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MUSCLE AND JOINT PAINS

Treating severe aches and pains conventionally may bring unwanted side effects. Homeopathy has much to offer, says Dr. Shreepad Khedekar MD (Hom)

One of the most brilliant cases treated by Dr. Shreepad Khedekar is the one of Miss. Ana M a young girl from Belgrade who developed Juvenile Rheumatoid arthritis at the age of 10 years after her father left the family and married his Argentinian girlfriend. Ana was devastated and started venting out in Art and music. She could barely walk and was brought to Dr. Shreepad Khedekar’s Belgrade clinic on a wheel chair. After a careful analysis she was prescribed the remedy CARCINOSINUM 200C and to great surprise she responded miraculously to it. So much so that she later joined the Red Star club in Belgrade as a running Athlete! She has won several medals for her club. Her case history can be requested by email on imperialclinics@gmail.com

Some of the most common presentations in general practice are problems of pain in joints and muscles. Sometimes these problems are acute, as in sports injuries, sometimes they are chronic, as in osteoarthritis, and sometimes they are intermittent, as in back pain. Whatever the problem, they provide the GP with a challenge for management. Its most important to find out the main cause of these pathologies which is usually deep seated in the individual’s life experiences and mind. The homeopath must investigate in detail like a detective and then treat the cause to then cure the disease.

Dr. Shreepad Khedekar explains the art of curing joint problems

The homeopath must take a careful history, examine the affected part, and make a diagnosis, possibly with the help of blood tests, x-rays or MRI scans. Having confirmed the diagnosis, the treatment option must then be decided, which should not be the prescription of an anti-inflammatory drug, such as ibuprofen, a local steroid injection, a referral for physiotherapy or a referral to a rheumatologist. All these unfortunately are only palliative, meaning they only reduce the pain and NEVER cure the problem from its roots.

Mentioned below are some of the most commonly met joint problems:

Back problems
Of course, we must always remember our homeopathic basics, so Rhus tox would only be appropriate if the modalities of stiffness after rest, pain better for heat, and relief by gradual movement were present. So when Clive, aged 41, came to see me with a 10-year history of backache, caused by jarring his spine in a diving accident, I needed to know the modalities of his pain. In his case, the pain was a lot worse on moving, and pain-free at rest and was relieved by ice-packs, so I prescribed Bryonia 200C one dose. When I next saw him, he had achieved a 90 per cent improvement, and was delighted.

Knee problems
Similarly Bob, aged 53, had a four-year history of pain in his knees, which had started after a strenuous game of golf. His pain was also worse for movement, and he had no early morning stiffness. As a person he was extremely thirsty and his thermal preference was amelioration in cold weather, I prescribed Lachesis 30c, one dose for him too. Again, after one month, he had improved enough to stop his painkillers.

Moving pains
It is always very satisfying to treat a patient successfully using homeopathy, who has puzzled the rheumatology specialists. Rochelle, aged 65, was one such case, who came to see me privately with an acute arthritis of unknown origin. When she came to me, she had severe pain in her right elbow, such that she could not even feed herself, and her left ankle and forefoot were very inflamed, making walking very painful. The joints including her elbow were very painful, such that she could not even feed herself, and her left ankle and forefoot were very inflamed, making walking very painful. The joints were swollen, but not red, very stiff in the mornings, and improved by both heat and ice-packs. The site of the affected joint flitted around, such that a week previously it had been her left shoulder and left elbow.

She was on maximum doses of ibuprofen, and also some powerful second-line anti-arthritic drugs, to no avail. In her character, she was a changeable person, describing herself as being either up or down. She was very weepy and loved consolation and cuddles. She admitted to liking to be the centre of attention and, indeed, had been an actress. She craved fresh air, was not particularly thirsty, and was averse to fatty food.

The local joint modalities were difficult to prescribe on, but her constitutional type was plainly Pulsatilla. To the amazement of her rheumatologist, within a month of taking Pulsatilla 200C, her joint pains all subsided and the swelling resolved in all but her right ankle, which had completely resolved by the second follow-up consultation.

Prevention better than cure
Equally successful was the case of Rinni, aged 28, who had developed flitting joint pains at the age of 15. Both her mother and grandmother suffered from rheumatoid arthritis, and she was obviously worried that she was developing the same. So far, her blood tests for rheumatoid had been negative.

When I saw her, the pains were worse for pressure and better for motion, with a lot of stiffness, and more comfortable in the warm weather.

As a person, she was chilly, and loved the sunshine. She described herself as an optimist, with a positive attitude to life. She was very emotional and empathetic to others; very affectionate, with a need for physical touch.

On these symptoms, I prescribed Phosphorus on a constitutional level, and this settled her symptoms very quickly. Over the years that I have been treating her, she has needed one or two doses of Phosphorus per year to keep her joint problems under control.

I have a strong feeling that had she not been treated homeopathically, she might well have gone on to develop rheumatoid arthritis like her family members.

Severe rheumatoid arthritis
Obviously, prevention is better than cure, and the treatment of patients with established rheumatoid arthritis is often less dramatic. However, some help can be given with symptom control, as was the case with Miss S.G., aged 60, who came to see me with very long-standing rheumatoid arthritis, which had caused severe deformities of her hands and feet. She had had a knee replacement, and had had operations to both feet.

She had had Ayurvedic gold treatment 20 years ago, which had caused some kidney damage. By the time she came to me, her disease had more or less burnt out, but she was suffering from extreme fatigue and some residual joint pains. I treated her constitutionally with Natrum muriaticum. On this regime she managed very well over the several years that I looked after her.

Tennis and golfer’s elbow
Tennis elbow is an incapacitating condition. It is pain on the outer side of the elbow, caused not only by tennis, but also any other repetitive action that involves flexion of the forearm muscles, like cleaning windows. Golfer’s elbow is identical, but on the inner side of the elbow. It often responds extremely well to Opium (like I had prescribed for a world famous tennis coach to Jank Tipsarevic, which is a remedy that affects the insertion of tendons into the periosteum of the bones. Opium in potentised form has exactly the same modalities as Rhus tox, ie better for heat, stiffness after rest, better on gradual movement, but has different tissue affinities – tendons and periosteum rather than muscle.

Gout
Conditions such as gout can also be managed successfully using homeopathic remedies. Colchicum, the autumn crocus, has in its materia medica an exact description of the symptoms of gout ­“Inflammation of the great toe, cannot bear to have it touched or moved” (Boericke). Ledum (marsh tea) has the clinical picture of swollen, hot, pale joints, with the ball of the great toe swollen. Formica rufa (crushed live ants) is excellent for chronic gout and stiffness in the joints. The skin on the gouty joint is red, itching and burning.

Conditions of muscles
Conditions of the muscles such as fibrositis, fibromyalgia and polymyalgia rheumatica are difficult to treat conventionally. Diagnosis is often delayed and can be very difficult.

Fibrositis is thought to be caused by small adhesions between individual muscle fibres, causing stiffness and pain in isolated spots, “trigger points”, mainly in the back, shoulders and buttocks. The remedy Kali bichromicum fits this description well, having “pain in small spots”.

Fibromyalgia is very similar but involves more diffuse tenderness and pains in the muscles. Remedies such as Rhus tox, if the modalities fit, can be very useful.

Polymyalgia rheumatica is a specific inflammation of the proximal muscles of the upper arms and thighs, which are very tender and weak. Climbing stairs is particularly difficult, as is raising the arms above the head to open cupboards, etc. This condition responds very well to steroids, but as the disease usually takes a couple of years to run its natural course, the steroids may have to be maintained for this length of time. To avoid the side-effects of steroids, homeopathic treatment can be tried.

Mrs E.C., age 48, developed pains in her upper arms and thighs, and a blood test showed she was suffering from polymyalgia rheumatica. She asked me to treat her homeopathically rather than go on steroids, so I gave her Rhus tox, which fitted her modalities well. However, after some weeks of treatment, there was very little improvement, so I gave her Psorinum, which is a nosode, useful if the well-indicated remedy fails to work. The improvement with this was dramatic, causing a rapid decrease in pain and increase in strength.

Homeopathy on a constitutional basis is the most successful way of treating all these conditions, but local prescribing sometimes can be useful although I rarely use this.

Frozen shoulder
Frozen shoulder is another condition that runs a very prolonged course. It often seems to be provoked by minimal trauma, or by painful conditions of the chest wall causing lack of use of the shoulder, which then seizes up. The natural course is severe pain in the shoulder for a year, and then complete “freezing” of the joint for another year. After that the whole thing resolves spontaneously. Of course most people do not want to wait for natural resolution, and various homeopathic shoulder remedies can be useful. Kalmia latifolia (mountain laurel) is indicated for right-sided shoulder pain and Ferrum metallicum for left-sided shoulder pain.

Repetitive strain injury
Repetitive strain injury should be treated by immobilisation of the painful part for two weeks, accompanied by an appropriate remedy, such as Ruta grav. Obviously it is important to modify the behaviour that caused the problem in the first place, by paying attention to posture and hand positioning at a keyboard, for example.

This article by no means comprehensively covers the whole field of joint and muscle problems but hopefully gives a flavour of what homeopathy can do in this area. I do not want to give the impression that homeopathy is a miracle cure in all such cases, and indeed some patients fail to respond to apparently well-indicated remedies. A lot of improvement can be achieved by homeopathic self-help, but more complicated problems will need to be managed by a homeopathic practitioner.

ARTHRITIS AND RHEUMATISM

Dr. Shreepad Khedekar MD (Hom)  discusses his approach to this common, painful and potentially crippling group of conditions

Arthritis and rheumatism are among the commonest forms of chronic disease and, with an aging population, are set to become commoner still. Strictly speaking, arthritis means disease of the joints, while rheumatism is disease of the soft connective tissues which support and move the joints. In fact, the distinction is often artificial, since many of these conditions affect both the joints and connective tissues.

Osteoarthritis, the commonest of these conditions, is basically “wear and tear” of the joints. The root of the problem is wearing out of the cartilage, the tough, slippery “gristle”, which allows the ends of the bone to slide smoothly over each other and absorbs shocks. The joint becomes stiff and painful, and may creak as it is moved.

As the cartilage wears down, the bones on either side of the joint may react by forming small bony outgrowths called osteophytes. One of the sites where bony nodes can easily be seen is the last joint of the fingers. Spondylosis is a similar problem affecting the spine; here the main problem is degeneration of the disks which separate the vertebrae.

As one would expect with a degenerative condition the prevalence of osteoarthritis increases with age, it affects nine per cent of the total population but around 70 per cent of the over-70s. It is the commonest of all rheumatological conditions, and indeed probably the commonest of all chronic diseases, because many sufferers live with it for many years. Not surprisingly it tends to affect weight-bearing joints (eg low back, hips and knees). Joint injuries or overuse (for instance heavy physical work or professional sport) predispose to osteoarthritis later in life. Overweight is another important factor.

The other two main groups of arthritis and rheumatism are inflammatory arthritis, of which the commonest form is rheumatoid arthritis, and soft tissue rheumatism. Rheumatoid arthritis affects about one person in a hundred; it is nearly three times commoner in women than men (for unknown reasons). Its cause, too, remains frustratingly elusive. It tends to come on at an earlier age than osteoarthritis (typically in the 30s to 50s) and is more aggressive, running a more rapid course: about a third of sufferers are seriously disabled within ten years, although it is very variable. It particularly affects the small joints, especially of the hands and feet, causing a typical hand deformity where the fingers slant sideways. But it can affect almost any joint in the body, and also cause nodules under the skin and eye problems. There are many other forms of inflammatory arthritis, some of them associated with infections.

The final group is true rheumatism, affecting the soft connective tissues rather then the joints themselves. There are many forms, some with picturesque names. They include enthesopathies which affect the point at which tendons connect to the bones – the best known of these are tennis elbow, affecting the outer side of the elbow, and golfer’s elbow, which affects the inner side. Capsulitis – inflammation of the capsule of tissues that surround the joint – most commonly affects the shoulder, and may lead to a stiff “frozen” shoulder. Some of the more amusing names are reserved for bursitis – inflammation of the bursae, cushioning pads which overlie many joints. These include Housemaid’s Knee (also known as Clergyman’s Knee), from too much kneeling. But my favourite is Weaver’s Bottom – so called because it used to affect weavers who had to shuffle up and down long benches to tend their looms!

The most common form of soft tissue rheumatism, however, is fibromyalgia (which used to be known as fibrositis). It affects about two per cent of people and is much commoner in women than men. It is a controversial condition; some believe that fibromyalgia and chronic fatigue syndrome (ME) are varieties of the same condition, certainly there are similarities. The typical features are widespread musculoskeletal pain and aching with tender points at several specific locations. It is frequently associated with poor sleep and fatigue as well as other problems including migraine and irritable bowel syndrome.

There are many problems with current conventional treatment of arthritis and rheumatism. For instance, although osteoarthritis rarely, if ever, killed anyone, a group of drugs often used in its treatment, the non-steroidal anti-inflammatory agents (NSAIDs), including aspirin, Ibuprofen and Voltarol among many others, certainly has. There are some 12,000 hospital admissions and 2,000 deaths from these drugs every year in the Mumbai alone. Although the new generation of NSAIDs is safer, they are only glorified painkillers, which do not affect the basic disease process. Similarly for rheumatoid arthritis, a range of powerful drugs is available but all of these have long and alarming lists of side effects. Mostly cytostatic used in Cancer management are used and they have deadly side-effects.

WHAT HOMEOPATHY COSTS?

Your first consultation with a private homeopath will usually cost between INR 500 to INR 10,000. Further appointments usually cost less – about INR 500 to INR 5000 depending on the location of the place and experience of homeopath. It will also depend on the skill level of his staff or assistants who usually take the first case and prepare it for the main consultant.

Your remedy will usually be included in the consultation price, but do check this first. Homeopathic tablets or other products usually cost around INR 100 to INR500 if you need to buy them separately in India.

Dr. Shreepad A. Khedekar, BHMS, MD (homeopathy), a specialist for over 17 years, he has used homeopathy in his Switzerland, Belgrade and Mumbai practice for the last 17 years. He lectures in homeopathy at Switzerland, Croatia and at the Serbian Doctors Association (SLD) Teaching Centre in Belgrade and has a busy private practice in Dadar, Mumbai and at Shushrusha Citizens co-operative hospital, Mumbai and is the only Homeopath in their 60 year history.

Dr. Shreepad Khedekar  is the Clinical Director, Imperial clinics Mumbai and Imperial clinics Belgrade, Consultant at Shushrusha Citizens Co-op Hospital Mumbai and Physician to several international stars and celebrities.