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Date posted: February 5, 2012

Dr Mansoor Ali.

The most important basic requirement for getting a better result in spinal disorders is that case taking should be perfect. If you neglect making careful examinations, the patient will be the first sufferer, and then you also suffer from it and ultimately homoeopathy also.

We are going to discuss a methodology, the methodology that everybody can follow with ease with which we can improve our practice with very high success rate with limited failures.

A case of IVDP
Female 35 Years   IP No.202    DOA : 28.09.06

Presenting Complaint

  • Pain in lumbosacral region – < since  2 months
  • < walking, standing
  • > lying on sides

HPC : Complaints started 4 years back as pain in lumbosacral region  on turning in bed. Took allopathic treatment with transient relief.

Numbness appeared in lower limbs, no touch sensation, no desire for stool.

Diagnosed as IVDP at L4-L5 and L5-S1 and advised surgery

Past History
R/C tonsillitis, UTI and Chicken Pox

Mental General

  • Desire to be alone
  • Irritability during pain
  • Angered easily

Physical Generals

  • Chilly pt ,bathing in warm water
  • Appetite decreased
  • Easy satiety
  • Desire chillies, pickles
  • Hard insufficient stool
  • Offensive perspiration
  • Dreams of falling from height 

Particulars :

  • HA from exposure to sun, eyestrain, crowd
  • Emptiness not > eating
  • Cramps from cold
  • White coated tongue 

Miasmatic Expression

Symptom Psora Sycosis Syphilis
Pain back < Walking< motion< standing< lying on back ++++
Gets angered easily + + +
Irritability on pain + +
Desire to be alone +
Appetite less,easy satiety +
Desire chillies +
Hard insufficient stool +
Offensive perspiration +
HA < Sun exposure to +
Emptiness not > eating +

If you are doing a miasmatic cleavage like this, you can find out the dominant miasm and also the correct antimiasmatic remedy.

Physical Examination :

  • SLR +ve below 40 on both sides
  • PSLR +ve below 40 on both sides
  • Gaenslen’s test –ve
  • X-ray :Space reduction b/n L4 & L5, L5& S1
  • MRI :Posterior & postero lateral disc prolapse at L4-L5 causing thecal sac & L5 root compression.Posterior disc bulge at L5-S1 with minimal thecal compression.Spinal canal stenosis at L5 

Repertorial Totality :

  • Mind. Company aversion to
  • Stomach. Appetite easy satiety
  • Stomach. Desire pungent things
  • Sleep. Dreams falling from high places
  • Perspiration. Odor offensive
  • Stomach. Emptiness eating not >
  • Head. Pain. Sun from exposure to
  • Back. Pain Walking while
  • Back. Pain Standing while

 We had not considered lack of desire for stool, urinary complaints ect. Since these are the common symptoms of IVDP

Result :

  • Sulphur 16/7
  • Sepia 14/7
  • Lyco 13/6
  • Thuja 13/6
  • Phos 12/7

 PDF

  • Gets angered easily
  • Cramps from cold
  • Chilly patient 

Basis of selection
Offensive perspiration,mental picture of the patient and particular modality pointed to Sepia

Prescription

28.09.06 Sepia 200
05.10.06 Can walk with less pain,other symptoms persist SL
12.10.06 Can walk but with pain Sepia 1M
26.01.07 < of pain Sepia 1M
24.03.07 Pain if walked and exerted much SL

Inference

  • Pain is not relieved within a week. After two week she could walk, but with pain,intensity rezuced after Sepia 1M.
  • After 1 month she could stand without pain.
  • After 6 months pain comes only if walked for a long distance and if she exerted much.
  • We had verified in several patients in our OPD & IPD that – higher potencies yield much better results in both acute and chronic spinal disorders.

IVDP- Related rubrics
We have to consider the following rubrics in addition to the mental generals and physical generals of the patient to get a better result.

1.Back pain:   Cervical region
Lumbar region
Lumbosacral region
Sacral region
Coccyx

We have to select specific location where actually the pain is, then we will get the correct  remedy which have specific action on that location

2.Sciatica :  Extr. Pain.Lower limb. Sciatica

3.Stiffness : Back. Stiffness- Cervical
Nape of neck
Lumbo sacral
Sacral

4.Numbness : Back. Numbness.
Cervical
Scapulae
Lumbo sacral
Sacral

5.Weakness  : Back. Weakness
Extr. Weakness

6.Paralysis    : Extr. Paralysis

Prescribing on Etiology offers excellent results

If the cause is removed effect goes off by themselves

  • Cervical pain over lifting from   : Calc.c
  • From false position in sleep  : Rhus.tox
  • Back Pain after LSCS  : Hypericum
  • Fall on Coccyx : Hyper, Silicia, Sitting <: Kali.bich
  • Lumbago after injury : Agaricus
  • Fall on  sacral region : Kali.C

 Sciatica

  • Acute Management  and  Chronic Management
  • We have to give immediate relief to the pain in sciatica 

Give importance to

    Side :  Right : Coloc, Lach, Lyc, Gnaph

               Left   : Phos, Spigelia

    Modality : Flexing limb < : Colocynth

                      Standing <, motion > etc

   Concomitance :  Accompanied by….

                               Haemerrhoids : Aesc

                               Numbness with : Gnaph

   Extension :

 Aetilogy : Injuries after : Arn, Hyper, Ruta (We got much result from Hypericum  higher potency than other remedies)

Therapeutics in sciatica: We found the following remedied highly useful, but never limit your prescription to these remedies)

Sciatica on both side : Chamomilla mother tincture offers immediate relief to pain

Deformed vertebra : Calc.Phos

Parts cold to touch, periodicity : Ars.alb

Lumbago + Sciatica : Rhus.tox- It  is  the best remedy for a  combination   of  lumbago  and sciatica. Sciatica arising from over-exposure to wet  or  from   lifting, wrenching  and  over-exertion.  Great relief from  warmth.

Sitting <,Walking>,Lying down OK : Amm.m

Pain < by sitting & standing: Valeriana

Pain from buttock to ankle, least movement aggravates, with perspiration, lying on painful side > : Bry

Murphy’s Repertory : Readers are requested to read carefully the following chapters in Murphy’s repertory that contain so many useful rubrics for our day to day practice.

  • Emergency : Back. Injuries after
  • Leg : Sciatica

A Case Cervical Spondylosis

  • Male 50 years admitted in our IPD
  • Pain in neck with stiffness, can’t turn to left ,<jar++,moving,yawning
  • >Warm bathing,lying on sides
  • Fish selling in bicycle, stopped since 6 months
  • Concomitant : Numbness of palms, weakness of hands
  • Extension : Shoulder, chest,dorsal region

Repertorial Totality :

  • Mind. Contradiction Intolerant of
  • Gen.F&D. Sweets desire
  • Sleep.Sleeplessness noise from
  • Mouth. Cracked tongue
  • Ext.throat. Torticollis
  • Back.Pain. Cervical region moving on
  • Back.Stiffness. Cervical region
  • Extr. Numbness hand
  • Phos. 15/7
  • Lyc. 15/6
  • Sulphur. 14/8
  • Nux. 13/9
  • Calc. 10/6 

PDF

  • Renal calculi
  • Cervical region
  • Warm bathing >
  • Lying head high < 

Prescription :  Lyc. 200/

Lyc 200 prescribed – not much improvement for pain within one week

So we prescribed Lycopodium 1M – with in next one week much relief to pain

Then  prescribed and raised the potency  infrequently at longer intervals- since Lycopdium is a long acting remedy – If we are repeating Lycopodium and Phosphorous   like remedies in chronic cases frequently that may spoil the entire case – so called as double edged swords.

This case we got immense relief within 2 months and now he is again ding his fish selling in bicycle.

Important remedies for cervical spondylosis verified in our college

Cimicifuga : Most suitable for IT professionals & stenos with stiffness & pain in neck

Nux.v : Sedentary, constipation, alcohol,burning spine, turning difficult

Lachananthes : Torticollis   with severe muscle spasm, numbness- specific action- acute remedy

Calc.carb : Most successful remedy in several cases with rigidity & stiffness in morning, turning difficult and tendency to strain easily

Kalmia : Rt. Ext. down, with numbness, C5-C7

Rhus.tox : Pain from false position,<sitting, exertion,> warmth application

Lycopodium : Pain + Urinary + GIT   Acute : Berberis .v  mother tincture

Rubrics to be considered in cervical spondylosis

Give importance to

•          Side   Right : Sang, Kalmia

                    Left : Conium

Modality

        Looking up <  : Graph

        Stooping <      : Rhus.t

        Coughing on    : Sulphur

        Turning <  : Agaricus, Aesc, Bry, Sulph etc.

Extension : Consider this also

Look for the associated complaints like

  •     Vertigo
  •     Tinnitus
  •     Blurring of vision  and select additional rubrics 

Role of Physiotherapy in Homoeopathy
We are doing physiotherapy in the following conditions in our college

  • Pain- all types
  • Paralysis
  • Nerve Injury
  • Deformities
  • Muscle weakness
  • Stiffness
  • Post traumatic cases
  • Soft tissue injury
  • Arthritis
  • OA Knee
  • Gynaecological pain
  • Cx & Lumbar spondylosis
  • Fibromyositis
  • Migraine
  • Frozen shoulder
  • Bell’s palsy
  • Tennis elbow
  • Plantar fasciitis
  • Muscle spasm/cramps 

Local applications not good ?
$194 (a)
It is not useful, either in acute local diseases of recent origin or in local affections that have already a long time, to rub in or apply externally to the spot an external remedy, even though it be the specific  homoeopathicity, even although it should be at the same time administered internally; for the acute topical affections , which have not been caused by external injury of proportionate violence, but by dynamic or internal causes….

Internal & External together- not good
$197
…… the simultaneous local application, along with the internal employment, of the remedy in diseases whose chief symptom is a constant local affection,  has this great disadvantage, that, by such a topical application, this chief symptom (local affection)  will usually be annihilated sooner than the internal disease, ……..  a perfect cure; or at least it will be difficult, and in some cases impossible.

Reduction,bandage,local application- Good in
$186
Those so-called local maladies which have been produced a short time previously, solely by an external lesion,  ….. the whole living organism sympathizes . The treatment of such diseases is relegated to surgery; but this is right only in so far as the affected parts require mechanical aid, ….. by the reduction of dislocations, by bandages, by the extraction of foreign bodies etc…. then the services of the dynamic physician and his helpful homoeopathy come into requisition.

Kent

  • Never apply local heat or oils to relive pain- really worse for the patient
  • But good in stiffness & paralysis (Homeopathic materia medica- Kalmia)       

Farrington

  • Salt application- to relieve pain, weakness of muscles & nerves
  • May prevent deformities  (Natrum family- Clinical materia medica) 

Remember : The accessory management or accessory life saving measures are not the monopoly of any of the medical system. Try to incorporate it in your practice, which offers faster and better results.

Summary

  • Homeopathy offers effective treatment for Neurospinal disorders
  • Detailed case taking and proper repertorisation are essential
  • Aetiological prescription offers immediate relief
  • Higher potencies are useful both in acute & chronic
  • Homeopathic remedies along with accessory mgt offers  excellent, speedy recovery
  • It is better to avoid external applications to relive pain

Lastly
This is only a methodology. Study the subject in detail. Homoeopaths should see opportunity in every difficulty…   but not difficulty in every opportunity. We must have good vision, loyalty and dedication. Take homoeopathy in to greater heights.

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Comments

One Response so far.

  1. T Bachaspathi says:

    Sir

    My wife aged 55 years developed back pain just 6 months back. Now after seeing the spine surgeon he advised for immediate surgery. But she was afraid and we consulted another Spine physician who have given medicines and asked not to go for operation. I am also giving Homeopathy like Cal. Flour, Cal Phos. Symphytom,Rhus tox, ruta, Cimicifuga all inb 1 M potency, but the results are very slow. Now her pain has reduced, swelling in face and hand also reduced but not gone completely. Doctor said there is a gap in L5 and it is slip disc, it will take time to recover. Kindly advise some good homeopathic medicine with proper potencies. Kindly do the needful regards

    T Bachaspathi

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