A Case of Synovial Cyst

July  Serguei Krissiouk

Dr. Serguei Krissiouk takes an anthroposophical approach to a complex case of synovial cyst.

A 51-year-old female patient started having sharp, shooting, and persistent lower back pain radiating down the right buttock and thigh following an episode of overexertion while moving heavy objects. At first, she did not pay much attention to the pain and was not worried about it, since she had similar episodes of lumbago which occurred before and eventually resolved with rest and massage. This time, though, the pain persisted for several months without showing any signs of improvement.  As the pain worsened, she began to bend forward as she walked to ease the pain. She was not able to sit for long periods of time and her sleep was restless due to lower back pain.

The patient went to see a doctor at the local hospital, and an MRI scan of her vertebral column was performed.  It revealed degenerative anterior subluxation of L4 over L5, disc dehydration seen at all lumbar disc spaces, bulging disc seen at L2-L3 and L3-L4 levels narrowing the spinal canal, bulging annulus seen at C4-C5, C5-C6 and C6-C7 levels narrowing the spinal canal and slightly indenting the cord surface, degenerative changes with osteophytosis seen at the level of L4-L5, and the right facet synovial cyst compressing the descending L5 nerve root (right side). The orthopedic surgeon suggested the epidural steroid injections in the spine to relieve the pressure and ease the pain, and as a result of this treatment the patient endured the most excruciatingly painful procedure. She was not able to work for many months and had to wear a cumbersome back brace following the procedure. This made her feel depressed.  The surgeon also suggested a possibility of spinal surgery in case of ineffectiveness of the epidural steroid injections into the spine.

The patient came to me looking for a non-invasive treatment of her persistent pain. I performed a thorough examination and in-depth history of the ailment and patient’s lifestyle.

MRI study – July 7, 2011

 July 2016 Serguei Krissiouk1

Analysis of the case:

History of present illness: due to anatomical peculiarity, the patient’s lower extremities have been uneven since childhood (right leg is shorter than the left one). As a result, later in her life she developed several degenerative spine problems due to uneven body weight distribution and disturbance of the normal gate. Being an active and energetic individual, she did not spare her body of all kinds of physical stresses and overexertion. The present lower back problem had been developing gradually, in the course of many years, and only recently it presented itself with full force.

General behavior: she is an active and lively person, very sociable, enjoys company of adults and children, and works as a theatre teacher at the school. She is very creative and artistic – an accomplished piano player and a singer – and enjoys being the heart and soul of a social gathering. She craves affection and attention, displays variable moods – liveliness may be altered by sadness with crying and blaming others for not giving her the support and affection she needs. She is overly trusting and sometimes gullible (Pulsatilla).

She is also very energetic, busy, self-confident, and independent; hypersensitive to loud noise and bright light. She is a tobacco user, likes coffee, drinks alcoholic beverages and enjoys rich and spicy foods (Nux vomica).

Neurologic symptoms: weakness and degenerative changes of the spine; sharp, shooting, pressing and constricting lower back pains, increasing progressively and decreasing gradually (Stannum metallicum), peripheral neural pain following a nerve path (Gnaphalium), weariness, general weakness, generalized aches, heavy limbs (Gelsemium).

Digestive symptoms: slow and difficult digestion, with acidity, bloating, eructation with a taste of food (Antimonium crudum, Pulsatilla).

Modalities:  aggravation from cold wet weather and from heat; improvement from cool fresh air, at the seashore, from continued movement (Pulsatilla).

Morphology: blonde, blue-eyed female with a tendency of venous stasis (Pulsatilla).

In choosing the appropriate treatment regimen, I used the principles of Homeopathic and Anthroposophical medicine. However, the classical homeopathic principle of prescribing a single remedy could not be used in this case of chronic ailment due to its complexity. Instead, a number of homeopathic medicines with targeted action on various tissues and processes had to be chosen. The goal of treatment was to reduce the spinal pain and tissue inflammation, revitalize and tone intervertebral discs, joints and ligaments in a patient with drying and hardening tendencies and to promote self-healing forces of the body.

Two compound homeopathic preparations Bambusa Pulsatilla and Bambusa Rhus (available from the Uriel Pharmacy – a homeopathic pharmacy in Troy, Wisconsin, USA) have specific indications for spinal column weakness and neuropathy, degenerative disc diseases, osteochondrosis, spondylarthrosis, especially disturbances of this type during menopause, acute root neuralgia, and

discopathies (disc prolapse, compression).

Bambusa Pulsatilla preparation contains the following homeopathic remedies (X =decimal homeopathic dilutions):

  • Disci intervertebr. (cervic., thorac. lumb.) 6X – homeopathic preparation of the bovine intervertebral discs;
  • Bambusa e nodo 6X – homeopathic preparation of the bamboo tree nodes;
  • Stannum metallicum 7X;
  • Equisetum ex herba 5X;
  • Formica ex anim. 5X;
  • Viscum Mali e pl. tota 3X – homeopathic preparation of mistletoe plant grown on an apple tree;
  • Pulsatilla e flor. 5X;
  • Betonica ex herba 6X;
  • Rosmarinus ex herba 6X.

Bambusa Rhus contains:

  • Disci intervertebr. (cervic., thorac. lumb.) 8X;
  • Bambusa e nodo 6X;
  • Formica ex anim. 7X;
  • Arnica e pl. tota 20X;
  • Argentum metal. 20X;
  • Aconitum e tub. 20X;
  • Gnaphalium e pl.tota 4X;
  • Gelsemium e rad. 4X;
  • Mandragora e rad. 6X;
  • Rhus tox. 6X;
  • Betonica ex herba 6X;
  • Rosmarinus ex herba 6X.

According to the homeopathic principle of similia similibus curantur, or like cures like,  Disci intervertebrales , Bambusa e nodo , and Stannum metallicum  produce anti-degenerative, revitalizing effect on intervertebral discs, joints, ligaments and adjacent spinal nerves. Equisetum ex herba and Formica ex animale facilitate formative, boundary-creating (Equisetum) and warming, promoting healthy metabolism and decay-counteracting (Formica) processes. Viscum mali strengthens the innate self-healing forces and promotes the robust immune defense, especially in a female patient. Pulsatilla serves as a constitutional remedy for this specific sensitive type. Betonica and Rosmarinus are indicated in cases of lumbar pain syndrome with intervertebral disc prolapse to stabilize the forces working in the lumbosacral region of the spine. Arnica relieves pain and tissue inflammation, Aconitum is indicated in cases of intense neuralgia with sudden and violent onset.  Gnaphalium has strong affinity for the peripheral nervous system in cases of intense shooting pains along the nerve paths. Gelsemium relieves congestive neural pains and reduces anxiety. Argentum metal alleviates nervous exhaustion, improves restful sleep, and helps to counteract inflammatory, irritable conditions.  Mandragora is effective in cases of chronic arthrosis and osteoarthritis, and Rhus tox. is indicated in cases of lumbago and sciatica with tearing pains, worse during rest and improved by movement.

The patient was instructed to use both preparations Bambusa Pulsatilla and Bambusa Rhus alternatively in order to promote targeted multifaceted effects on organs and tissues involved. She concurred.

3 months follow-up:

The patient started to feel better within two weeks of treatment. Her pain significantly decreased, mobility improved, and depression eventually went away. Over 3 months’ time she returned to her normal, free-from-pain condition.

6 months follow-up:

The patient was pain free, her general state of health improved, and her back pain virtually disappeared.  An MRI scan was repeated five months after the onset of acute lower back pain, and noticeable decrease of the synovial cyst was detected (please see below).

Currently the patient uses both remedies less frequently on an as-needed basis.

MRI study – November 22, 2011

 July 2016 Serguei Krissiouk

About the author

Serguei Krissiouk

Serguei Krissiouk

Dr. Serguei Krissiouk obtained his medical education and earned his Doctor of Medicine Degree at the prestigious O.O. Bogomolets National Medical University of Ukraine in 1991. From 1991-1993 he worked as a pediatrician at the Ukrainian Scientific Research Institute for Pediatrics, Obstetrics, and Gynecology to diagnose and treat unusual and unknown childhood disorders related to radiation exposure following the tragic Chernobyl nuclear power plant disaster.
Dr. Krissiouk also studied complementary medicine, homeopathy, and anthroposophically-extended medicine in England, Germany, Switzerland, and Ukraine. He relocated to the U.S. in 1999, passed the USMLE (United States Medical Licensing Examinations) and obtained ECFMG (Educational Commission for Foreign Medical Graduates) certificate. He has also completed the course in Clinical Homeopathy at the Center for Education and Development of Clinical Homeopathy in New York. He has been practicing complementary medicine and holistic counseling in Rhode Island, Massachusetts, and New York.

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