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Non Surgical Homoeopathic Treatment for Avascular Necrosis of Femoral Head

My colleague, homeopathic Doctor, 42 years old, Male, called me on 5th August 12, having severe pain in Right Hip Joint since 2 months. Actually, he took some Anti-inflammatory medicines without any effect. Being a doctor, working with the orthopedics and observing a recent case of osteo-sarcoma in his OPD, he was worried about the cancer. He himself has done at first X-rays of both hips AP and LATERAL views which looked absolutely normal.

 

 

 

Stevenfruitsmaak Photo: The head of femur (lat. "caput femurs") with some synovium attached at the bottom and the ligament of the head of femur (Lat. "ligamentum capitis femurs") attached at the top. Creative Commons

 

He took Ars Alb, Thuja, Rhus Tox as suggested by some senior homoeopaths without any result. His pain was increasing and affecting his daily work. He was not able to squat or sit down and began limping due to severe pain, he had an MRI of both hips which showed:

  • Altered marrow signal in the right femoral head & the neck is most likely suggestive of transient bone marrow oedema or early changes of Avascular necrosis of femoral head.
  • Moderate right hip joint effusion.

His chief complaint was

  • Right Hip Joint Pain: Heaviness as well as throbbing

                < by cold draft

                < by squatting

                < at the start of motion

                 > continued motion

  • Right Hand, Dorsally a flat wart since 6 months.

 

Past history:

  • H/O Bilateral Renal Calculi
  • Left heel Corn operated in childhood

Family History:

  • Diabetes: Father & mother
  • BEP: Father
  • Paralysis: Father
  • Hypertension: Mother
  • Herpes Zoster: mother

 

State of Disposition & Mind:

Being a Homoeopath, he has explained his mental state very nicely in a descriptive style. He started explaining his past disappointment in love before marriage around in 1993-94 which made a lot of impact on him. He got married with a Doctor in 1996. He has 2 daughters. He has explained regarding his past life to his wife. As a result of depression of the disappointment in love, he joined a Religious commune & got much attached with it thereafter till today. Because of his attachment with the religious commune, he was spending much time in the temple. This has created some disputes between him & his wife. She was expecting his responsibility regarding the daughters as well as his attention at home which she was missing. There used to be some fights or quarrels between them. Whenever there used to be a dispute, he used to escape from home to temple. He told that he is much lazy and not proper in following the timings. Because of the disappointment & dispute, he became indifferent towards everything. He used to be much conscientious regarding every little matters as well as relations with parents as well as with patients. During the interview, he asked me number of questions. He used to frown a lot while talking.

Before the MRI was done, he had a fear of Cancer in his mind & when the diagnosis Avascular Necrosis was found, he started worrying about the future. Due to pain, he was saying – ‘when these pains will stop, I am fade-up from these pains.’ While talking, he told number of his thoughts, theories regarding his life.

He was seen by the Orthopedician who advised him to take Anti-inflammatory along with complete rest till the pain settles, avoid sitting down, squatting etc.

 

Physical Examination:

Weight: 66.5 Kg

P: 78/Min

B.P.: 127/79 MM Hg

Face: Greasy, has a big religious mark on his forehead, brown spots on his face.

 

Clinical Examination:

  • Not able to lift the Right Leg easily as it was much painful
  • Not able to bend his right leg & thigh on abdomen.
  • Not able to squat in lying down position
  • Tenderness +++ in Right Hip Anteriorly

 

Miasmatic Background:   SYCO-SYPHILITIC

 

Result of the Repertorisation:

Remedy Name

Sep

Sulph

Lyc

Ars

Puls

Verat

Nux-v

Lach

Totality

34

32

27

30

29

25

28

26

Symptoms Covered

14

13

12

11

11

11

10

10

Kingdom

 

 

 

 

 

 

 

 

[Complete ] [Mind]Love:Disappointment, unhappy, ailments from, agg.:

1

3

 

 

3

3

2

3

[Complete ] [Mind]Indifference, apathy:Everything, to:

4

1

3

3

4

1

3

1

[Complete ] [Mind]Escape, desire to:

3

1

3

4

2

3

3

1

[Complete ] [Mind]Religious affections:

4

4

3

4

4

4

1

4

[Complete ] [Mind]Conscientious about trifles:

4

4

4

4

4

4

4

3

[Complete ] [Mind]Inquisitive:

1

1

1

 

1

1

 

1

[Complete ] [Mind]Fear:Cancer, of:

1

 

 

4

 

1

 

 

[Complete ] [Mind]Anxiety:Future, about:

3

4

1

3

3

1

3

3

[Complete ] [Mind]Mood:Repulsive:

1

1

1

1

3

 

3

3

[Complete ] [Face]Greasy:

1

1

1

1

1

 

 

 

[Complete ] [Face]Brown:Spots:

3

3

3

1

 

 

1

 

[Complete ] [Mind]Frown, disposed to:

1

1

3

 

 

1

4

 

[Complete ] [Mind]Theorizing:

3

4

1

1

1

3

 

3

[Complete ] [Mind]Indolence, aversion to work:

4

4

3

4

3

3

4

4

 

 

 

Homoeopathic Management:

12/08/2012:

  • No restriction of the movements
  • Asked him to do all the activites

 

  • Sepia 1M                                    3                      Doses

 

  • Bio-combinaton No.26                 BD                   15 Days

 

This is my personal 20 years experience that Bio-chemic Salts when used on the basis of their pathogenetic actions, works very fast & hasten the cure process. Bio-combination No.26 by name is for Easy Parturition but it contains following tissue salts which cover the patient’s pathology perfectly.

Bio-combination no.26

  • Calc Flour     6X       Degenerative Pathology & Vascular affection
  • Mag Phos     6X        Spasm & Pain
  • Calc Phos      6X       For Regeneration & remodeling
  • Kali Phos       6X       Homoeopathic Tranquilizer

This combination is very useful in all types of Degenerative Bony & Muscular Pathologies such as Osteo Arthritis, Cervical & Lumbar Spondylosis etc.

The question always arises that why not Sepia only?

 This is definitely a debatable issue. My answer to the question is that Sepia alone can also be sufficient but it will take its own time to work even though you used it in any potency. The group of the patient generally I use to see is not that much capable of understanding the difference between the Palliation & the Cure. They want the difference in the pain & an early result. This was not the issue for this case but as a routine I prescribed it to him also. And why not we should be result oriented? Since 20 years I am working on these Bio-chemic Salts & those being the semi dynamic, found to produce very fast results at the cellular level. If the marrow oedema settles immediately, patient becomes very comfortable to continue the treatment for long duration. Calc Fluor is the medicine which has the capacity to dissolve the osteophytes. I have experienced it number of times regarding this action. In cases of Osteo-arthritis, Spondylosis, Spinal Canal Steniosis one must think of this remedy.

 

Follow-Ups

 

28/08/2012:

  • Pain in right hip: 80% better;  occasionally < start of motion > continued motion
  • Limping while walking still persist
  • Able to squat 70% on lying down
  • Able to bend the hip
  • Tenderness on Right Hip: Absent
  • Wart on right hand decreased in size

 

  • Homoeopathic Management:
  • Asked him to try squatting in sitting posture
  • Bio-combination No.26                BD                   continued

 

24/09/2012:

  • Pain in Right Hip: Absent
  • Able to squat in sitting as well as lying down posture
  • Limp absent
  • He danced in religious commune without any trouble
  • Able to bend his Hip
  • One hour played a Tabala in squatting position
  • Very much happy as he was able to perform all his duties & enjoy the hobbies

 

  • Homoeopathic Management:
  • Asked to continue all the activities
  • Bio-combination No.26                HS                   continued

 

DISCUSSION

As this case was very Acute & Recent in appearance (Even though the disease is chronic in nature), proper Homoeopathic Management can bring such patients very fast in a gentle way.  

Now a day, I am treating Avascular Necrosis cases often & what I observed is Lachesis, Sepia & Calc Fluor appeared commonly in those cases. So, I studied the cases in retrospective manner to find out that whether I am becoming prejudiced in prescribing? But it was not the case. So, I studied the action of all three remedies & found that all of them have an action on Vascular System, Circulation, Venous System. I think, we must study the actions of our medicines even at cellular & tissue level so that we can make our Materia Medica more rich & more perfect.

 

 

Tags: Avascular, Homoeopathy, Necrosis

Views: 6196

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Replies to This Discussion

Dr Prasad - Fabulous presentation. We can discuss. Interesting that others had recommended Ars Alb, Thuja, Rhus Tox to begin, yet in your analysis only Arsenicum was listed, not any of the others based upon rubrics chosen (Sepia, Sulphur, Lycopodium, Arsenicum, Pulsatilla, Veratrum album, Nux-vomica, Lachesis)

We can see a religious connection and I wonder if you had gathered much more in-depth information from case-taking. I wonder whether he told you more in the family history and family dynamics to conclude which rubrics to select as most important. Then, how it is you chose Sepia above the other possible remedies? Was there a main theme and has this remedy been used for this pathology in documentation? Thanks so much for great case sharing. 

 

In addition, Miranda Castro will be giving a presentation on the Health Inn Show in December concerning her combination cell salts that she finds extraordinarily helpful. Thank you for telling us about your cell salt combination and the best times to use them. Are they taken daily, dry, in water, and when to stop taking?

Dear Debbie,

Many thanks for an immediate nice & inquisitive reply.

When I used to prescribe, I always consider whether the remedy covers each & every rubric selected for repertorisation? Because, that is a real totality which I have considered for finding out a similimum. Instead of theorizing about a remedy, its always better for me to consider the repertorial totality. So that every aspect about a case as well as about a remedy get considered.

I used to consider Past & Family History only to understand the Miasm at the time of birth and its evolution during a the patients life. Because of this understanding, it becomes a one more confirmation ragarding the medicine which I have selected, its depth of action etc. If we go through the Materia Medica, we understand the pathogenetic action & miasmatic aspect about Sepia. It has its action on vascular system causing a portal congestion, on ovaries, uterus causing congestion as well as ulceration, on GIT, liver, Kidneys producing congestion & torpidity, on skin cachectic, waxy, earthy appearence denotes the Syco-Tuberculo-Syphilitic background which is present in this case. So, the remedy has that much of depth to penetrate & cover the pathological state.

Bio-chemic salts I used to prescribe as 4 tablets dry, 2-3 times a day till the expected recovery. In this case, even though the pain disappeared mostly because of decrease in marrow oedema, it is necessary to develop a softness to the surface of the femoral head which has becomes rough & irregular. Till, the patient is not able to perform all the functions of the Hip Joint, I used to continue Bio-chemic salts in OD doses.

Thank You very much.

Dear Dr Arind Rasal

Very nice case presentation. I mostly work classical homeopathy, however the results with this case are very prominent.

I have experienced Lyc and Arn in patients with diabetic foot ulcers. As you know the main pathology in diabetics is vascular derangement. I think the two remedies may have curative results in patients with avascular necrosis of femur, as well.

Good Luck and Live Long.

Dear Seyedaghanoorji..

Many thanks for your reply.

Definitely, Lyco as well as Arnica are useful remedies for AVN cases depending on the causative, constitutional, miasmatic background. Just try my aspect in your cases & give me a feed back. Please, do share your Homoepathic knowledge in HWC.

Please, do watch my blog www.drprasadrasal.blogspot.com to discuss numbar of cases.

Thank You!

Dr Prasad Rasal

Nice presentation. We need to be more open minded about Bio Salt as it has certain soothing effect without hampering the action of indicated remedy. I prescribe 2 tabs dry in stead of 4 tabs and have found equal good result.

regards

farid

Thanks a lot Faridji...

Do share your experiences...

With regards,

Dr Prasad Rasal...

I use a lot of bio salts even for cancer cases and the results good.

Dear Dr Gopalji,

Thanks a lot! Please, share your aspect of treating the cancer cases so that it will be more beneficial for everyone.

Dr Prasad...

Very good case Dr. Rasal. Thanks. Mind symptoms were plenty.

Nice one sir. Bio chemics definetly acts with homeopathy.

Dear Dr. Prasad. You have done best of the best...My roommet also having avscular necrosis of femoral head & he is taking treatmen from Dr. Mayur Tolat an experienced homoeopath in Surat ( Gujarat ) ..He is also improoving by homoeopathic treatment.

Dear Dr Navtar,

Many thanks for sharing your experience.

Dr Prasad...

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