A 31 years old obese female came to the peripheral OPD on 22.12.2021 with K/C/O left calcaneal spur, plantar fasciitis and cracked heels. She has a complaint of throbbing pain in left heel and swelling in ankles since 2 to 3 years with difficulty in walking since one year. Pain is aggravated by pressure, walking, morning and cold application. She has desire to sit for some time before she begins to walk and her swelling is aggravated by walking and in the morning. She also has c/o cracked heels since 2-3yrs which is < during winter.
Physical Generals :
Appetite : 3 times / day
Thirst : 6-7glasses / day
Urine : 5-6 times / 1time
Stool : once daily
Sleep : 6 to 7 hours / day
Craving : spicy+, sour+
Perspiration : whole body; in soles++ and palms++
Obstetric History : G2P2L2A0 : FTND 1; LSCS 1.
Past History : Fall 10 years ago
Family History : Father DM
General Examination :
Weight : 77kgs
BP : 134/86mmHg
Nails : Pinkish, long
Conjunctiva : Pinkish
Tongue : white coated in centre, red papillae, pigmented at the sides of the tip of the tongue.
Local Examination :
B/L heels : Cracked+++; Tender++
Dorsum of foot : Non pitting oedema+
B/L Ankle Joints : Swelling+
Life Space :
Repertorial Totality :
Boenninghausen’s Approach :
- Throbbing pain+++
- < Cold application
- < Morning
- < Pressure
- < Walking
- < Winter
- Perspiration on palms++
- Perspiration on soles++
- Conscientious++
Prescription :
- Silicea 200 Stat dose
- SL 3pkts alternate day x 7days
- SL 1/2 dram 4pills TDS x 7days
Follow up :
| Date | Symptoms | Prescription | Interpretation |
| 29/12/2021 | Heel Pain < in morning > 30%
Heel Pain < in evening after walking++
|
1. Silicea 200 Stat dose
2. SL 3pkts alternate day x 7days 3. SL 1/2 dram 4pills TDS x 7days |
Symptomatic relief. Bony overgrowth and obesity may trigger her pain. |
|
Gap of 8 weeks in homoeopathic medicine. She got tested on 14.02.2022 and consulted orthopedic surgeon. Tablet Zerodol-P BD, Tablet Biorab 20 OD, Tab B.29 OD was prescribed to her for 15 days without any relief. |
|||
| 09/03/2022 | Heel Pain < in morning++
Heel Pain < in evening after walking++ |
1. Silicea 200 Stat dose
2. Silicea 6x 42 tablets given à2tab TDS x 7days |
Maintaining cause++, therefore, biochemic remedy started along with the constitutional Rx. |
| 16/03/2022 | Heel Pain < in morning SQ
Heel Pain < while walking SQ Heel Pain < weight lifting SQ Swelling SQ |
1. Silicea 0/3 1pkt
à Dissolve in 15ml dropper bottle with water à 10 strokes given à Take 8 drops TDS x 7days 2. SL 1/2 dram 3pills TDS x 7days |
Maintaining cause++
Sensitivity++ No relief from biochemic Rx therefore, LM potency started. |
| 23/03/2022
|
Heel Pain < morning >20%
Heel Pain < while walking >++ Now no desire to sit before initiating to walk She is able to walk more than before Swelling+ Tongue dry, white coated, tip clean; Lips : dry |
1. Silicea 0/3 1pkt
à Dissolve in 30ml dropper bottle with water à 10 strokes given à Take 8 drops TDS x 14days 2. SL 1 dram 3pills TDS x 14days |
Sensitivity towards pain and susceptibility of the patient satisfied with 20%. |
| Gap Of 4days In Homoeopathic Medicine As Patient Was Out Of Station | |||
| 06/04/2022
|
Heel Pain < in morning > 50%
Heel Pain < while walking > 50% Swelling+ (B/L Ankles and Dorsum of foot) Dryness of B/L palms (Rt > Lt) after making potato chips Thirst : 3 to 3.5 Litres / day Urine : 4-5 times / day Tongue dry thick white coat; pigmented tip
|
1. Silicea 0/3 1pkt
à Dissolve in 15ml dropper bottle with water à 10 strokes given à Take 8 drops TDS x 7days 2. SL 1/2 dram 3pills TDS x 7days |
Sensitivity towards pain and susceptibility of the patient satisfied with 50%. But, sensitivity & reactivity of skin high.
|
| 13/04/2022
|
Heel Pain < in morning > 50%
Heel Pain < while walking > 50% Heel Pain < while weight lifting >100% Swelling+ Thirst : 3 to 3.5 Litres / day Urine : 5-6 times / day
|
1. Silicea 0/3 1pkt
à Dissolve in 15ml dropper bottle with water à 10 strokes given à Take 8 drops TDS x 7days 2. SL 1/2 dram 3pills TDS x 7days |
Sensitivity & susceptibility of the patient satisfied with 60% to 70%. |
| Gap of 3days in homoeopathic medicine as patient was out of station | |||
| 20/04/2022
|
Heel Pain < in morning > 50%
Heel Pain < while walking >50% Swelling+ Thirst : 3 to 3.5 Litres / day Urine : 5-6 times / day Wt : 77Kgs BP : 130/80mmHg |
1. Silicea 0/3 1pkt
à Dissolve in 15ml dropper bottle with water à 10 strokes given à Take 8 drops TDS x 7days 2. SL 1/2 dram 3pills TDS x 7days |
Sensitivity and susceptibility of the patient satisfied with 50%. |
| 27/04/2022
|
Heel Pain < in morning > 60%-70%
Heel Pain < while walking > 60%-70% Heel Pain < standing from sitting position++ |
1. Silicea 0/3 1pkt
à Dissolve in 15ml dropper bottle with water à 10 strokes given à Take 8 drops TDS x 7days 2. SL 1/2 dram 3pills TDS x 7days |
Sensitivity and susceptibility of the patient satisfied 60%-70%. |
| 04/05/2022
|
Heel Pain < in morning > 100%
Heel Pain < while walking > 100% Heel Pain < standing from sitting position >80-85% BP : 128/82mmHg |
1. Silicea 0/3 1pkt
à Dissolve in 30ml dropper bottle with water à 10 strokes given à Take 8 drops TDS x 14 days 2. SL 1 dram 3pills TDS x 14 days |
Sensitivity and susceptibility of the patient satisfied 90%-95%. |
| 25/05/2022
|
Heel Pain < in morning > 100%
Heel Pain < while walking > 100% Heel Pain < standing from sitting position >90%-95% Cracks on heel++ |
1. Silicea 0/3 1pkt
à Dissolve in 8ml dropper bottle with water à 10 strokes given à Take 8 drops BD x 7days 2. SL 1/2 dram 3pills BD x 7days |
Sensitivity and susceptibility of the patient satisfied 95% to 100%. |
| 01/06/2022
|
Cracks on heel++
Left lower backache radiating to thigh since 3-4 days < Lying down > Sitting H/o 40 kms traveling in a car present No H/o Weight lifting seen |
1. Silicea 0/3 2 Pkts
àDissolve each packet in 30ml & 15ml dropper bottle with water à10 strokes given àTake 8 drops TDS x 21days 2. SL 1½ dram 3 Pills TDS x 21 days 3. Colocynth 30 ½ dram (SOS) |
Pt is suffering from functional backache.
Hence, constitutional Rx continued and advised for rest. If constitutional Rx does not act then acute Rx will be advised. |
| 22.06.2022 | Lt lower backache radiating to thigh >30%
Heel pain >90% Cracks on heel SQ
|
1. Silicea 0/3 1 Pkt
àDissolve it in 8ml dropper bottle with water à10 strokes given àTake 8 drops BD x 7days 2. SL ½ dram 4 Pills BD x 7 days 3. Colocynth 30 ½ dram (SOS) 4. Petroleum Jelly for cracked heels àClean soles and heels with warm water àDry it with a clean cloth àApply jelly on heels BD at bed time daily |
Acute episode of pain is settling with constitutional Rx therefore, Colocynth was not advised. In addition to this the doses of Silicea 0/3 dilution reduced to BD doses from TDS daily.
C/o cracks on heels SQ. Therefore, Local application was advised. |
| 29.06.2022 | Lt lower backache radiating to thigh >50%
Heel pain >100% Cracks on heel >+ |
1. Silicea 0/3 1 Pkt
àDissolve it in 8ml dropper bottle with water à10 strokes given àTake 8 drops BD x 7days 2. SL ½ dram 4 Pills BD x 7 days 3. Petroleum Jelly for cracked heels àApply BD at bed time daily |
Sensitivity and susceptibility towards acute episode of pain >50%.
Local application of petroleum jelly has initiated the action of remedy on heels. |
| 06.07.2022 | Lt lower backache radiating to thigh >70%
Heel pain >100% Cracks on heel >++
|
1. Silicea 0/3 1 Pkt
àDissolve it in 8ml dropper bottle with water à10 strokes given àTake 8 drops BD x 7days 2. SL ½ dram 4 Pills BD x 7 days 3. Petroleum Jelly for cracked heels àApply BD at bed time daily |
Sensitivity and susceptibility towards acute episode of pain >70%.
Local application of petroleum jelly is improving the complaint of cracked heels. |
| 13.07.2022 | Lt lower backache radiating to thigh >90%
Heel pain >100% Cracks on heel >90%
|
1. Silicea 0/3 1 Pkt
àDissolve it in 8ml dropper bottle with water à10 strokes given àTake 8 drops OD x 7days 2. SL ½ dram 4 Pills OD x 7 days 3. Petroleum Jelly for cracked heels àApply BD at bed time daily |
Sensitivity and susceptibility of the patient satisfied 90%-95%. Therefore, she has been advised to discontinue her treatment for 3months and F/u thereafter with her left heel radiological examination.
|
| 09.11.2022 | On telephonic conversation she said that she is better in her complaints.
No further radiological examination done. |
No Rx | Her susceptibility and sensitivity at physical & nerve level satisfied. |
Summary:
Silicea in LM potency has satisfied the susceptibility and sensitivity of patient suffering from calcaneal spur, plantar fasciitis and cracked heels. Moreover, these conditions are very painful to tackle by an obese person and surgery is ultimately the last option. In this case Silicea has acted as a “surgeon’s knife” for gentle and permanent recovery of patient.
