Homoeopathic Management in Fibromyalgia – A Case Report

March 6, 2025 admin Case Presentations 0

Dr Bramarambha K

ABSTRACT: Fibromyalgia is a long-term condition marked by widespread pain in the muscles and bones, typically accompanied by fatigue, sleep problems, cognitive difficulties, and mood disturbances. Although the precise cause is unknown, it is thought to involve irregular pain processing in the central nervous system, resulting in an increased sensitivity to pain. Case of Fibromyalgia in a 33-year-old female visited out- patient ward in Government Homoeopathic Medical College & Hospital, Bengaluru presented with complaint of Pain over the entire body. A detail case taking was done, followed by repertorisation lead to the prescription of Staphysagria. This case treated with individualized homoeopathic medicine showed remarkable improvement in a very short period of time.

Keywords: fibromyalgia, staphysagria, symptom severity scale, homoeopathy

INTRODUCTION:
Fibromyalgia is a long-term condition marked by widespread pain in the muscles and bones, often accompanied by fatigue, cognitive difficulties, mood disturbances, and sleep problems. While the exact cause remains unclear, research suggests that abnormal pain processing in the nervous system, particularly central sensitization, plays a significant role.1 Fibromyalgia occurs in all populations worldwide, and symptom prevalence ranges between 2% and 4% in the general population. The prevalence of people who are actually diagnosed with fibromyalgia is much lower.2Although fibromyalgia was once met with skepticism, it is now widely recognized as a significant global health issue affecting diverse populations. Advances in research have enhanced diagnostic approaches and treatment options, improving patient care. Ongoing studies continue to explore its underlying mechanisms to develop more effective therapies and enhance the quality of life for those affected.3

Individuals with fibromyalgia commonly experience stiffness, disrupted sleep, and increased sensitivity to various stimuli. These symptoms can severely impact daily life and overall well-being.4 Management of fibromyalgia requires a multidimensional approach, including pain management, pharmacological therapies, behavioral therapy, patient education, and exercise.5

Current Diagnostic Criteria for Fibromyalgia (ACR 2016 Revision)6

A diagnosis of fibromyalgia is made if the following three conditions are met:

  1. Widespread Pain Index (WPI) ≥ 7 and Symptom Severity Scale (SSS) score ≥ 5,
    OR
    WPI 4-6 and SSS score ≥ 9.

    • WPI (0-19): Counts the number of body regions with pain.
    • SSS (0-12): Evaluates symptom severity, including fatigue, cognitive issues (“fibro fog”), and unrefreshed sleep.
  2. Symptoms have persisted at a similar level for at least 3 months.
  3. No other disorder that better explains the symptoms.
    • Conditions like rheumatoid arthritis, lupus, and hypothyroidism must be ruled out.

Body Regions for WPI

The WPI is calculated based on 19 specific pain areas, including:

  • Upper body: Neck, shoulders, arms, chest
  • Lower body: Hips, legs
  • Axial: Lower back, upper back, abdomen

Additional Symptoms Considered

  • Fatigue
  • Unrefreshing sleep
  • Cognitive symptoms (“fibro fog”)
  • Other somatic symptoms (e.g., headaches, IBS, depression)

Case Presentation

Preliminary Data

  • Name – Mrs. PQRS
  • Age – 33 yrs
  • Address – Tumkuru
  • Occupation – Teacher
  • Marital status – Married since 11 yrs.
  • Religion – Hindu
  • Nationality – Indian

Presenting Complaint

  • C/O Pain over the entire body since 7 months

History of Presenting Complaint         

Patient was in good health until seven months ago when they began experiencing generalized muscle pain, which started following a fever episode.

Pain started first in upper extremities later whole body was involved. Patient finds it difficult to wake up in morning as pains are more in the morning.

Location- Muscular system

Sensation- dull & constant

Modalities – agg = cold weather, touch, morning

Amel = warm application

No concomitants

Past History

  • Medical history – Allergic rhinitis since childhood
  • Surgical history – Adenoidectomy at 7yrs of age
  • C- section – 11yrs back
  • Admission to hospital – for gastritis in 2021
  • No accidental history

Family History

Father – alive – apparently healthy

Mother – alive – diabetes mellitus since 1 year – on allopathic medication

Osteoarthritis since 2 years

Siblings

  • 1 elder sister- allergic rhinitis
  • 1 elder brother – AH
  • 1 elder sister- AH
  • Patient

Gynaecology & Obstetrics History

LMP – 22/03/2023

Menarche = 13yrs of age

  • Cycles – regular
  • Duration – 30 days
  • Duration of flow – 2 days.

D1 = 2 pads

D2 = 1 pad

  • Color – red to black
  • No odor
  • Lower abdomen pain on day 1 – amel = sleeping on abdomen
  • Leucorrhea = 2-3 months had profuse but now it is better. Agg = stress

G1P1L1A0

G1 = 11yrs daughter = C- section

Personal History

  • Diet – Mixed predominantly vegetarian
  • Habit – N.S
  • Appetite – Reduced, can’t tolerate hunger. Taste is reduced during pain
  • Hunger – Reduced
  • Thirst – thirstlessness
  • Desire – previously craved for mutton, lost interest in eating due to pains since 2-3 yrs
  • Aversion – N.S
  • Urine – 4-5 times in day, 1 time – night, no burning micturition
  • Stools – regular
  • Perspiration – scanty
  • Sleep – disturbed sleep
  • Dreams – doesn’t remember
  • Thermals – towards chilly
  • Sensitive to noise – gets irritated
  • Sensitive to sun- blurriness of eyes & weakness

Life Space Investigations
B/B in Chitradruga. Studied till 2 PUC. Discontinued studies due to financial problems at home. Married at the age of 20yrs. Blessed with a daughter who is studying 6th standard now.

Mind
The patient took a loan three years ago and has been facing financial difficulties since the COVID pandemic. Due to which the patient is unable repay the loan. Patient was worried what people will think about her. Patient took up financial responsibilities of since 2 years.

Patient had taken loan 3 yrs back, having financial problems since COVID time. Due to which I am not able to repay the loan. I am taking financial responsibilities of home since 2 years. Patient’s husband does not contribute his salary to household expenses; instead, he spends more and does not save. His earnings are insufficient to sustain the household. If patient tries to explain, he doesn’t understand. Patient’s relatives are well settled & she feels embarrassed to go out with them.

Patient is not able to stand for 10 mins also due the pain. Patient is unable to concentrate for her teacher’s competitive exam which is the around corner. Due to pains sometimes patient will be shouting. Patient informed that if allopathy medications are taken for presenting complaint menses will be affected hence, she doesn’t want to take them. Patient is very sensitive & wants good opinion from others about her. Patient doesn’t like if someone says anything to her. Since few days patient stopped expressing anger because it will increase arguments. Patient doesn’t like if people underestimate her. Sensitive to rudeness. Patient wants to live good life so that people speak good about her. Right now, patient has no interest in anything.

General Physical Examination

Patient is conscious & oriented to date, time & place.

  • Built and nourishment – moderate
  • Weight = 50 kgs Height = 5.5ft
  • Pallor – absent
  • Cyanosis – absent
  • Edema – absent
  • Clubbing – absent
  • Head = Hair –healthy, scalp – healthy
  • Eyes – conjunctiva – pink, Sclera – clear
  • Ears –no discharge
  • Nose – no DNS & Polyp
  • Mouth = tongue – clean, teeth – hygienic, gums – pink, buccal mucosa – pink
  • Neck – no lymphadenopathy
  • Extremities = upper limbs & lower limbs – healthy
  • Skin – healthy
  • Nails – no clubbing

Systemic Examination

Respiratory system = B/L NVBS+

Gastrointestinal system = Soft, non-tender

Central nervous system = conscious & oriented to date, time & place.

Laboratory Investigations

  • Hb = 13.7 g/dl
  • ESR = 20mm/hr
  • RBS = 81 mg/dl
  • TSH & Vitamin D levels were normal

Nosological Diagnosis :Fibromyalgia

Differential Diagnosis

  • Chronic fatigue syndrome
  • Polymyalgia rheumatica
  • Hypothyroid myopathy

Classification of Disease

True chronic miasmatic disease = Psoro- syphilitic

Analysis of the Case

COMMON UNCOMMON
·       Pain over the entire body.

 
  • Anger when things don’t go her way
  • No interest in life
  • Worried what others will think about me
  • Thermally towards chilly
  • Sensitive to rudeness
  • Pains agg morning

Evaluation of symptoms

Mental generals Physical generals Particulars
  • Loathing of life
  • Sensitive to opinion of others
  • Anger – contradiction from
  • ·Sensitive to rudeness
  • Thermally towards chilly
  • Thirstless
  • Pain over the entire body.
  • Pains agg morning

Totality of Symptoms

  • Loathing of life
  • Sensitive to opinion of others
  • Anger – contradiction from
  • Thermally towards chilly
  • Thirstless
  • Pain over the entire body.
  • Sensitive to rudeness
  • Pains agg morning

Basis of Prescription
Based on the analysis of mental generals, physical generals, particulars & reportorial result Staphysagaria 1M was prescribed. Patient wants to be respected by everyone, more of dignity patient is worried about. Aurum is more marked with death desire, silicea is also image conscious but suppression of anger more marked in staphysagaria. Spongia is a glandular remedy. Potency 1M was selected based on the susceptibility & condition of the disease.

Follow up

03/05/2023 : Feeling much better.  Pains are much better. Able to study for my exams. Appetite improved

04/05/2023 : Feeling much better, no pains.

Generals are good.

Conclusion
Homoeopathy helps in holistic healing which in turn improves the quality of life. Homoeopathy treatment is gentle, rapid & permanent. Homoeopathy has a potential of preventing recurrence of the condition when treated properly.

Consent for publication- written informed consent was obtained from the patient for publication of this case report.

References

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  • Bhargava J, Hurley JA. Fibromyalgia. [Updated 2023 Jun 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK540974/
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Dr Bramarambha K
PG Scholar MD PART 2
Department Of Materia Medica, Government Homoeopathic Medical College & Hospital Bengaluru – 560079
Email: vaishnavikshetty@gmail.com
Under The Guidance Of ; Dr. Ashok Kumar Dantkale Professor & PG Guide

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