arthritis/lupus-systemic-lupus-erythematosus/
 Australasian Society of Clinical Immunology and Allergy (2019, May) Systemic Lupus Erythematosis (SLE) allergy.org.au/patients/autoimmunity/systemic-lupus-erythematosus-sle
 Medline Plus. Systemic lupus erythematosus medlineplus.gov/ency/article/000435.htm
 U.S. National Library of Medicine (2020, February) Systemic lupus erythematosus ghr.nlm.nih.gov/condition/systemic-lupus-erythematosus
 Better Health Channel (2019, August) Lupus betterhealth.vic.gov.au/health/conditionsandtreatments/lupus