Cervical spondylosis is the most common cause of the pain in cervical spine. It is due to osteoarthritis of the cervical vertebrae.
The maximum site of affection is at Cervical vertebrae 5 and 6 (C5-C6) and at Cervical vertebrae 6 and 7(C6-C7).
Earlier, it considered as the disease of the old people, but nowadays it is one of the occupational disease and affects the youngsters.
Causes of cervical spondylosis
X Disc bulging-due to injury the intervertebral disc bulges out and pinches the nerve root.
X Old age- after the age of 40, the disc becomes dry out then it shrinks. This causes the direct contact of vertebral surfaces.
X New bone formation-due to degeneration of the vertebrae new bones are formed. It is known as spurs or osteophytes. And this spurs also cause pressure on spinal cord.
X Stiff ligaments-due to ageing the ligaments that connect the adjacent vertebrae become stiff and that limit the movement of the neck.
X Injury to spine-
X Direct injury or over strain to the neck as in gymnastics and weightlifters.
X Incorrect posture-
X Keeping the neck in an awkward position for a long time.
X Pain and tenderness of the neck
X Painful restriction of neck movements
X Palpable or audible crepitations
X Cervical myelopathy- if the herniated disc or spurs put pressure on spinal cord, then it is called as myelopathy. It will results in the following symptoms.
a-Tingling and numbness of arms, hands, legs and feet
b-Loss of control on bladder and bowel-it results in involuntary urination or defecation.
X If the osteophytes or spurs presses on the spinal nerve roots, it results in pain in both arms and front and back of chest. It is called as radiculopathy.
X ray cervical spine
Proper rest and physiotherapy
If the pain is severe immobilization of the neck muscles by using the cervical collar is advised.
In youngsters and adult homeopathy works wonders in managing the pain and also curing the cervical spondylosis. However, in old people and chronic cases only pain management is possible. Physiotherapy can be advised along with homeopathic medicines. But it should be under the supervision of a well experienced doctor.
Medicines-Acid phos, Lachnanthus, Rhs tox , Hypericum, Nux vom etc.;
Fibromyalgia is one of the most common causes of pain in muscles and soft tissues. It is associated with medically unexplained symptoms.
Fibromyalgia can occur at any age, including a teenager, but with a tendency for increased incidence with the advancing age. It is more common in women. Stressful life situations like divorce, marital disharmony, mental assault, low income, and self-reported childhood abuse play a role in the development of fibromyalgia.
However, the exact causation is not yet understood.
Main abnormalities that are commonly seen are-
2-Abnormal pain processing. Reduced tolerance to pain at characteristic sites throughout the body is the key feature of fibromyalgia.
Symptoms of fibromyalgia
Pain at multiple sites and at muscles, tendons and ligaments. Pain occurs at the different site, and pain may be throbbing, or stabbing, or burning type.
Severe fatigue-patient feels as if completely drained of energy.
Numbness and tingling in fingers
Bloating of the abdomen with colicky pain without any modalities
Frequent urination at night
General discomfort when touched.
The chief characteristics of the pain are the unresponsiveness to any traditional measures. Even analgesics won’t have any effect. And physiotherapy worsens the situation.
Patient present with unusual fatigues while during gardening, shopping, and during house work.
Counseling and educating the patients about the nature of the problem.
Homeopathy brings significant relief to fibromyalgia patients. Since it affects mentally and physically homeopathy is the ideal treatment as it gives importance to the mental and physical aspects of the patient. Since the symptoms of fibromyalgia changes from patients to patients who exactly meet the principle of homeopathic treatment that is individualization. And the triggering factors that are behind the fibromyalgia can be also managed by homeopathy. Homeopathy is the safe alternative for fibromyalgia.
Shoulder pain is nowadays becoming more common. When the pain increases there is a restriction of movements. However, as the disease progresses towards the pain become less but the movement become more restricted in all directions.
The main causes of frozen shoulder are-
Sometimes the disease may recover by itself but only after years.
As usual, the basic cause for frozen shoulder is considered first and then the physical and mental aspect of the patient as a whole is considered and a remedy covering all the above features is selected. The potency and the repletion of homeopathic remedy are decided by the chronicity, and the intensity of the complaint. Definitely, homeopathy is very effective for frozen shoulder. And the remedy selection also gives importance to the site of affection. Medicines like Ferrum met, Sangunaria, Rhus tox. Sypyllinum etc. is the usual remedies.
Gout is the hereditary disorder in which uric acid crystals are deposited in joints.
Males are affected more than females.
Normal level in man -3.5 to 7.0 mg/dl
Normal level in women- 2.5 to 5.7 mg/dl
Gout may be primary where no cause is found, and is more common in men over 40 years of age.
Secondary gout - it occurs secondary to some other disease like renal impairment or drug therapy. It is more common in age of 65 and in females.
In primary gout, the main source of uric acid concentration is from foods. The balance between the synthesis and its elimination via the kidneys determines the amount of the uric acid in blood.
Gout may be acute and chronic.
Alcohol intake, fat rich diet, certain drugs, exposure to cold, trauma, surgery, and heredity is the predisposing factors.
Clinical features are-
1-Sudden unexpected attack of pain usually at night is the warning symptom. The site of involvement is the big toes. The pain is so unbearable that even the touch of the bed sheet is intolerable. There is tenderness on the part involved.
The part becomes swelled and with redness. Pain subsides by about 5-14 days.
Later other joints get involved. Progressive attacks become severe and at short intervals.
2-Mild fever at times
After an acute attack, there may be no second attack. But in certain people symptoms may appear after a year.
Deposition of urate crystals in finger joints, hands, forearm, and wrist and ear cartilage results with the formation of nodules called tophi.
Uric acid crystals may get deposited in kidney causing renal colic.
Diet for gout patients
Low-fat milk and dairy products.
Choose foods that are rich in fibers like oats, spinach, broccoli, etc.;
Use olive oil as cooking medium.
Citrus foods like orange, lemon will reduce the level of uric acid in blood; in addition, Vitamin C plays the same role. Daily intakes of 500mg of vitamin C markedly reduce the level of uric acid.
Avoid bakery items, and sugary items. Cookies cakes and pastries will increase the gout symptoms.
Fruits like blueberries, cherries are highly recommended as they markedly neutralized the uric acid in blood.
Avoid high-protein diet in food.
Drink at least 2 to 3 liters of water per day. It will eliminate the uric acid through urine.
Avoid red meats and shell fishes.
Follow above-mentioned diet regulation and drink 2-3 liters of water.
Homeopathy offers a permanent solution for gout. The homeopathic treatment aims the control of the acute phase and complete eradication of the disease.
At first depending on the site involved and nature and severity of the pain a simillimum is selected. And when the symptoms are relieved after medication, constitutional medicines are selected, which will cure completely the relapsing tendency of gout.
If the gout occurs secondary to some other disease, the aim of homeopathic treatment is to control or cure the triggering disease also. The selection of homeopathic medicine is by considering the mental and physical aspect of the patient. And it takes a period of time for the complete cure.
INTERVERTEBRAL DISC PROLAPSE (IVDP)
Disc prolapse can occur in vertebra and anywhere in spine. But in the thoracic region, it is very rare. And it is more common in the lumbar vertebrae.
In the lumbar region, the commonest site is in the level of 4th and 5th lumbar vertebra-L4 –L5.
The most common cause is the injury and stress to the spine. Lifting the weight in a forward flexion is the risk factor. The disc is like a spongy substance that situates between each vertebra and works as a shock absorber. During stress the disc prolapse between the body of the vertebrae and press on the nerves that comes from the spinal cord.
Incorrect posture in work places and during exercise and driving, etc.
Sudden strain and repeated injuries.
Males are commonly affected, and the age group is between 20 and 50yrs.
Severe and sudden onset of pain after lifting a weight, twisting or stooping, the pain usually subsides after rest and treatment. Initially, the pain localized in the low back.
But next attack of pain starts after a minor strain and this pain is much more severe. Pain is worse from stooping, coughing, and sneezing. And pain radiates down to buttock, and extends along the course of sciatic nerve. So it is also known as sciatica. Tingling and numbness are felt along the course of sciatic nerve. But in spite of this pain, the general health is good.
Straight-Leg Raising Test. The patient is asked to lie down on his back, with legs fully extended. The limb is lifted by holding the ankle. Normally, people can rise up 80 degrees. But in case of nerve involvement, the patient feels pain even before it is raised to 80 degrees. The degree at which patient feels pain is noted as positive SLRT. The angle is measured between the bed and the limb.
The unaffected limb is also raised and test for SLRT. If while doing these, patients feel pain in affected limb, it is known as contralateral positive SLRT.
In this test, the leg is lifted to 80 degrees but knee in bent position. Then the knee is gradually extended by the doctor. Full extension is impossible, and the patient will complain of pain the hamstring muscles.
Strict bed rest on a hard surface for a few weeks is necessary.
Do not bend forward and lift weights in stooping position.
Reduction of weight in obese patients.
Exact posture with good ergonomics during sitting and working.
Mild exercise and calcium-rich diet in older patients.
With full bed rest, a period and time and homeopathic treatment will give complete relief to the patient irrespective of the cause. The homeopathic medicine is selected according to the principle of similia similibus curantur.
Homeopathic medicines prevent further degeneration of the bones in old patients, and the patient can lead a normal painless life. The patient's symptoms and pathological aspects are taken into consideration for the selection of the remedy.
Medicines like Arnica Ruta, Hypericum, etc.; are the medicines if the IVDP is due to strain and injury.
Calc flour, Syphyllinum, Aurum met, Calc phos. Calc carb are the medicines used in cases of IVDP due to old age or due to some other diseases.
Homeopathy is a very good and second to none in the treatment of IVDP, and homeopathy gives the complete cure also.
Low back pain or Backache (LBA) is one of the commonest pains that world’s population experiences at least once in his or her life time.
Back pain may be due to -
Non mechanical causes
Duet some specific causes.
Majority of the back pain falls into this group.
The history pain starts after a trauma like sudden bending or lifting a heavy thing. And the pain worsens after mechanical activity and feels better by rest. Peoples between 20-55 years the common suffers. Pain usually localizes at the lumbo sacral area, or buttock or thigh and doesn’t have an extension beyond knees.
LBA is more common in heavy manual workers. Psychological factors such as job dissatisfaction and depression also cause LBA.
NON MECHANICAL CAUSES
Other than mechanical causes, The possibility of LBA is malignancy. Malignancy of pancreas, colon, uterus and prostate will cause LBA. Fracture of vertebra and infection will also cause LBA.
Spondylitis (inflammation of vertebrae) will cause LBA. It is of gradual onset, and occurs before the age of 30. The peculiarity of the inflammatory pain is that there is morning stiffness, and pain is worse in morning and is better by activity.
If there is a nerve involvement, the pain is sharp and extends from the back of leg and beyond the knees. Pain is worse by coughing, sneezing and straining during stool.
SPONDYLOSIS AND SPONDYLOLISTHESIS
Spondylosis is a broad term used to describe the degenerative changes in spine.
The main cause is due to fracture as seen gymnastics, long-distance runners, etc..... In spondylolisthesis, there is an overriding of the vertebra the one below. This may occur as a congenital defect, after a trauma or as part of degeneration.
In spondylolisthesis, backache is common factor and worse from standing and sitting.
Both Spondylosis and spondylolisthesis are diagnosed by x ray lumbar spine and MRI.
Muscle strengthening exercise.
Homeopathic treatment-since the disease ultimately leads to degeneration of vertebrae, before prescribing the miasmatic aspect also should be considered. While selecting homeopathic medicines, those medicines which have a particular affinity for bones are given importance. For example, homeopathic medicines like Calc phos, Calc carb, Calc flour, Kali iod, Ruta etc; have a special affinity for bones. Except in congenital causes, homeopathy is highly effective and patients much are relieved from the complained after the homeopathic treatment. The results are repeatedly verified in the clinic.
OA is the most common form of arthritis. It is one of the major causes of pain and disability in aged people. Here the sponge-like thing- the cartilage in between the joints undergoes wear and tear and there is new bone formation in the joints. Ultimately, there is a remodeling of the contour of the joint.
The important feature is that, there is no inflammation in joints.
The disease nowadays starts even at the age of 30.
80 of the people show radiographic evidence of OA. But 25 to 30% are symptomatic. The knees and hips are mainly affected. Elbow and ankle are also affected but less commonly. Usually, it occurs secondary to some predisposing factors.
The basic lesion is degeneration (wear and tear) in cartilage due to excessive weight or due to a normal weight in damaged cartilage.
The predisposing factors include-
Trauma, fracture, or dislocation
Abnormal shape of the joint like genu valgum and varum.
Due to specific causes that affect the joints- like tuberculosis, septic arthritis, and rheumatoid arthritis.
Metabolic diseases like gout.
Primary osteoarthritis occurs in old age groups with obesity.
Primary OA occurs mostly in obese females after 50 years of age. It affects chiefly the knee joints, distal finger joints, toe joints, lumbar joints, and cervical joints.
Secondary OA occurs in younger age groups, after a specific cause. There is an insidious onset of pain and gradually increases and become constant, and is better by exercise.
Stiffness occurs slowly, and patient feels a difficulty in extending the joint.
Diagnosis is from clinical features and blood examination and x-ray of the affected joint.
The most important risk factor of OA knee is trauma, especially in men, and it occurs as one-sided OA.
In female, it is bilateral and symmetrical.
Pain is worse from going up and down the stairs.
Symptoms of osteoarthritis
Pain and swelling of the affected joint
Pain and stiffness of the joint worse during morning hours and after a period of inactivity
Movement of the joint is affected.
Weight reduction is the primary measure. Plenty of diets rich in calcium and vitamin D should be included in food.
Since the disease is degenerative, complete recovery is impossible. Homeopathy is equally effective in the symptomatic treatment. By effectively controlling the signs and symptoms the quality of life can be improved.
Medicines usually prescribed are Calc flour, Ruta, Calc phos, Syphilinum, Rhus tox etc;
Osteoporosis is the generalized reduction in bone density that occurs when the rate of bone resorption exceeds the bone formation. It is one of the most common bone diseases. There is increased risk of fracture.
The prevalence increases with age. There is a reduction in bone mass per unit volume.
Causes of osteoporosis
Senile osteoporosis. After the age of 40 years, there is a progressive decrease in the bone matrix. Reduce food intake, protein insufficiency, and insufficiency of sex hormones are the contributory factors for senile osteoporosis.
Prolonged recumbency due to immobilization or paralysis also cause osteoporosis.
Rickets and scurvy are another cause.
Drugs-like corticosteroids, sedatives, alcohol excess.
Chronic liver diseases.
The main pathological feature is the reduced bone mass of the entire skeleton, especially of the spine. The vertebrae become spongy and soft and compression fracture occurs after a minor trauma.
More common in women after 40 years.
At first asymptomatic later starts as generalized backache.
Fracture can effect at any bone, but the most common sites are at the forearm (Colles’ fracture), spine and hip.
X ray-generalized rarefaction of the entire skeleton
Ground glass appearance of the spine in x ray.
Increase physical activity.
Supplement with calcium, vitamin D and protein diet.
Spinal extension exercises.
The principle in the treatment of osteoporosis is to prevent further deterioration of bone and helps the patient to lead a ‘fracture free’ life.
Since ageing is a contributory factor for osteoporosis, restoration to normalcy by homeopathic medicine is impossible. However, it can help the patient by reducing the distressing signs and symptoms and also homeopathy helps them to arrest the prognosis of osteoporosis. Medicines like Calc carb, Calc flour, Ruta, Symphytum, Bellis per, etc are the main remedies. Besides these miasmatic remedies like Acid flour, Syphyllinum is also can be given as intercurrent.
Psoriatic arthropathy resembles that of rheumatoid arthritis. But arthritis is preceded by skin lesion and nail changes of psoriasis.
Onset is between 25 to 40 years of age. Psoriatic arthropathy occurs in 7% of patients with psoriasis.
Distal interphalangeal joints of hands first and then proximal interphalangeal joints are affected. But metacarpophalangeal joints (the knuckle between hand and finger) are not involved.
Symmetrical polyarthritis is seen in women.
Fever, ulnar deviation deformity of hand and lymph node enlargement are absent. ESR is elevated. Rheumatoid factor is negative.
Aim of homeopathic treatment is multifactorial.
First, the basic cause of the arthritis should be treated. Here the cause is psoriasis.
And the second thing is to control the joint affections like stiffness, pain and deformity.
However, from my clinical experience, psoriasis is not completely of curable. Even so, the ray hope in homeopathy is that the disease can be controlled and can very well prevent the complication that is the psoriatic arthropathy.
But if the patient approaches even with well developed psoriatic arthropathy homeopathy can control the pain and will definitely prevent further worsening of the arthropathy. Depending up on the chronicity of the disease, it will take some months to control the progress. But pain and other unwanted symptoms can be controlled within days of starting the treatment itself.
RHEUMATOID ARTHRITIS (RA)
RA is the chronic inflammatory joint disorder. There are multiple joint involvements, and symmetrical joints are affected.
The exact cause of RA is not known.
Currently, it is an autoimmune disorder. Frequency is increased in first degree of relative of patients with RA. Female gender is a risk factor. In postpartum period and in the breast feeding period, susceptibility is increased.
Cigarette smoking is a risk factor.
Persistent synovitis is the hallmark of RA. The symptoms may flare up followed by a period of the asymptomatic period.
There is a gradual onset of symmetrical involvement of small joints of hands, feet and wrist. Since the small joints of hands are involved the deformity results in the form of swan neck. Even though there is swelling of joints, there is no redness of the affected part.
There is morning stiffness of the joints.
There is swelling in the joints with pain.
Symmetrical joint involvement.
X-ray of the affected joint
RA (Rheumatoid Factor) in blood.
The disease being an autoimmune disorder constitutional homeopathic remedies are needed. Good prognosis in cases where no deformities are developed. If the treatment is started from the beginning itself, deformity formation can be prevented, and it is equally very effective to control the pain.
Effective homeopathic remedies are.
Calc flour ,Syphyllinum, Rhus tox. Calc phos , Puls etc;
CARPAL TUNNEL SYNDROME
Carpal tunnel is a narrow space that situates in palmar surface of the wrist. And it is through the carpal tunnel, the median nerve and tendons pass from the forearm to the palm. And the median nerve controls the movement and sensation of the first three fingers.
Pain and numbness occur when the carpal tunnel becomes narrowed.
Causes of carpal tunnel syndrome
Frequent use of the wrist
Symptoms affect mainly thumb, index finger,
Numbness is more on waking from sleep, or holding something for a long time.
Complete blood count
NCS-(nerve conduction studies)
In severe cases surgical decompression.
If started from beginning surgery can be avoided.
Homeopathic medicine is selected based on the side affected, and the underlying causes if any and also the mental and physical aspect to the patient. Since homeopathic medicines are free from side effects, it can be used safely.
The usual homeopathic medicines are Rhus tox, Medorrhinum, Viol O, Calc flour, and Calc carb, etc:.