Muscle & joint problems

Treating severe aches & pains conventionally may bring unwanted side effects. Homeopathy has much to offer, says Dr Janet Gray 

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.

The GP must take a careful history, examine the affected part, and  make a diagnosis, possibly with the help of blood tests and x-rays.  Having confirmed the diagnosis, the treatment option must then be  decided, which may 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.

As a GP myself, I use all these options, and we are lucky enough in  our practice to have a physiotherapist trained also in acupuncture.  However, I also have another therapeutic option up my sleeve – the use  of homeopathy. This method of treatment really comes into its own when  side-effects are experienced with the use of conventional medication,  some of which can be very serious.

Homeopathy can offer help in many situations which otherwise might  cause prolonged incapacity. For instance, the use of Arnica in acute  injury is well known, but often forgotten in the heat of the moment. The  sooner it can be given, the more effective it is, but it is not too  late to start it even several days after an injury. I will quite often  see a patient with a sprained ankle, done two to three days previously,  and I will then start not only Arnica, but also Rhus tox given  concurrently. This combination is very useful in other situations, such  as a bad back, caused by gardening, or a knee injury done at football. 

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 6c, twice daily for one month. 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, so despite the lack of a marked  reaction to heat or cold, I prescribed Bryonia 6c, twice daily, 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. Margaret, 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, 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 is better than cure 

Equally successful was the case of Emma, 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.

Although it cannot be proved, I have a strong feeling that had she  not been treated homeopathically, she might well have gone on to develop  rheumatoid arthritis.

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 67, 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 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, and gave  her Bryonia as a local prescription for her joint pains. On this regime  she managed very well over the several years that I looked after her.

Tennis & golf 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 Ruta graveolens, which is  a remedy that affects the insertion of tendons into the periosteum of  the bones. Ruta 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 45, 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  Sycotic co, which is a bowel 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 can be very useful.

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.

Dr Janet Gray MA MBBChir MRCOG MFHom  DRCOG DFFP