Hi All,

Was reading the article Hans wrote on back pain - on his site. I am wondering if anyone has used Dulcamara with any of the back pain cases they have treated. I am considering Merc, Rhus-tox, Puls and open to hearing other suggestions.

I would like to hear others ideas on this case:

The case I'm looking at now has quick catching pains in the lower lumber. This is an old problem that hasn't come up for about 5 years.

It came on suddenly after a nap a couple of days ago. When the patient awoke from the nap - there was perspiration (went to sleep a bit chilly and woke up hot and perspiring). Patient is living in a hot climate - with air-conditioners running. Seems to have caught a draft of cold air on the sweaty back(chill) and this seems to have set off an initial muscle spasm in the muscle that runs along the spine.

The next morning, the patient says the muscle spasm was gone - but lower down the spine - there was a dullish pain and the back 'was catching'. Like it was going to 'give out'.

Can bend forward (in sitting position)- it seems to relieve the pain but still feels strained. If bending forward in a standing position - the back 'catches' when either bending forward or returning to the upright position.

If reaching out for something (like across a table) - then back feels like it will give out. There is - quick acute pain with this action - that lessens once returned a normal posture.

The pain is much relieved (temporarily) for external heat - or a hot bath (verrrry hot).

After a bath - patient says they have to be careful when drying off - not to let the back catch a chill (therefore wraps the back in a towel).

Worse standing -- can't stand properly - feels the back will give out and finds himself shifting to find some relief from the catching-feeling in the lower back.

Can twist to right and left -- and the spine clicked (popped) when twisting to the left. It didn't pop when twisting to the right. Felt the urge to 'pop' back. Doesn't seem to be a lot of pain when doing this - but felt he must be careful. Advised him not to pop his back for now.

Sitting position: (no catching sensation) - though still feels pain - just a general dull ache - almost like an undulating pain - constant but low key. It's better if he sits on a chair with support for the back but the pain is still low key. If sitting with no support against the back - there is more pain. Pain is constant and he says he squirms to find relief (finds none in this position).

If he leans back when in a sitting position - the pain is excruciating. It's sharp, intense and very painful.

If sitting indian style (with legs folded criss-cross under each other) AND slouched forward (shoulders slumped in bad posture!) there is relief - almost no pain - but if he straigtens his spine or moves or squirms in this position - the pain is worse. Also, if he sits in this position too long, then the pain gradually is felt and he has to move/shift around again.
Also, when in this position - if he leans forward/left, his right lower lumber (L5 I think) hurts more. If he moves forward/right or straight forward - the pain also intensifies also but not as much as when leaning the forward/left. Hope this makes sense!

Lying down (like on the couch to watch t.v.) is tricky - must get into a position carefully, but finds he can't stay in any position for too long or it hurts - has to move and adjust position.

Lying on stomach causes no pain - seems to relieve. So he slept on his stomach last night, but woke on his side this morning. Today he's worse and is worried that his back will totally give out now. He's moving around carefully.

Lying on side isn't great, but can find a position (with pillow between knees) where there isn't the pressure on the disc. Feels like a bulging or slipped disc.

Since the onset, has wanted to be alone. Doesn't want to be bothered by anyone. Isn't particularly irritable or anything - just wants to be left alone in peace and quiet til he feels better and feels able to move around freely again.

This patient did not lift anything heavy. The only thing we can trace is the chill after getting hot and perspiring while sleeping - -- then getting up quickly and catching a chill with the perspiration.

The patient says there is also a slight trembling weak feeling (all over - hands trembles slightly) when the pain is at a peak -- e.g., when the back catches and the pain intensifies. When this happens - there is a a break out of perspiration -- and a sort of whoozy feeling - almost like they drank alchohol and feel slightly tipsy. I thought this was odd and am not sure how this translates.

He also said he feels he would get some relief from the pressure he feels on the disc if he passes stool. He passed a stool this morning (easily) and said there was temporary relief. Don't know if this is that important or not.

Any thoughts anyone? Looking forward to hearing some other ideas.
Lisa

[ 25. September 2003, 10:32: Message edited by: LisaAnnan ]

__________________
"The significance of a fact is measured by the capacity of the observer."
Carroll Dunham

lisa, it sounds like rhus tox, with the agg from a draught on wet skin.
placidity argues against nux.
the patient moves around to try to get relief.
the fact that he can sleep at night argues against merc.
the wooziness with the pain at its worst is also covered by rhus.

edited:
Tried a dose of Rhus-tox 30c. No changes. Am ordering Dulcamara just in case we need it later (discovered I don't have it).

Since the rhus-tox didn't help, I wondering if it's a matter of posology - wrong potency - or if it's just the wrong remedy.

I have help with this case, but thought it would be good a good case to discuss, if anyone else is interested.

Lisa

[ 25. September 2003, 15:32: Message edited by: LisaAnnan ]

__________________
"The significance of a fact is measured by the capacity of the observer."
Carroll Dunham

lisa, you wouldn't necessarily get an instant effect, but if rhus would help i would have expected signs that it is acting in an acute by now.

At first, I thought this acute might be something that could be worked on in isolation - something to use to differentiate remedies (MM exercise as such). But, since I'm not able to post the whole case -- history and all, I can see it's going to be too difficult to work without full disclosure. Thanks anyway....
Lisa

__________________
"The significance of a fact is measured by the capacity of the observer."
Carroll Dunham

There are some interesting symptoms here. As a simple repertory exercise it brings up Plumbum metallicum

Back pain > bending forward
Restlessness during the pain
Back pain > lying on abdomen
Back pain > passing stool
Weakness of back on standing

There is, however, no reference to the Plb state being caused by becoming chilled when wet. Plb is listed as being sensitive to cold air, so this may be enough.

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David Kempson.<br />Dip.Homoeopathic Medicine.<br />Lecturer Australian College of Natural Therapies (Brisbane Campus)<br />Member AHA, AROH, HMA<br />Member Australian Homoeopathic Association. Member#0442.

David, Thanks for your thoughts. The patient isn't sensitive to cold air!

After being heated/hot, there was subsequent perspiration - then the patient caught a draft which set off this acute-state with the back pain. There is no doubt that this immediately preceeded the acute.

The interesting thing (also) is that this isn't the first time the sensitivity to drafts has been seen in this patient. There have been several other acutes that were preceeded by exposure to a draft - over some time. All with slight differences between them - including this back-episode. e.g. not every previous acute that was set off by a draft was preceeded by being hot with subsequent perspiration. Some were preceeded by perspiration but not always being hot, that the patient could recall.
AND, not every acute that was agg by a draft were centred round the back - they were completely different acutes....

The difference between Rhus-tox and Dulc, in this case (for anyone interested) - as was explained to me:

Aggravation (of old symptom) from chilling (from a draft), after being overheated with perspiration. The important factor that was pointed out to me was - having been hot, with perspiration, prior to the draft. Dulcamara has this - ailments from.... Rhus-tox, on the face of it - seemed very close but doesn't have this heat beforehand.... Easily missed since it's such a subtle difference.

There are obviously other factors to this case, which I can't disclose and which hamper me from further justifying the choice. That's why I came back and posted that it was probably moot to continue discussing it for lack of a complete history which would probably make more sense of the selection.

__________________
"The significance of a fact is measured by the capacity of the observer."
Carroll Dunham

Dear Lisa
May I whisper: Dampness+ exertion&lt;:
Calc-c
You can look au the rest for yourself.
Best of luck--Hans

__________________
Hans Weitbrecht
Consultant Homeopath

That's interesting. I wish I could disclose the whole case to see if you would still suggest Calc. It certainly covers a lot of the complaint!

Have you ever needed to use Dulcamara before?

I will, thanks.
Best regards,
Lisa

__________________
"The significance of a fact is measured by the capacity of the observer."
Carroll Dunham

i remember a patient with an acute flare up of back pain responded fast to calc [within 24 hours significant alleviation, followed by complete alleviation in a few days] - so it can be the one even for acutes.