Clinical Cases

A Case of Chronic Back Pain

Written by F Joan Macdonald

The author treats a chronic case of back pain in a patient oversensitive to remedies.

Initial consultation: 13, April, 2013

Female, age 65

Observation: walking with cane in right hand, leaning toward right side. Very cautious turning to sit, placed right leg under carefully to take weight off left leg. Standing, sitting, shifting weight from left side to sitting upright to leaning to right.

Aetiology – Presenting Complaints

  1. Pain across lower back

Causation: Investigation discovered in 2011 – collapsed disc in spine, past history abscess in this region. 7 years ago, trauma, car accident, neck whiplash.

Duration: 2 years   Location: lower back, radiates to outside left hip, down leg outside thigh to knee

Treatment: Osteopathy, Reiki

Sensation: Lower back, muscle soreness, bruised, stiffness

Modalities: < standing longer than 10 minutes, < soft chairs

Concomitants: Hip pain and skin eczema, gastric heart burn

  1. Pain in left hip

Causation: just recently x-rayed, found non-diagnosed fracture from car accident

Duration: 7 years

Location: pain radiates from lower back to left hip down leg outside thigh to knee

Treatment: Reiki, Osteopathy. Sensitive to and cannot tolerate allopathic pain medicines. Also in the past, she was intolerant to homoeopathy remedies prescribed just for her skin eczema, which created an immediate severe adverse skin flare-up all over the body, especially on face, hands, feet where past cortisone ointment was applied.

Sensation: stiffness, pain dull. Sharp neuralgic pain from pressure after sitting in hard chair too long, and at night when sleeping

Modalities: > when standing upright, very straight, < sleeping on left hip, back

April 2013 – 3 weeks ago – 1 week prior to hip replacement surgery, it was cancelled when examination discovered an irregular heart beat, thought a result of past infection from abscess in spinal column.

  1. Skin condition – frequent flare-ups, dry, rough, painful cracking

Causation: Cortisone cream applied by hospital nurse to dry skin, eczema

Duration: 10 years

Location: face, hands, feet

Treatment: only tolerate one specific Chinese skin ointment

Sensation: burning, itching, on covered areas

Modalities: < summer+++, sun, heat, water, warmth, covering, tight clothing; > cool air, nothing covering areas

  1. Gastric – heart burn

Causation: from stress, eating certain types of foods

Duration: have had for a long time

Location: center of chest, in one spot

Treatment: no medicines, allopathic or homoeopathic

Sensation: burning and very uncomfortable

Modalities: < in evening 2 hours after meal, before bedtime, lying down; > sitting upright, standing and sipping warm to hottish water

The client is again on a waiting list for hip replacement surgery, going through complete medical evaluation. Injured hip will be a Maintaining Cause until surgery.

Other information gathered

Generalities – evaluation: d

Head to foot scan

Thermal relationship

Appetite – desire and aversions for foods

Thirst – frequency, preference temperature, etc.

Sleep – refreshed on waking

Natural discharges (stool, urine, menses, perspiration)

Patient’s past and family medical history

Overall Sense of well-being: 3/10 (10 being good)

Background medical information: childhood allergies, food intolerances, dietary restrictions, environmental and chemical sensitivities. Skin – eczema, recurrent flare-ups from sensitivity to certain foods, skin products, heat, allopathic medicines. Worsened in intensity and frequency after hospital nurse applied cortisone cream to face, hands, feet. (10 years ago)

Many past severe skin flare-ups, reactions to natural creams, lotions and herbal, and homoeopathic remedy (Rhus tox 30C), allopathic medicines. Learned over the years, that she may use on skin one skin product, a Chinese ointment.

Patient, at this time, asking for help with:

  1. Lower back pain (Homeopathy Treatment for Back Pain) radiating toward left hip, < from constantly leaning in one position, sensation of muscular soreness, bruised, stiffness.
  1. Heartburn – center of chest, in one spot. < in evening 2 hours after meal, before bedtime, lying down; > sitting upright, standing and sipping warm to hottish water

Patient not on any allopathic pain medications. Past history of being able to use:

Arnica 30C (1 dry dose = 1 pellet) to relieve pain.

Magnesium phos 6X Tissue Salt (1 tablet, dry) neuralgic pain, left hip down outside of leg during sleep, night.

Ferrum phos 6X Tissue Salt (1 tablet, dry) inflammation, irritation of back, hip.

First prescription based on patient’s wishes:

  1. Lower back – feeling a sensation from pressure, sore, bruised, and stiffness, > if able to stand erect.

Only one remedy covers this: Bellis perennis

Boericke Materia Medica & Repertory used for confirmation:

– traumatism, muscular soreness, as if bruised.

– “It is a princely remedy for old laborers, especially gardeners.” (Burnett.)

(remaining in same position for a time)

Bellis perennis 30C (1 dry dose = 1 pellet) may need to repeat in 3 to 4 months. Client highly sensitive therefore unable to take in water, sipping. Past history, 1 globule sufficient. Repeat of remedy dependent on scheduled hip surgery.

  1. Gastric heartburn – spot in centre of chest, < 1 hour in evening after eating, < lying down

Patient very sensitive, cannot use a complementing, collateral related homoeopathic remedy as it might interfere with Bellis per 30C.

Patient explained, how she must be cautious when taking any natural health products, pharmaceuticals, in the past able to use certain Bio-chemic, Tissues Salts. A very sensitive, excitable constitution, therefore a homoeopathically made Tissue Salt complements Bellis per 30C without interference.

Heartburn: Natrum phos 6X, Tissue Salt, 1 dry dose = 1 tablet, take as needed

  1. Neuralgic hip pain: Magnesium phos 6X Tissue Salt, 1 dry dose = 1 tablet – in the past had used at night when wakened, continue using as needed

Second appointment – 6 weeks, during which time will update by telephone, results of reports for several medical appointments, evaluations and tests.

20, May, 2013

Lower back – better after Bellis per 30C – walking more upright without the exaggerated leaning to right – discomfort now 6 – 7/10 (10 being good)

Report: tests continue, will have a bone scan, blood tests, heart checkup, etc.

Bellis per 30C – is still working, wait and watch

Natrum phos 6X Tissue Salt really improves heartburn (1 tablet works well)

Client wants something for:

  1. Stress, anxiety, nervous dread of so many specialist tests and long wait for surgery.

Kali phos 6X Tissue Salt: 1 tablet dry, as needed

  1. Left hip – irritation, inflammation, pain from standing, walking, sitting long periods waiting in hospital.

Ferrum phos 6X, Tissue Salt: 1 tablet dry, as needed

Third appointment: 24, July, 2013

Client waiting 2 ½ years for surgery. Having regular weekly osteopathy care. At home using a walker for easing left hip.

Mother passed away in June. Also had been away for ten days visiting family.

Walking still more upright and also hasn’t been as worried


Blood tests – fine

Bone scan – fine


Bellis per 30C still working, not repeated

Continue with tissue salts as needed for acute discomfort:

Mag phos 6X – for neuralgic pain during night

Natrum phos 6X – for heartburn

Kali phos 6X – for anxiety, stress, worry

Ferrum phon 6X – irritation, inflammation from standing, sitting, walking

Fourth appointment: 17, September, 3013

Waiting for telephone call for hip surgery. Continue seeing an Osteopath weekly.

Pain – in back returning, < bending down forward and to the right side, sleeping on back. Pain now is 4/10 (10 being good)

Repeating Bellis per 30C, 1 dry dose = 1 globule

Initial dose – Bellis per 30C: 13, April, 2013

Continue with tissue salts as needed for discomfort:

Mag phos 6X – for neuralgic pain during night

Natrum phos 6X – for heartburn

Kali phos 6X – for anxiety, stress, worry

Ferrum phos 6X – irritation, inflammation from standing, sitting, walking

Will update by telephone when surgery scheduled, and results of investigations, medical appointments.


  • The single globule really worked well in a highly sensitive individual not on any allopathic medicines
  • Client in constant pain as body skeletal structure being affected, unable to straighten up without much effort, trying to ease pressure from left hip
  • Sensitive to homoeopathic medicines
  • Used 1 small, dry dose – waiting and watching – as client was extremely good at noticing small, gradual changes in status of pain
  • Client’s overall case will be retaken after hip surgery

About the author

F Joan Macdonald

F. Joan Macdonald, PGHom (UK), CCH(NA), RSHom(NA) currently resides in Halifax, Nova Scotia, Canada. Presently her cliental are mostly immigrating families that had a classical family homoeopath in their native country. She has been studying homoeopathy since 1993, having international, accredited post-graduate clinical training with the Allen College of Homoeopathy, UK. Canada She is Coordinator for Allen College post-graduate studies, and conducts a live-link discussion Study Group for USA, Allen College students, graduates. She is also a registered mentor with the North America Society of Homeopaths (NASH).


  • Thank you for your comment.

    Unfortunately, this couldn’t be a strictly Classical prescription after all Hahnemann hadn’t today’s manufactured bio-chemic tissue salts.

    One factor was the individual’s extensive experience in understanding her over-sensitiveness to many products, herbals, etc. therefore unable to use homoeopathic tinctures.

    And as the single globule wasn’t tolerated dissolved in water, sipping – a single globule, dry dose “as a weaker power” (Aphorism 285, 5th) – “the dose is vastly diminished” (Aphorism 285, footnote, 6th)

    And it was necessary to only use a single remedy – wait and watch – and maintain patient’s confidence that homoeopathy might be of aid and pains comforted by using the individual tissue salts accordingly.

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