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 Table of Contents  
CASE REPORT
Year : 2019  |  Volume : 13  |  Issue : 2  |  Page : 125-130

Case of lumbar spondylosis treated with Homoeopathic medicine Calcarea fluorica


Regional Research Institute (Homoeopathy), Under CCRH, Government of India, Guwahati, Assam, India

Date of Submission21-Oct-2017
Date of Acceptance20-May-2019
Date of Web Publication27-Jun-2019

Correspondence Address:
Dr. Ranjit Sonny
C/O Justice P. K. Sakia, H.NO. 11, Niribili Path, Ghoramara, Guwahati - 781 028, Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijrh.ijrh_56_17

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  Abstract 


Chronic Low Back Pain (CLBP) is one of the most common problems with which people of all age groups report to physicians. It is a very troublesome complaint affecting day-to-day life, leading to decreased productivity. Amongst all the causes, lumbar spondylosis is one of the major causes of CLBP. Lumbar spondylosis commonly affects middle to later age groups. This case report describes patient with symptoms of recurrent pain in low back for the last 10 years. X-ray of the lumbosacral (L.S.) spine showed features of osteophyte confirming the diagnosis of lumbar spondylosis. After careful case-taking, homoeopathic medicine Calcarea fluorica in different potencies was prescribed as per homoeopathic principles with ever-increasing improvement. Pain in the low back gradually diminished. Ultimately, the patient got rid of all the symptoms with general improvement. After that, he was on placebo for 5 months. X-ray of the L.S spine done after treatment revealed no feature of lumbar spondylosis along with remission of osteophyte.

Keywords: Calcarea fluorica, Homoeopathy, Lumbar spondylosis, Osteophyte


How to cite this article:
Sonny R. Case of lumbar spondylosis treated with Homoeopathic medicine Calcarea fluorica. Indian J Res Homoeopathy 2019;13:125-30

How to cite this URL:
Sonny R. Case of lumbar spondylosis treated with Homoeopathic medicine Calcarea fluorica. Indian J Res Homoeopathy [serial online] 2019 [cited 2019 Sep 19];13:125-30. Available from: http://www.ijrh.org/text.asp?2019/13/2/125/261641




  Introduction Top


Homoeopathy is the second largest way of treatment in terms of use and practice. Various difficult and rare cases are successfully treated by homoeopathic medicines. Through this article, a case of lumbar spondylosis is shared with the profession which had been treated with homoeopathic medicine Calcarea fluorica.

Low back pain is the leading cause of activity limitation and work absence throughout the world, imposing a high economic burden on individuals, families, communities, industries and governments.[1] Amongst different causes, lumbar spondylosis is the important cause of Chronic Low Back Pain (CLBP). Different age groups may suffer from this problem hampering their regular duties. There are a number of systems of medicine prevailing all over the world at our disposal. We all are aware with the usefulness of Homoeopathy in chronic conditions. Our Materia Medica reports many medicines whose sphere of action encompasses the complaints of spine. Amongst them, Calcarea fluorica is very effective if prescribed on the basis of symptom similarity. This case reflects the prowess of Calcarea fluorica in controlling low back pain due to lumbar spondylosis. Lumbar spondylosis is the osteoarthritis of lumbar spine caused by degenerative changes in the spine. Osteophyte (a kind of exostosis) formation in the body of the spine is the frequent presentation in the skiagram. Pain, instability and stiffness in the low back are the usual symptoms present. Lumbar spondylosis usually presents as CLBP which is defined as pain symptoms in low back persisting beyond 3 months. There are a considerable number of people suffering from low back pain. Risk factors include obesity, female gender, older age, prior history of back pain, restricted spinal mobility, high levels of psychological distress, minimal physical activity, smoking and job dissatisfaction.[2] Amongst different causes, restricted spinal mobility arising out of lumbar spondylosis is the important cause.

The lifetime prevalence of non-specific (common) low back pain is estimated at 60%–70% in industrialised countries. The 2010 Global Burden of Disease Study estimated that low back pain is amongst the top 10 diseases and injuries that account for the highest number of disability-adjusted life years worldwide.[1]

While jotting down this case, different websites such as PubMed, ScienceDirect.com, Karger.com and Liebertpub.com and some other journals were searched. Few studies were found in respect ro CLBP. In one of the studies, it was concluded that Homoeopathy is ineffective for any type of pain.[3]

Two double-blind, randomised placebo-controlled studies were found, but in those studies, a combination of homoeopathic medicines was used.[4],[5] In one of the studies, homoeopathic medicine was used for CLBP, but whether single medicine or multiple medicines used are not clear.[6] However, no case report was found where Calcarea fluorica used for CLBP caused by lumbar spondylosis.


  Case Report Top


It was a diagnosed case of lumbar spondylosis represented by M47.8 under ICD-10 classification. A businessman aged 61 years, Hindu by religion, came for the treatment on 4th February 2017. He was suffering from CLBP for the last 10 years. X-ray of the lumbosacral (L.S.) spine showed lumbar spondylosis with osteophyte formation on the body of the spine [Figure 1]. He took allopathic treatment for 1 month almost 1½ years ago without desired relief followed by no treatment for the last 1 year except regular morning walk. The modalities of the pain were aggravation from the first motion and amelioration by continued motion and pressure. There was relief from warm application also.
Figure 1: X-ray of lumbosacral spine showing osteophyte dated 16/04/2015

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Homoeopathic generalities

Mental

Mentally, he was irritable. There was an episode of grief due to death of 35 years old son 2 years ago. However, that attack of grief was causing no severe affection to the patient. The patient had coped himself with that.

Physical

The patient was fatty, flabby with big belly and dark complexion and short stature in height. Appetite was good, desire for sweet, salty food and meat. There was aversion to sour. Stool was regular and twice daily, semisolid. He had sound sleep. There were no significant dreams.

Past history

There was a history of hypertension, for which he was taking antihypertensive drug prescribed by an allopathic physician. Anal fistula was operated 20 years ago.

Family history

In family history, both paternal and maternal, nothing significant was found.

Other systemic examinations were normal.

Miasmatic analysis

Miasmatic analysis of all the presenting symptoms, including mentals and physical generals, was done by referring to different classical books on miasms.[7] It was found that this case is of mixed–miasm with syphilitic predominance.

Repertorisation

After case-taking and analysis, the characteristic symptoms were taken and converted into rubrics for repertorisation as follows:

  • Back-pain-lumbo-sacral region
  • Back-pain-motion-beginning of-agg
  • Back-pain-motion-continued motion-amel
  • Back-pain-warm-applications-amel
  • Generals-exostosis.
  • Generals-food and drinks-sweets-desire
  • Generals-food and drinks-salt-desire
  • Generals-food and drinks-meat-desire
  • Generals-food and drinks-sour foods, acids-aversion


Repertorisation was done following Synthesis repertory[8] in Radar 10.0[9] on the basis of 9 rubrics. Following medicines appear as given in the repertorisation chart [Figure 2]. In the repertorisation chart, Phosphorus appeared as the topmost medicine, but Calcarea fluorica was prescribed by referring to Materia Medica. The presenting symptom of the patient with modalities was more prominent in Calcarea fluorica in comparison to the other medicines, especially with osteophyte formation.
Figure 2: Repertorisation chart, RADAR 10.0 Software, 4th Feb, 2018

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Treatment and follow-up

After case-taking, Calcarea fluorica 30/4 doses was prescribed. The patient started improving, but no satisfactory relief of pain was found. Calcarea fluorica 200/2 doses was given in the next follow up. Pain in low back diminished, but after 5 days, pain slightly reappeared. 1M potency of the same medicine was then prescribed. Pain was relieved completely but after 15 days again reappeared. Calcarea fluorica was again repeated in the same potency. That gave desired result and there was no reappearance of pain again. The patient was taking placebo for the last 5 months. In the meantime, X-ray of L.S spine was done, which showed remission of osteophyte [Figure 3] which was present previously. Before the last visit, he had travelled more than 1000 km by train even then there was no reappearance of pain. In the last visit, the patient came with acute upper respiratory tract infection, for which Hepar sulphuris 30/4 doses was prescribed on the basis of indications. Date-wise treatment and follow-ups are given in [Table 1].
Figure 3: X-ray of lumbosacral spine done after treatment showing no osteophyte

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Table 1: Prescriptions and follow-ups

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  Discussion Top


After case analysis, it was found that the low back pain was emerging from bony defect. X-ray of the L.S. spine showed bony outgrowth in the form of osteophyte. Symptom of the patient was pain in low back < first motion > by continued motion. There was relief from warm massage. Such symptoms indicated Calcarea fluorica. This type of pain is also present in Rhus toxicodendron, but the sphere of action of Rhus toxicodendron is mainly the affections of soft tissue. Here, the involvement of spine led me to prescribe Calcarea fluorica. Calcarea fluorica was evolved from Schussler's 'bone salt' (CaF2) to full-fledged homoeopathic medicine after drug proving by Mezger in 1953 under the direction of Dr Leeser.[10] It is found in the surface of bones, in the enamel of teeth, in elastic fibres and in the cells of the epidermis. Calcarea fluorica prescribed in 30, 200 and 1M as per homoeopathic principles not only relieved the patient symptomatically but also helped resolve the pathology i.e. osteophyte formation. The patient continued antihypertensive drugs for hypertension. Symptoms of Calcarea fluorica in low back pain with the involvement of spine as stated by different stalwarts of Homoeopathy are quoted below:

Clarke – 'It has been principally used for dispersing bony growths' lumbago from strains; < after rest, > after moving a little and from warmth.[11]

Boger – 'Exostoses'. 'Lumbago'.[12]

Boericke – 'Chronic lumbago; aggravated when beginning to move and ameliorated on continuous motion. Osseous tumours (exostosis)'. 'Pain in the lower part of back with burning'.[13]

This case shows that symptoms similarity between the patient and of the medicine is the most important thing, irrespective of the name of the disease.[14]

Indication, i.e., symptom, is the only weapon in our hand to treat diseases. During drug proving, we find numerous symptoms of a particular drug; amongst them, there are few characteristics and rare symptoms which represent the medicine as a whole which are termed keynote symptoms or 'prognostic factors' by the modern homoeopathic researchers. We should look for those symptoms in patients and match with that of medicine consulting repertory if required.


  Conclusion Top


This case, of cured osteophyte along with diminution of symptoms, provides a clinical evidence of successful homoeopathic management of one of the most common and troublesome conditions-lumbar spondylosis.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

The study was funded by Ministry of AYUSH, Government of India.

Conflicts of interest

None declared.



 
  References Top

1.
World Health Organisation. Geneva: Priority Diseases and Reasons for Inclusion. Available from: http://www.who.int/medicines/areas/priority_medicines/Ch6_24LBP.pdf. [Last accessed on 2017 Sep 20].  Back to cited text no. 1
    
2.
Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL. Harrison's Principles of Internal Medicine. 17th ed., Vol. 1. New York: MacGraw Hill Companies Inc.; 2008. p. 115.  Back to cited text no. 2
    
3.
Ernst E, Pittler MH. Experts' opinions on complementary/alternative therapies for low back pain. J Manipulative Physiol Ther 1999;22:87-90.  Back to cited text no. 3
    
4.
Morris M, Pellow J, Solomon EM, Tsele-Tebakang T. Physiotherapy and a homeopathic complex for chronic low-back pain due to osteoarthritis: A randomized, controlled pilot study. Altern Ther Health Med 2016;22:48-56.  Back to cited text no. 4
    
5.
Beer AM, Fey S, Zimmer M, Teske W, Schremmer D, Wiebelitz KR, et al. Effectiveness and safety of a homeopathic drug combination in the treatment of chronic low back pain. A double-blind, randomized, placebo-controlled clinical trial. MMW Fortschr Med 2012;154 Suppl 2:48-57.  Back to cited text no. 5
    
6.
Gmünder R, Kissling R. The efficacy of homeopathy in the treatment of chronic low back pain compared to standardized physiotherapy. Z Orthop Ihre Grenzgeb 2002;140:503-8.  Back to cited text no. 6
    
7.
Mast HH, The Foundation of The Chronic Miasms in The Practice of Homoeopathy, Florida: Lutea Press, LLC; 2005.  Back to cited text no. 7
    
8.
Schroyens F. Synthesis Repertorium Homeopathicum Syntheticum. 9.1 ed. New Delhi: B. Jain Publishers (P) Ltd.; 2009.  Back to cited text no. 8
    
9.
Radar 10-EH. Belgium: Archibel Homeopathic Software; 2009.  Back to cited text no. 9
    
10.
Julian OA. Dictionary of Homoeopathic Materia Medica of 131 New Homoeotherapeutics. Reprint ed. New Delhi: B. Jain Publishers (P) Ltd.; 2006. p. 64-5.  Back to cited text no. 10
    
11.
Clarke JH. A Dictionary of Practical Materia Medica. Vol. 1. New Delhi: B. Jain Publishers (P) Ltd.; 2013. p. 353-4.  Back to cited text no. 11
    
12.
Boger CM. A Synoptic Key to the Materia Medica. Low Priced Edition. New Delhi: B. Jain Publishers (P) Ltd.; 2002:147-8.  Back to cited text no. 12
    
13.
Boericke W. Boericke's New Manual of Homoeopathic Materia Medica with Repertory. Reprint Edition. New Delhi: B. Jain Publishers (P) Ltd.; 2008:133-5.  Back to cited text no. 13
    
14.
Hahnemann S. Organon of Medicine. Low Price Edition. New Delhi: B. Jain Publishers (P) Ltd.; 2002:71-2.  Back to cited text no. 14
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1]



 

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