From

Dr. L.Swathi

Dept. of Postgraduate Studies in Homoeopathic Materia Medica

D.B.H.P.Sabha’s

Dr. B.D.Jatti Homoeopathic MedicalCollegeHospital,

And Post-Graduate Research Centre,

D.C.Compound, Dharwad-580001

To

The Registrar,

RajivGandhiUniversity of Health Sciences Karnataka

Bangalore.

Through

The Principal

D.B.H.P.Sabha’s

Dr.B.D.Jatti Homoeopathic MedicalCollegeHospital,

And Post-Graduate Research Centre

D.C.Compound, Dharwad-580001

Respected Sir,

Sub: Submission of Completed Proforma for registration of subject

For dissertation.

*****

I request you to kindly register the below mentioned subject against my name for the Submission of dissertation to the Rajiv Gandhi University of Health Sciences, Bangalore for Partial fulfillment of M.D. (Homoeo.)

TITLE OF DISSERTATION:

“EFFECT OF HOMEOPATHIC MEDICINES IN THE TREATMENT OF SCIATICA”

I am here with enclosing completed Proforma for registration of subject for Dissertation.

Thanking You,

Yours Sincerely,

Place: Dharwad.

Date: / 11 / 2010.

(Dr. L.Swathi)

RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE.

ANNEXURE – II

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1 / Name of the Candidate and Address / Dr. L.Swathi
Dept. of Homoeopathic Materia Medica
Dr. B.D.Jatti Homoeopathic MedicalCollege And Hospital, And Post-Graduate Research Centre,
Dharwad-580 001
2 / Name of the Institution / D.B.H.P.Sabha’s
Dr. B.D.Jatti Homoeopathic MedicalCollegeHospital,
Dharwad-580 001
3 / Course of Study and Subject / M.D.(Doctor of Medicine in Homoeopathy) Homoeopathic Materia Medica
4 / Date of admission of course / 07/07/2010
5 / Title of the topic / EFFECT OF HOMEOPATHIC MEDICINES IN THE TREATMENT OF SCIATICA
6 / Brief Resume of the Intended Work
6.1 / Need for the Study:
Sciatica is defined as nerve pain which radiates into the buttocks, legs, ankles or feet. It is most commonly experienced in conjunction with lower back pain, but is sometimes present in the lower extremities alone1.
  1. Sciatica is a painful syndrome, which is caused by inflammation of the sciatic nerve that is most probably caused by neuritis or in simple words inflammation of the nerves. Sciatica’s most important symptom is tingling or paresthesias, which are located in the leg and thigh area, which is an irradiation of sciatic nerve territory, and this tingling can sometimes reach muscle atrophy.
  2. The complications include, the complete lesion of this nerve is very rare & cause complete paralysis of hamstring muscles and all muscles below knee. Incomplete lesion of nerve by subtrochanteric fracture of femur or posterior dislocation of hip of common peroneal nerve causes paralysis of extensor and peroneal muscles and lead to deformity, of foot known as ‘Talipes Equinovarus’ ‘Dropped Foot’. The paralysis of fibial part of nerve lead to ‘Talipes calcanes valgus,’ where patient unable to plantar flex the joint2.
  3. In allopathy, both Non-surgical treatment and surgical treatment is followed.There are many types of conservative or nonsurgical treatment options that are available to help calm down the sciatic discomfort and pain and two most common of them are11:
a)Alternating heat or ice treatment for acute sciatic pain. Heat and/or ice packets are easily available and help in relieving pain, but most probably in the starting phase of sciatica.
b)Use of pain medications for sciatica treatment: Over-the-counter pain medications are very helpful in relieving sciatic pain.
Homeopathy has numerous remedies for treating sciatica pain. Numerous, because homeopathy treats symptoms based on individuality of the patient. There are different remedies for people depending upon their attitudes, mental state, behaviors, sleeping patterns, lifestyles and of course, the symptoms of the disease. Traditional homeopathy swears by the principle of ‘single remedy’. It is nearly impossible to list all the homeopathic remedies for sciatica as each remedy carries a rider which explains the kind of patients that it is most suitable for. However, some of the frequently indicated remedies for sciatica are as follows4:
Aconite– This herb is helpful when the condition is aggravated at night and in a hot room.
Ammonium muriaticum- This herb is helpful when there is left-sided pain that aggravates upon sitting.
Arnica- This herb is indicated when the condition aggravates in evenings or the sciatica is caused by trauma and the patient creates a scene upon arrival of the doctor.
Belladonna- This herb is indicated when there is an increase in pain by slightest contact, touch, sound or gush of wind. The pain is episodic, beginning in the afternoon and ending at midnight.
Homeopathy is one of the most important sciatica alternative remedies and should be given its due place among effective therapies. Conventional medicine refutes the claims made by proponents of homeopathy and the debate is not liable to reach any conclusion.
6.2 / Review of Literature:
Sciatica is the term given to low back pain which travels in the distribution of the sciatic nerve and is caused due to compression of the sciatic nerve. The sciatic nerve is the largest and longest nerve in the human body which runs from each side of the lower spine through deep in the rear and back of the thigh, and all the way down to the foot, connecting the spinal cord with the leg and foot muscles.
Symptoms of Sciatica3
  • Usually sciatica affects one side of the body.
  • Radiating pain from lower back through the back of the thigh and down through the leg to the foot or toes.
  • Pain may be constant or intermittent, dull, sharp, shooting, burning or tingling sensation.
  • Weakness, numbness or difficulty moving the leg or foot.
  • Everyday activity like walking, sitting and standing may be painful and difficult.
  • Coughing and sneezing can increase the pain.
  • Losing control of bowel or bladder – this is a sign of Cauda Equina Syndrome which is an emergency situation and requires immediate medical attention.

Causes of Sciatica8.

Any condition that compresses the sciatic nerve causing sciatica pain is listed below:
  • Herniated lumbar discs
  • Degenerative Disc Disease
  • Diabetes
  • Lumbar Spinal Stenosis
  • Isthmic Spondylolisthesis
  • Piriformis syndrome
  • Trauma
  • Spinal Tumors and Infections
  • Sciatic nerve tumor or injury

Preventive & Self Care Measures9

Along with homeopathic treatment these self care measures can help relieve the symptoms of sciatica and also prevent recurrence.
  • Cold and hot packs. Use alternate cold and hot packs to reduce swelling and relieve discomfort.
  • Practice good posture. Stand up straight with your ears aligned with your shoulders, your shoulders aligned with your hips and your buttocks tucked in. Your knees should be bent slightly.
  • Regular exercise: improves flexibility and helps prevent age-related degenerative changes in your back.
  • Lift objects safely. Always lift from a squatting position, using your hips and legs to do the heavy work. Never bend over and lift with a straight back.
  • Avoid sitting or standing for extended periods. If you sit at work, take regular breaks to stand and walk around. If you must be on your feet, prop one foot on a small block or footrest, and then switch feet throughout the day.
  • Avoid wearing high heels. Shoes with heels that are more than 1½ inches high shift your weight forward, throwing the body out of alignment.
  • Do abdominal crunches. These exercises strengthen the abdominal muscles that help to support your lower back. Lie with your back on the floor, hands behind your head and knees bent. Press your lower back to the floor, lift your shoulders up about 10 inches off the floor, and then lower them. Repeat 10 to 20 times daily.
Treatments available10,
Cases of sciatica are treated with different measures. Evidence of the effectiveness of these measures is limited. However, Some of these measures are:
  • Physical therapy / Stretching exercises
  • Massage therapy
  • Yoga- Saddle Pose, Pigeon Pose
  • Weight loss reduces pressure on Spinal nerve roots

Homeopathic Approach to Sciatica12

Homeopathy is the only form of treatment that has shown an overwhelming positive response in treating sciatica. Constitutionally prescribed homeopathic remedies can effectively and permanently reduce pain and other symptoms of sciatica.
Homeopathic medicines treat by strengthening our vital force which is an intelligent energy principle in our body that balances many functions and provides protection from illness. Homeopathic treatment being based on the hypothesis of "like cures like" and a deep emphasis on the principles of holistic medicine (treat the whole person), its remedies work by stimulating the body's own healing power by introducing tiny doses of natural substances that stimulates a person's immune system and defense system to correct itself naturally. Due to the individualized constitutional approach of homeopathy a remedy which matches all of your symptoms will stimulate your vital force to restore balance and health. However, some of the frequently indicated remedies for sciatica are as follows:5,6,7.
  1. Colocynth. [Coloc]
  2. Gnaphalium. [Gnaph]
  3. Rhus toxicodendron. [Rhus-t]
  4. Kali mur [Kali-m]
  5. Ammonium muriaticum. [Am-m]
  6. Pulsatilla. [Puls]
  7. Nux vomica. [Nux-v]
Hence, every individual suffering from sciatica must consider homeopathy to provide relief and lifetime cure. Homeopathic treatment can change a person’s life from one of distress to one of health.
6.3 / AIMS and Objectives:
  1. The Basic aim of study of role of homoeopathic medicine in treatment of sciatica in to high light the greatness of homoeopathy and its drugs and prevents the criticism of homoeopathy.
  2. To enlighten the Homoeopathy that sciatica can be treated with Homoeopathic medicines itself without the need of surgery in most cases.
  3. In day to day practice also many cases that come to us are sciatica as they are well treated in homoeopathy than any other system. To study the Homoeopathic management and treatment of sciatica.

7 / Materials and Methods:-
7.1 / Source of Data:
  1. The Subject of the study will be collected from OPD/IPD of Dr.B.D.JattiHomoeopathicMedicalCollege and Hospital, Dharwad.
  2. Rural OPDs of Dr. B.D.Jatti Homoeopathic MedicalCollege, Dharwad.

7.2 / Methods of Collection of Data (Including Sampling Procedure if any)
Definition of the Subject Study:
Patients are considered on basis of clinical presentation like pain, numbness, tingling etc.,
Following are the inclusion criteria:
  1. Patients between the age group of 50-60 years of both sexes are only taken for the study.
  2. Patients irrespective of ethnic group socio economic status and occupation will be considered for the study.
Following are the exclusion Criteria:
  1. Patients with Systemic diseases like diabetes, immuno compromised diseases on active treatment for same are not taken up for study.
  2. Cases of fracture of pelvis, dislocation of hip, compression and trauma of sciatic nerve, osteoarthritis.
Patients will be selected as per the inclusion and exclusion criteria
STUDY SAMPLING DESIGN :
Sampling method :
Simple Random Sampling Method
Study Sampling Design: Prevalence rate of sciatica in our hospital is 4% considering the 95% confidence interval at 6% permissible error, Sample size works out to be 41 cases. Since it is a time bound study, all admitted and opd cases are included in my study period.
Study design :
Simple random method of selection of cases. The cases are selected according to inclusion and exclusion criterias.
Follow up :
Follow up of the cases would depend on severity of the symptoms, and as per the need and necessity of the case, preferably once in week for One Month and later once in 15 days.
Parameters used are :
Change in clinical findings like the presenting symptoms, signs, change in investigations are parameter for accessing cure, improved and not improved criteria.
CURE:
Regression of the signs and symptoms along with no signs of inflammation till the end of my study period.
IMPROVED:
1)Relief of signs and symptoms, but again occurs within end of my study period.
2)Relief of signs and symptoms.
3)Regression of the inflammation but signs and symptoms not totally relieved.
NOT IMPROVED:
1)Drop out cases.
2)Neither relief of inflammation of sciatica nor relief of signs and symptoms.
Study Period: From 30/11/2010 to 30/11/2012
Statistical Test: Appropriate test is being used.
7.3 / Does the study require any investigations or any interventions to be conducted on patients or other humans or animals? If so describe briefly.
The Study requires following investigations
  1. X-Ray
  2. MRI
  3. Blood to exclude Diabetes and exclude sulphites.
  4. Urine to exclude diabetic peripheral enmity etc

7.4 / Has Ethical Clearance been obtained from your institution in case of7.3?
Yes ethical clearance has been obtained from the institution
8 / List of References
  1. B.D Chaurasia, Human Anatomy,Volume II, CBS Publishers & Distributors, Pg 75.
  1. Dr. S. Das, A Manual on clinical surgery, 5th edition, S. Das publishers, Pg 104.
  1. Rustom Jalvakil and Aspif Golwalla, Physical Diagnosis, 12th edition, Media promoters & publishers pvt Ltd, Pg No. 504.
  1. Dr. S.K Dubey, Textbook of Meteria Medica, New central book Agency Pvt Ltd, Pg No. 146-147.
  1. Lilienthal, Homeopathic therapeutics, Sett Dey & Co, Pg. No 641
  1. J.T Kent, Repertory of Homoeopathic Materia Medica, B.Jain publishers (P) Ltd, Pg No 1095.
  1. William Boericke, New Manual of Homeopathic Materia Medica & Repertory,9th Edition, B. Jain Publishers, Pg No 301g
  1. Menino de Souza, How to examine a patient, 5th edition, Varghese publishing house, pg No 464

9 / Signature of the Candidate
10 / Remarks of the Guide
11 / 11.1 / Name & Designation
(in block letters) of Guide / Shri Dr. R.Y NadafM.D (Homoeo)
PROF. & H.O.D. P.G MATERIA MEDICA
DR. B.D.JATTI HOMOEOPATHIC MEDICALCOLLEGE & HOSPITAL, DHARWAD.
11.2 / Signature
11.3 / Co-guide if any
11.4 / Signature
11.5 / Head of the Department / Shri Dr. R.Y Nadaf M.D (Homoeo)
PROF. & H.O.D. P.G MATERIA MEDICA
DR. B.D.JATTI HOMOEOPATHIC MEDICALCOLLEGE & HOSPITAL, DHARWAD.
11.6 / Signature
12 / 12.1 / Remarks of the Chairman
& Principal
12.2 / Signature