What You Should Know About Muscle And Joint Pain In Lupus

Studies revealed that 90% of people with lupus experience joint and/or muscle pain at some time during this illness.Very often, the aching pain in joints and muscles can determine the patient believe he has a viral or flu-like illness, while other patients may have symptoms similar with those produced by arthritis. There exist also another category of patients with intense muscle inflammation, and they can also experience progressive weakness and loss of strength.

It must be said that muscle and joint pains are symptoms of lupus but usually it's not the systemic lupus erythematosus responsible for them. They are more frequently caused by other illnesses.

Usually, the joint pain caused by lupus arthritis comes, may last for days or weeks, and then disappear, returning at a later time. It is known that the joints farthest from the trunk of the body are most frequently affected. Characteristic to lupus is stiffness and pain in the morning which improves during the day and can return later in the day when the person is tired, and also the fact that the pain is usually symmetrical, similar joints on both sides of the body are affected. It is good to know that even if a person has been diagnosed with lupus, there can appear pains that have nothing to do with this disease. For example, backaches or neck pains, a single, chronically painful are not provoked by lupus.A fact that also should be remembered is that usually, lupus arthritis doesn't cause deformities or destruction of the joints.Best clues in order to determine if the pain is caused by the systemic lupus erythematosus is the pattern of joint pain and the setting in which it occurs.There can be made X-ras of the painful joints and an examination of the synovial fluid within a swollen joint, to rule out other possible causes for the joint. It is known that if arthritis is the only symptom of lupus, diagnosis can be extremely difficult.It is good to mention that sometimes, performing the anti-nuclear antibody test and the test for rheumatoid factor can be helpful.

For treating lupus arthritis, there are usually used non-steroidal, anti-inflammatory medications like ibuprofen, naproxen or aspirin. Usually, these medications have effect, but if this therapy is not effective, there can be added antimalarial drugs such as hydroxychloroquine.In rare cases, if the joints remain swollen and painful despite other treatment, there begins the treatment with corticosteroids.It is important that people learn joint protection procedures in order to rest the joints during flares of lupus arthritis, and another fact that must be known is that cytotoxic medications should not be used to treat only lupus arthritis.

It is known that the systemic lupus erythematosus can seriously damage the muscles, and as a result, there can appear muscle weakness and loss of strength. Inflamed muscles can be painful and tender to the touch, but the most common symptom that lupus myositis shows is muscle weakness. Usually, the muscles at he trunk of the body are affected , such as neck, pelvic girdle and thighs, shoulder girdle and upper arms.

There are some tests that can determine the severity of muscle involvement. These tests measure the level of some chemical enzymes in the blood. Normally, that enzymes are being concentrated within muscle fibers. They escape into the blood circulation when the muscle fibers are being damaged by inflammation.There can also be made an electromyogram to determine the character of muscle damage in lupus myositis, and also biopsy may be performed in order to confirm the presence of inflammation and to identify how severe it is.

As a treatment, corticosteroids are used initially in high doses, to keep the inflammation under control, and then, after it subsides, it is gradually reduced. Most of the patients responde well to this treatment, but there are rare cases when it is necessary to add cytotoxic or immunosuppressive medications.A well directed exercise program should be started after the inflammation passed, in order to regain normal muscle strength and function.

It may happen when the patient is prescribed high doses of corticosteroids with or without cytotoxic agents to appear bone damage and muscle weakness. These complications in rare cases appear due to the effects of the medications alone, they usually come because of a combination of factors.It was found that patients with systemic lupus erythematosus which took steroids for a long time can develop ischemic necrosis of bone. Altered blood flow to a portion of bone causes the death of that area, and as the bone repairs the area, a weakening of the bone occurs and a portion of the bone surface may collapse. Most affected are the hips, shoulders and knees.The first symptom of ischemic necrosis is pain when the joints are being moved or bearing weight, and the pain can be felt even when the person is resting, at night, when the condition progresses.Osteoporosis can also appear if a patient uses corticosteroids for a long time. Having osteoporosis means that the bone mass is decreased and a higher risk of bone fracture and compression of vertebrae in the spine appears. It is known that women are at a higher risk of developing osteoporosis and using calcium and vitamin D in addition to regular exercise may help prevent osteoporosis.

It is important to remember that people with lupus myositis should take a regular, well-designed exercise program in order to prevent muscle weakness.

Osteoarthritis Natural Ayurvedic Remedies and Causes

Arthritis is a joint disorder characterized by inflammation of joint, and Osteoarthritis is one of the several types of arthritis. It is the commonest form of arthritis noticeable in elderly people. Osteoarthritis is also known by the names of wear and tear arthritis, degenerative joint disease or old person's arthritis. When osteoarthritis occurs, there is wear and tear or degradation of articular cartilage and subchondral bone, as a result of which several mechanical abnormalities arise.

When cartilages are lost due to degeneration, bones at the joint are exposed to each other, and get damaged due to friction. The friction may often lead to the formation of spurs or bony outgrowths named as osteophytes. All these cause severe pain at the joints, and may even cause immobility at the joint. Due to decreased movement, atrophy of the muscles around the joint may occur, and the ligaments holding the bones in place may become loose, or stop functioning in their natural way. Hands, feet, spine, knee or hip joints are usually attacked by osteoarthritis. The pain at the affected joint may worsen, at the end of the day's usage. Humid or cold weather also worsens the pain in many osteoarthritis patients.

Causes of Osteoarthritis

1. Aging is the primary cause of osteoarthritis. As body starts aging, cartilages become weak, owing to accumulation of fluids in the cartilage and degeneration or breaking up of the protein make up. The cartilages thus become brittle, may start flaking or tiny crevasses may be formed on the surface of the cartilages. In no time total loss of cartilage may occur, exposing the bones to rub against each other. Such worn out joints become inflamed or swollen through repetitive use.

2. Obesity also causes osteoarthritis. As weight increases, the joints are compelled to bear the load of extra weight which is often beyond their capacity. The excessive pressure causes much wear and tear of the cartilage cushions.

3. Heredity or genetic grounds is also responsible for causing osteoarthritis. The disorder is often seen to run in the family.

4. Congenital joint disorder may also lead to osteoarthritis.

5. Past history of septic joint or any other joint infection may cause osteoarthritis in future.

6. Trauma or injury to joint due to accident may in future take the shape of osteoarthritis.

7. Ligamentous deterioration may cause osteoarthritis.

8. Inflammatory diseases like perthe's disease, lyme disease, gout, costochondritis may lead to osteoarthritis ultimately.

9. Diabetes is another factor causing osteoarthritis.

10. Marfan syndrome, Wilson's disease, hemochromatosis are other factors leading to osteoarthritis.

Ayurvedic herbal supplement Rumatone Gold Capsule is an effective natural remedy for osteoarthritis. One can apply Rumatone Gold Oil in conjunction with supplementing Rumatone Gold Capsule for getting faster relief from osteoarthritis.

Meniscal Tears

Arthroscopy of the knee is the most common procedure performed by orthopedic surgeons and the most frequent reason for arthroscopic knee surgery is to investigate and repair meniscal tears. Although there are two menisci in the knee: one medial and one lateral. The medial meniscus, located on the inside of the knee, is the one torn most often. There are two types of meniscal tears that occur: sudden/acute tears and degenerative tears. Sudden meniscal tears can happen during activities, like sports, through direct contact, like a football tackle, or by a movement that torques or rotates the knee. In this type of tear, some people report hearing a "pop". Conversely, degenerative tears tend to happen over time, typically without an acute injury or traumatic event. Medial meniscal tears are more likely to occur in older people, particularly from the fourth to sixth decades of life, simply because the aging tissue within the knee cannot withstand as much stress. During a flare-up, these tears can cause noticeable pain on the inside or outside part of the knee.

Common symptoms of a torn menisci are: stiffness, swelling, buckling or locking of the knee and a limited range of motion. Most patients are able to continue walking on their injured knee. The patient who has a degenerative meniscal tear tends to have good days and bad days, depending upon how irritated the meniscus is and how inflamed the knee becomes. If the patient has minimal symptoms that they can tolerate, then continued observation is appropriate. However, if the patient has disabling symptoms, arthroscopic surgery would be performed to alleviate the pain and restore motion and function.

If the symptoms become problematic for a period of six weeks or more, an MRI scan can help diagnosis the source of the problem. X-rays are not helpful in the diagnosis of a meniscal tear as they only provide imaging of the bone, but they may help your specialist rule out another problem, such as arthritis. If a meniscal tear is confirmed, your orthpaedic specialist will probably prescribe a regimen designed to reduce inflammation and to rest the injured knee.

The RICE protocol ( Rest, Ice, Compression and Elevation) along with Ibuprofen or Naproxen may provide enough relief so that the patient can tolerate the meniscal tear without considering surgery. However, if the painful symptoms do not resolve, further treatment is generally surgical in nature. The meniscus does not have a good blood supply on the inner two-thirds of its anatomy. Because of this, once a tear occurs, the likelihood of it healing is minimal.

Arthroscopic knee surgery is performed on an outpatient basis. The procedure is done through two small incisions in the front of the patient's knee, allowing access to the entire inside/outside part of the knee for treatment. The surgeon inserts a miniature camera into the knee so that the structures of the knee can be clearly visualized. Once the meniscal tear is visualized, the surgeon will insert very small surgical instruments into the knee and will trim or repair the menisci as necessary. The patient is able to go home the day of the surgery.

When recovering, the patient can put full weight on the knee and begin range of motion activities immediately. When comfortable, the patient may return to all activities. If there are no arthritic changes in the knee, recovery usually happens quickly. Your orthopaedic specialist may recommend special strengthening and Range of Motion exercises to help you achieve maximum recovery. Usually patients can rehabilitate at home, although Physical Therapy may be prescribed. Most patients recover well and without incident from Meniscal Surgery.

If you suspect you may have a Meniscal tear, you should consult with a skilled orthopaedic surgeon to get a definitive diagnosis and effective treatment plan.

A New Medieval Treatment For Knee Osteoarthritis

It sounds like something out of medieval times. Using leeches to treat every disease and condition known to man. But as it turns out leeches are actually very powerful for treating a wide variety of ailments including knee osteoarthritis.

Knee osteoarthritis is a degenerative joint disease that results in the breakdown of the cartilage between the joints in the knees. This leads to pain, loss of range of motion and bone damage. There appears to be several origins of knee osteoarthritis including joint deformity, repeated injury, or excess weight. There is no cure for osteoarthritis so the focus is on treatments for the pain and reduction of continued damage to the joint.

And this is where leeches come in. Leeches secrete morphine, a potent pain killer. Leeches also secrete an anticoagulant which improves blood flow to the area where the leeches are applied and an anti-inflammatory. Since inflammation is responsible for the symptoms of osteoarthritis, researchers believe that leeches might relieve pain in patients with osteoarthritis.

The U.S. Food and Drug Administration (FDA) classify leeches as medical devices and has approved them for microsurgery. The FDA is also involved in the regulation of the transport and sale of leeches. In Germany there has been an estimated 70,000 treatments a year over the last few years with four to five used for each treatment. Most of these treatments have been aimed at pain reduction in knee osteoarthritis.

Several studies have been conducted regarding the use of leeches for treating knee osteoarthritis.

One study, reported in the Annals of the Rheumatic Diseases, focused on 16 patients with an average age 68. These patients had experienced persistent knee pain for more than six months. None had suffered any knee injuries and all had x-ray evidence of osteoarthritis. These patients were already treating their knee osteoarthritis with physical therapy, relaxation, diet and exercise.

In this study, part of the group was provided traditional treatment and the rest were treated with leeches. Four leeches were applied to the knee for 80 minutes. Pain levels were measured three days before and 28 day after the treatment. The results were rapid. Treatment with leeches resulted in pain relief after three days and continued through the 28 day test period. The patients who received traditional treatment did not experience relief. There were no side effects noted from the leeches and the patients reported that the initial leech bite was mildly painful.

A larger study was conducted involving 51 patients age 40 and above with knee osteoarthritis with high pain. Four to six leeches were applied to the affected knee and were allowed to remain until they detached themselves, which took about 70 minutes. Then the patients rested the knee for 12 hours. Researchers then measured the patients' pain, stiffness and range of motion after 3, 7, 28, and 91 days.

The results were similar to the smaller study. The patients receiving leech therapy reported less pain, less stiffness, better function, and fewer total osteoarthritis symptoms through the full 91 days that the researchers followed them.

These studies give hope for alternative treatments of knee osteoarthritis for reducing pain and increasing mobility. In order to properly validate these studies additional research needs to be conducted over a longer period of time. But it appears that leeches do provide relief to knee osteoarthritis sufferers.

What is the Most Effective Supplement to Use For Joint Pain?

Joint pain or arthritis - regardless of what you decide to call it - is one of those health issues all of us anticipate we'll never ever have problems with. Regrettably, the simple fact is that 29% of people in the 45 to 65 year age bracket will display the condition. Once you hit 65 or beyond that number grows to over 50%. Studies tell us that the chances are piled against us for certain!

Arthritis (or joint pain) is the phrase applied to cover a range of associated diseases. One of those conditions is osteoarthritis - the form of joint pain many people recognize. This type of arthritis is normally common when you reach 45. What many people don't understand regarding arthritis is the fact that very early diagnosis of the condition can insure much lower severity in later years.

Before we look at what is the best supplement to take for joint pain, here are two invaluable suggestions to deal with inflamed or overtly swollen joints:

Treatment Using Ice: An ice pack should be your first course of action when attempting to manage swelling in your joints as a consequence of injury, surgery or an acute attack of arthritic joint pain. It's preferable to use ice in the afternoon and evening. Under no circumstances leave ice near to the skin for longer than 15-20 minutes at a time for the risk of frostbite of the skin. It can be remarkably effective in lowering pain, muscle spasm and inflammation.

Treatment Using Heat: Use heat in the morning while the joints are immobile after sleeping or just cold in the winter time. Warmth is perfect for maximizing the flow of blood to parts of our body that happen to be under tension. It's better utilized when swelling has reduced - never use heat on swollen joints (apply ice). Be mindful not to scold yourself when utilizing heat packs such as wheat bags or hot water bottles.

There are far too many health supplements intended for joint pain and arthritis available in the market to mention them all here in this article currently. This is not a comparison - it is merely a summary of the most likely joint pain nutritional supplement choices. Remember, what works for one person might not work for another person. Keep a positive open mind and keep trying till you locate something that starts to make a difference. Have patience, improvements frequently occur little by little at first.

There are some excellent natural alternative treatments for arthritis in shops to test. Combining supplements may perhaps work better for you than just one. An example of this could well be to put together fish oil with green lipped mussel extract. I typically get consumers informing me they consider green lipped mussel vastly better to glucosamine and chondroitin.

So - what is the best supplement to take for joint pain? Listed here are the most likely natural treatments for arthritis, as well as back pain and knee pain:

1. Check your Vitamin D levels as a protective measure against deteriorating bones as a consequence of deficient calcium uptake. You can get Vitamin D by soaking up the suns rays onto the skin each day, by way of eating habits and nutrition, and by way of supplementing. Individuals with substantial levels of Vitamin D experience less by physical diseases such as joint pain and arthritis.

2. Supplement with Glucosamine Sulphate and Chondroitin Sulphate products. Glucosamine is very nicely suited to the treatment of joint pain and inflammation since it is able to regulate cartilage metabolic process which, subsequently, helps to prevent cartilage from degenerating. Glucosamine encourages your system's natural restore mechanisms. Chondroitin works with glucosamine and should be taken simultaneously. It provides a lubricating affect on joints.

3. Fish Oil (omega 3 DHA) nutritional supplements come highly recommended in the battle against joint pain. Fish oil has both natural anti-inflammatory benefits and coronary heart health benefits. If you take hardly any other dietary supplements - you must take fish oil each day. Combine that together with green lipped mussel extract for unbelievable results in joint pain relief within just 1-3 months.

4. New Zealand Green Lipped Mussel Extract is quickly overtaking glucosamine in level of popularity and for very good reason. This natural and organic anti-inflammatory made out of ground up green mussels found solely contained in the seas encircling New Zealand can have surprising benefits with people affected by joint pain and arthritis. Loaded with omega 3 essential fatty acids, this joint dietary supplement can also be ideal for treating quite a few other inflammatory disorders for example asthma, crohns disorder, etc. Being a natural whole food, there are almost no side effects.

5. Gin-Soaked Golden Raisins. Quite a few people recommend this popular folk remedy for arthritis and joint pain. Soak the raisins in straight gin for about 7-10 days. Then eat 9 raisins on a daily basis so long as you obtain any benefit.

6. Cherry Juice contains powerful anti-oxidants known as anthocyanins that really help minimize and get rid of unfavorable free-radicals from the body. It has been found to be effective in the treatment of arthritis and gout by reducing uric acid in the bloodstream.

7. Turmeric happens to be an Asian spice that has an active ingredient named curcumin. It is this compound that is believed to be beneficial as a health supplement for joints. Include it with food or take it as a joint wellness supplement.

Is Bikram Yoga Safe For Knees After Surgery?

Knee surgery for a torn meniscus or entire knee replacement sometimes becomes imperative; its rehabilitation takes about seven to eight weeks; by that time any inflammation, redness or pain will be taken care of; as soon as you are able to put your weight on your affected leg without pain, you are ready for Bikram (hot) yoga. It is better to go slow in the beginning- right after the surgery- if there is any indication of redness, swelling or soreness, remember to ice it. Also avoid stretching or bending the leg too far. In Bikram yoga an hour and a half of performance of very challenging poses, in a room kept at 105 degrees Fahrenheit and humidity level at forty percent, produces profuse perspiration to relieve the body of all toxic wastes. It also increases the strength and elasticity in knees after surgery; and prevents injuries in future

Rewards of Bikram Yoga after Surgery

• Strengthens inner and outer quadriceps


• Strong inner, outer, upper and lower muscles support the weak knee


• Increased blood flow and nutrients for the affected knee

Knee Protection while Performing Yoga

After knee surgery, one might want to return to one's lifestyle quickly, it is important to do so with extreme caution. Adopting wrong poses or pushing beyond limits can further endanger your knees. To practice Bikram yoga as you are recuperating, keep the following in mind.

• Keep your feet well placed and aligned. Push down through all four corners of your feet for most of the asanas. If your feet are not in the right position, your knees will be affected adversely.


• Your knees should be in line with your ankles, not moving out over them. This is important especially for lunges and knee bends. The knee must be directing towards the middle toe. In standing extended-leg forward fold, remember to pull up on the arches of the feet.


• Some postures in Bikram yoga require locking the knees, refrain from that after surgery; you may pull in the knee-caps to take up a pose. If you need to hyperextend your knees for a certain pose, do so by keeping the knees slightly bent in most standing and forward folding positions.


• If your hips are not opened up or extended fully, your knees will have to bear extra pressure during most of the standing postures. You must open your hips early in a class to avoid putting this strain on your knees.

Bikram yoga practitioners who have gone through knee surgery must take extra care to perform certain poses. Hero's pose if not performed rightly can pull at the knee-ligaments, while done properly, proves beneficial in healing the knees. In Triangle pose there is a risk of locking or hyper-extending your knees. In Seated-Forward Fold, bend your knees a little to avoid any further damage to your knee. To practice Child's pose, put a blanket between your buttocks and calves to reduce strain on your affected knee. As this branch of yoga puts a great emphasis on patience, you must remember to be patient and allow enough time for your body to heal fully before you put it through a demanding regimen.

Cyberwar in Estonia and the Middle East

Did a member of your family help launch a cyber attack that brought an entire nation to its knees? No, seriously, don't laugh. In April 2007, communications in the Baltic state of Estonia were crippled through a coordinated attack that relied on the computers of millions of innocent users around the world, just like you and your kin. The strike was notable in fully demonstrating how cyber war had moved from idea to reality. And it all started with the movements of a single soldier.

The Bronze Soldier is a two-meter statue which formerly stood in a small square in Tallinn, the Estonian capital, above the burial site of Soviet soldiers lost in the Second World War. The memorial has long divided the population of the country, with native Estonians considering it a symbol of Soviet (and formerly Nazi) occupation and a large minority population (around 25% of the total) of ethnic Russian immigrants seeing it as an emblem of Soviet victory over the Nazis and Russian claims over Estonia. When the country's newly appointed Ansip government initiated plans to relocate the statue and the remains as part of a 2007 electoral mandate, the move sparked the worst riots the country had ever seen - and a startling cyber attack from Russia.

On April 27, as two days of rioting shook the country and the Estonian embassy in Moscow found itself under siege, a massive distributed denial-of service (DDoS) attack overwhelmed most of Estonia's internet infrastructure, bringing online activity almost to a standstill. The targets were not military websites but civilian sites belonging to organizations such as banks, newspapers, internet service providers (ISPs), and even home users. Much of the onslaught came from hackers using ISP addresses in Russia, but the most devastating element in the attack was a botnet which co-opted millions of previously virus infected computers around the globe to pummel the Estonian infrastructure.

Anatomy of a Cyber Attack

The botnet fooled Estonian network routers into continuously resending useless packets of information to one another, rapidly flooding the infrastructure used to conduct all online business in the country. The attack centered mainly on small websites which were easy to knock out, but nevertheless was devastatingly effective. Bank websites became unreachable, paralyzing most of Estonia's financial activity. Press sites also came under attack, in an attempt to disable news sources. And ISPs were overwhelmed, blacking out internet access for significant portions of the population.

While the Estonian government was expecting there to be an online backlash to its decision to move the statue, it was completely unprepared for the scale of the cyber attack. Estonia's defense minister went on record to declare the attack "a national security situation", adding "it can effectively be compared to when your ports are shut to the sea."(1)

Once it became clear that most of the country's online business infrastructure was being affected, the Computer Emergency Response Team for Estonia (CERT-EE) issued a plea for help from IT security specialists worldwide and an ad-hoc digital rescue team was assembled, which included people from my own firm, Beyond Security. It took us a few days to get to the bottom of the threat and begin setting up frontline defenses, which mainly involved implementing BCP 38 network ingress filtering techniques across affected routers to prevent source address spoofing of internet traffic. The attack waned quickly once we started taking defensive measures. But in the days it took to fight off the attack, it is likely that the country lost billions of Euros in reduced productivity and business downtime.

Cyber War in the Middle East

The Estonian incident will go down in history as the first major (and hopefully biggest ever) example of full-blown cyber warfare. However, there is one place on earth where cyber war has become part of the day-to-day online landscape - and it is still ongoing.

In the Middle East, the Arab-Israeli conflict has a significant online element, with thousands of attacks and counter-attacks a year. This has been the situation since the collapse of peace talks in the region and was preceded by a spontaneous wide-scale cyber war between Arab and Israeli hackers in 1999 and 2000. Arab sympathizers from many nations are involved. A group of Moroccan hackers have been defacing Israeli web sites for the last six years or so, and recently Israel's military radio station was infiltrated by an Iraqi hacker.

Unlike the blitzkrieg-like strike in Estonia, this protracted warfare is not intended to paralyze critical enemy functions but more to sap morale, drain resources and hamper the economy. The targets are typically low-hanging fruit in internet terms: small transactional, informational and even homespun web sites whose security can easily be compromised. Taking over and defacing these sites is a way of intimidating the opposition - creating a feeling of 'if they are here, where else might they be?' - and leads to significant loss of data, profits and trust for the site owners.

Cyber War Spreads

If the Estonia and Middle East examples were our only experiences of cyber warfare then it might be tempting to put them down to local factors and therefore not of concern to the wider security community. Sadly, however, these instances are simply part of a much larger trend towards causing disruption on digital communications platforms. In January this year, for example, two of Kyrgyzstan's four ISPs were knocked out by a major DDoS hit whose authors remain unknown.(2) Although details are sketchy, the attack is said to have disabled as much as 80% of all internet traffic between the former Soviet Union republic and the west.

The strike appeared to have originated from Russian networks which are thought to have had links to criminal activity in the past, and probably the only thing preventing widespread disruption in this instance was the fact that Kyrgyzstan's online services, unlike those in Estonia, are poor at the best of times. It was apparently not the first such attack in the country, either.(3) It is claimed there was a politically-motivated DDoS in the country's 2005 presidential elections, allegedly attributed to a Kyrgyz journalist sympathizing with the opposition party.

China has also engaged in cyber warfare in recent years, albeit on a smaller scale. Hackers from within the country are said to have penetrated the laptop of the US defense secretary, sensitive French networks, US and German government computers, New Zealand networks and Taiwan's police, defense, election and central bank computer systems.

In a similar fashion, in 2003 cyber pests hacked into the UK Labor Party's official website and posted up a picture of US President George Bush carrying his dog - with the head of Tony Blair, the Prime Minister of the UK at the time, superimposed on it.(4) The incident drew attention to government sites' lax approach to security although in this particular event it was reported that hackers had exploited the fact that monitoring equipment used by the site hosting company had not been working properly. And as long ago as 2001, animal rights activists were resorting to hacking as a way of protesting against the fur trade, defacing luxury brand Chanel's website with images of slaughtered animals. (5)

The Case for the Defense

What do all these incidents mean for policy makers worldwide? Both the Estonian and Middle Eastern experiences show clearly that cyber war is a reality and the former, in particular, demonstrates its devastating potential. In fairness, Estonia was in some ways the perfect target for a cyber strike. Emerging from Russian sovereignty in the early 1990s with little legacy communications infrastructure, the nation was able to leapfrog the developments of western European countries and establish an economy firmly based on online services, such as banking, commerce and e-government. At the same time, the small size of the country - it is one of the least populous in the European Union - meant that most of its web sites were similarly minor and could be easily overwhelmed in the event of an attack. Last but not least, at the time of the Estonian incident, nothing on a similar scale had been experienced before.

It is safe to say that other nations will now not be caught out so easily. In fact, if anything, what happened in Estonia will have demonstrated to the rest of the world that cyber weapons can be highly effective, and so should be considered a priority for military and defense planning.

What might make cyber warfare the tactic of choice for a belligerent state? There are at least five good reasons. The first is that it is 'clean'. It can knock out a target nation's entire economy without damaging any of the underlying infrastructure.

The second is that it is an almost completely painless form of engagement for the aggressor: an attack can be launched at the press of a button without the need to commit a single soldier.

The third reason is cost-effectiveness. A 21,000-machine botnet can be acquired for 'just a few thousand dollars', a fraction of the cost of a conventional weapon, and yet can cause damage and disruption easily worth hundreds of times that.(6)

The fourth is that it is particularly difficult for national administrations to police and protect their online borders. A DDoS attack may be prevented simply by installing better firewalls around a web site (for example), but no nation currently has the power to tell its ISPs, telecommunications companies and other online businesses that they should do this, which leaves the country wide open to cyber strikes.

The last but by no means least reason is plausible deniability. In none of the cyber war attacks seen so far has it been possible to link the strike with a government authority, and in fact it would be almost impossible to do so. In the case of the Chinese hack attacks, for instance, the authorities have provided a defense which amounts to saying: 'There are probably a billion hackers on our soil and if it was us we would have to be stupid to do it from a Chinese IP address.'

A similar logic potentially provides absolution to the Russian administration in the case of Estonia: if it is so cheap and easy to get a botnet to mount a DDoS attack, why would the Russians bother mounting hack attacks from their own ISPs? And in the Kyrgyz attack, although the source of the DDoS clearly points to a Russian hand, the motives for Russia's involvement remain hazy, leading to a suggestion that it may have been caused by Kyrgyzstan's own incumbent party, acting with hired cyber criminals from Russia.

Tactics For Protection

With all these advantages, it is unlikely that any military power worth its salt is by this stage still ignoring the potential of cyber warfare. In fact, since the Estonia incident it is even possible that the incidence of cyber warfare has increased, and we are simply not aware of the fact because the defensive capabilities of the sparring nations have increased. After all, another important lesson from Estonia is that it is possible to mount a defense against cyber attacks. There is no single solution, no silver bullet, but a range of measures can be taken to deal with the kinds of DDoS issues faced by Estonia and the kinds of hacker attacks still going on in the Middle East.

For DDoS strike avoidance, there are four types of defense:
o Blocking SYN floods, which are caused when the attacker (for example) spoofs the return address of a client machine so that a server receiving a connection message from it is left hanging when it attempts to acknowledge receipt.
o Implementing BCP 38 network ingress filtering techniques to guard against forged information packets, as employed successfully in Estonia.
o Zombie Zappers, which are free, open source tools that can tell a device (or 'zombie') which is flooding a system to stop doing so.
o Low-bandwidth web sites, which prevent primitive DDoS attacks simply by not having enough capacity to help propagate the flood.

For hacker attacks such as those seen in the Middle East, meanwhile, there are
three main types of defense:
o Scanning for known vulnerabilities in the system.
o Checking for web application holes.
o Testing the entire network to detect the weakest link and plug any potential entry points.

A Doomsday Scenario?
All the above are useful defensive tactics, but what about strategic actions? First and foremost, the Estonian experience showed that it is important for the local CERT to have priority in the event of an attack, in order to ensure that things can return to normal as soon as possible.

Authorities can also as far as possible check national infrastructures for DoS and DDoS weaknesses,, and finally, national CERTs can scan all the networks they are responsible for - something the Belgian CERT has already started doing. Given the openness of the internet and the differing challenges and interests of those operating on it, these measures will of course only provide partial protection. But it is hoped they would be enough to prevent another Estonia incident. Or would they?

There is, unfortunately, another type of cyber war strike which we have yet to see and which could be several times more devastating that what happened in Estonia. Rather than trying to hack into web sites just to deface them - a time-consuming effort with relatively little payback - this tactic would involve placing 'time bombs' in the web systems concerned. These could be set to lay dormant until triggered by a specific time and date or a particular event, such as a given headline in the national news feed. They would then activate and shut down their host web site, either using an internal DoS or some other mechanism.

The code bombs could lay dormant for long enough for a malicious agency to crack and infect most or all of the major web sites of a country. And in today's networked world, this is no longer about simply causing inconvenience. Think of the number of essential services, from telephone networks to healthcare systems, which now rely on internet platforms. Knocking all these out in one go could have a truly overwhelming impact on a nation's defensive capabilities, without the need for an aggressor to send a single soldier into combat.

The means to create such an attack definitely exist. So do the means to defeat it. What has happened in Estonia and the Middle East shows we now need to consider cyber warfare as a very real threat. What could happen if we fail to guard against it really does not bear thinking about.

References
1. Mark Landler and John Markoff: 'Digital fears emerge after data siege
in Estonia'. New York Times, 29 May 2007.
2. Danny Bradbury: 'The fog of cyberwar'. The Guardian, 5 February 2009.
3. Ibid.
4. 'Labour website hacked'. BBC News, 16 June 2003.
5. 'The fur flies'. Wired, 23 January 2001.
6. Spencer Kelly: 'Buying a botnet'. BBC
World News, 12 March 2009.