Dr Shobhan Bose
Introduction:-
It is a condition characterised by severe pain and stiffness of the shoulder joint.
It may occur left or right or both shoulder. All movement affecting side of shoulder partly or fully arrested according to severity.
We know shoulder joint is a ball and socket joint. It is a joint of glenoid cavity of scapula attached with head of humerus (glinohumeral) and acromion part of scapula attached with lateral side of clavicle (acromioclavicular). It is a synovial joint. The joint covered with Hyaline cartilage.
Flexion and extension, abduction and adduction, horizontal circumduction like various movements occurs in shoulder joint.
But in case of Frozen shoulder all type of movements are painful and partly or fully restricted. When working hand is affected then it create difficulty in daily life.
Clinical feature:-
Pain, stiffness, swelling, difficulty in movement of shoulder joint, tenderness are main clinical feature of Frozen shoulder.
Cause :-
Frozen shoulder mainly occur due to inflammatory condition like bursitis, tendinitis, capsulitis, myositis of shoulder joint or thickening, fibrosis, tightness necrosis, scarring, shrinkage of the capsule, dryness of synovial fluid, bone damage of shoulder joint.
Accidental injury or any type of trauma of shoulder joint is main cause of frozen shoulder. Other causes are diabetes, weak immunity, hormonal disorders, inactivity of shoulder joint due to surgery or injury, illness of nerves etc.
Diagnosis:-
Sign and symptom are help diagnosis clinically of Frozen shoulder. Lab diagnosis – Magnetic resonance imaging scan (MRI), X-ray or other pathological test help in confirm diagnosis of Frozen shoulder.
A case of Frozen shoulder.
A patient came my clinic suffering in Frozen shoulder of both hands. Right hand was her working hand.
This hand severe affected and she tried to work by left hand.
So, she was taken more weight, stress, work load of daily life in left hand and left hand became injured due to continued un-habitually work by this hand.
So Frozen shoulder affected her in left side also.
Her husband was working in a semi-government company. She got free medical treatment from their hospital. They prescribed her several types of analgesic, anti- inflammatory tablets, pain relief ointments for external use on affecting part of hands.
They advised her much management like physical exercise, take food in proper time, avoid spicy food, hot application, bed rest etc.
This type of treatment when not beneficial to remove pain in long time for her then they prescribed injections (I/M) twice daily.
All types of treatment gave her temporary relief for some days. Her pain again reappeared and not reduced permanently by older ones.
At least they told her no needs of taking medicine; she became cure without injections or ointment but by taking proper management, exercise, hot water bag, massage, absolute rest etc. They also advised her to consult with physiotherapist.
She could not sleep at night due to severe pain mainly right hand and pain in left hand also. Pain was severe at bed at night, stiffness at morning and slightly relief by some movement of hand.
She couldn’t done her normal home work like wearing saree – blouse or other cloths , dressings her hair, lift and hold like water pot, children in lap and physical exercise due to her pain . All options were closed for her. She asked me to treat her.
According to symptoms totality I prescribed her medicine.
After taking medicine severe aggravation occurred at first then gradually pain decrease.
She told me that you treat me for reduce my pain but not for aggravated pain and I could not tolerate more pain.
I suffered in shoulder pain for more than two years. I lost my hope became cure now.
I habituated to tolerate this pain but I could not tolerate more.
Case taking
Name – Mrs. ED W/O – Late Mr.NL
Age – 65 years Sex – Female
Address – Jamtara, Jharkhand Cast – Hindu
Nationality – Indian Occupation – Housewife
Marital status – Married Height – 5 ‘ft
Weight – 51 kg BP – 130/80 mm/Hg
Pulse – 74/m Temperature – 97oF
Addiction – Nil Diet – Normal
Thirst – Normal Tongue – Red tip
Stool – Normal Urine – Normal
C V S – N/A Respiratory system – N/A
G.I.T. – N/A C N S – N/A
Sleep – Disturbance due pain. Dream – N/A
Physical general –
Severe pain, stiffness in left and right shoulder joint. Severe pain during movement or weight lifting in normal home work. Jump up from bed due to pain, cannot sleep properly.
Mental general –
Anxiety, hopeless, depression.
Aggravation –
By rest, at morning and night.
Amelioration –
By movement, day time, light work.
P/ History – Fever, injury
F/ History – N/A
Selection of medicine –
According to symptoms totality of this case –
I prescribed her Rhus Tox 30 twice in a day for 10 days.
After 10 days she came in my clinic with severe increase of pain for 1st 4 days and then last 5 days gradually reduced pain. She told me that she can’t tolerate increase of pain.
So I change the way of treatment.
Follow up : –
2nd follow up
Rhus Tox 0/1 and placebo one OD for10 days.
3rd follow up
She came my clinic to treat after 10 days, no relief or worse in pain of her both shoulders.
I increased the power of medicine.
Rhus Tox 0/2 and placebo one OD each for 10 days .
4th follow up
After 1month she came again with no relief of pain.
I increased power of medicine again.
Rhus Tox 0/3 and placebo one OD each for 10 days.
5th follow up
After 40 days when she came to my clinic, then I noticed slightly pain reduced.
So I increased power again.
Rhus Tox 0/4 & placebo for 10 days in same manner.
6th follow up
After 50 days of treatment she came and told me her shoulder pain reduce about 20 %.
Increased power for better results.
Rhus Tox 0/5 & placebo for 10 days.
7th follow up
After 2 months her pain decrease approximate 40%
I increased power again
Rhus Tox 0/6 with placebo for 10 days.
8th follow up
Patient came again, pain reduce slightly more .She can sleep at night.
I saw medicine work gradually so I increased medicinal power again.
I also advised her to started physical exercise mainly affected hands without given more stress in pain full area.
Rhus Tox 0/7 & placebo for 10 days.
9th follow up
After 80 days she said me her pain of both hands better more than 50 %. So I increase power for more result.
Rhus Tox 0/8 & placebo for 10 days.
10th follow up
After 3 months she came my clinic, at that time her pain of left shoulder was completely reduced and pain of right shoulder about 70% relief.
She can do her normal house job more or less and physical exercise, normal sleeps at night.
I increase power again but placebo for next 10 days more.
Rhus Tox 0/9 one OD for 10 days & placebo for 20 days.
11th follow up
She came again 20 days after with cent percent relief of pain in right hand and pain of left reduce before. Some movement of right hand still creates problem.
Rhus Tox 0/10 & placebo for 10 days.
12th follow up
After 4 months she came again in my clinic with smiling face. She was completely free from her chronic suffering of shoulder pain and stiffness.
So, no medicine to prescribe again, only second best for next 1 month only for psychological support to avoid fear of recurrences of pain.
Conclusion:-
Frozen shoulders manage by Homoeopathic medicine. Her pain and stiffness of both shoulder reduced completely by LM potency of Rhus Tox . Her pain and stiffness not only reduced but also she got back her strength of hands which able her to do normal work at home. I advised her to continue physical exercise after complete my treatment.
Homoeopathic treatment depends upon individualization by symptoms totality.
I manage many cases of Frozen shoulder by LM potency of Rhus Tox in same manner.
Bibliography:-
- Hahnemann’s Organon of Medicine by Dr. B.K. Sarkar.
- Pocket manual homoeopathic Materia Medica by William Boericke.
- Lecture on Materia Medica by Dr. J. T. Kent.
- Repertory of the Homoeopathic Materia Medica by Dr. J.T. Kent
- www.homebook.com
- www.mayoclinic.org
- www.webmd.com
Dr Shobhan Bose
HOD,Department of physiology
Naiminath homoeopathic medical college hospital and research center Agra
