CERVICAL SPONDYLOSIS
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.
Risk
factors
X Age
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.
Symptoms
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.
Investigation
X ray cervical spine
CT
MRI
Treatment
Proper rest and physiotherapy
If the pain is severe immobilization of
the neck muscles by using the cervical collar is advised.
Homeopathic
treatment
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
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-
1-Sleep abnormality
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.
Poor concentration
Forgetfulness
Numbness and tingling in fingers
Morning stiffness
Tensional headache
Bloating of the abdomen with colicky
pain without any modalities
Frequent urination at night
General discomfort when touched.
Painful coition
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.
Management
Counseling and educating the patients
about the nature of the problem.
Treatment
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.
FROZEN
SHOULDER
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-
Diabetes mellitus
Local trauma
Hemiplegia
Myocardial infarction
Sometimes the disease may recover by itself
but only after years.
Treatment
Physiotherapy
Homeopathic
treatment
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
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
3-Malaise
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 alcohol.
Avoid red meats and shell fishes.
Treatment
General
measures
Follow above-mentioned diet regulation
and drink 2-3 liters of water.
Homeopathic treatment-
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.
Causes are-
Obesity
Ageing
Incorrect posture in work places and during exercise and driving,
etc.
Sudden strain and repeated injuries.
Clinical
features-
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.
SLR
TEST
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.
LASEGUE
TEST
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.
Treatment
General
treatment
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.
Homeopathic treatment
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 BACKACHE
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 -
Mechanical causes
Non mechanical causes
Inflammatory causes
Duet some specific causes.
MECHANICAL PAIN
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.
INFLAMMATORY
CAUSES
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.
Spondylolisthesis
Both Spondylosis and spondylolisthesis
are diagnosed by x ray lumbar spine and MRI.
Treatment
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.
OSTEOARTHRITIS (OA)
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.
Clinical
features.
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.
OA KNEE
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.
Treatment
General treatment
Weight reduction is the primary measure. Plenty of diets
rich in calcium and vitamin D should be included in food.
Homeopathic treatment
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
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.
Hyperparathyroidism.
Cancer deposits.
Multiple myelomas.
Leukemia.
Rheumatoid arthritis.
Drugs-like corticosteroids, sedatives,
alcohol excess.
Chronic liver diseases.
Malabsorption.
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.
Clinical
features.
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.
Investigations
X ray-generalized rarefaction of the
entire skeleton
Ground glass appearance of the spine in
x ray.
Bone-density test
Treatment
Increase physical activity.
Supplement with calcium, vitamin D and
protein diet.
Spinal extension exercises.
Homeopathic
treatment
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
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.
Clinical
features.
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.
Treatment
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.
Fever
Weight loss
Fatigue
Muscle wasting
Diagnosis
Symmetrical joint involvement.
X-ray of the affected joint
RA (Rheumatoid Factor) in blood.
Raised ESR
Raised CRP.
Homeopathic
treatment
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
Diabetes
Pregnancy
Hypothyroidism
Rheumatoid arthritis
Symptoms
Symptoms affect mainly thumb, index finger,
Numbness
Numbness is more on waking from sleep, or holding something for a long time.
Investigation
Complete blood count
NCS-(nerve conduction studies)
Electromyography
In severe cases surgical decompression.
Treatment
Lifestyle modification
Homeopathic treatment
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:.