From: Practical Homoeopathic Therapeutics – W. A. Dewey, M. D. (1901)
Colocynth – The most important remedy in Sciatica, corresponding to the worst cases. There are pains in the sciatic nerve extending to the knee or to the heel, worse from any motion, and especially aggravated by cold. The pain is paroxysmal, followed by numbness and partial paralysis. There is a sensation which has been described as if the thigh were bound with iron bands, or as though screwed in a vise. The muscles are fearfully tense and fixed. Particularly is the right side involved, and there are stitches during walking.
It is especially useful in recent cases, though Aegida cured a case of long standing with the 3rd dilution, in which there were spasms and violent pains. There is a sense of constriction around the hip. The pains, too, may come suddenly and leave suddenly; they may be sticking and burning, and all are worse from cold or damp and at night, when the patient can find no easy position for the limb. Colocynth typifies the sciatica due to nerve changes with no special inflammatory conditions attending it. Here it touches remedies like Arsenicum, Chamomilla, Gelsemium and Gnaphalium. The 6th potency will be found to act better than the lower potencies.
Gnaphalium – This remedy is quite similar to Colocynthis. O’Connor thinks it is the best remedy in the absence of the other symptoms and many others consider it specific. It has intense neuralgic pains along the nerve, and numbness. The whole trunk and the main branches seem affected, worse when lying down, worse from motion, stepping and better while sitting in a chair. The pains extend to the toes.
Terebinthina has exquisite sensitiveness of the lower extremities, with painfulness along the tract of the nerve; drawing, tearing, paralytic pains.
Arsenicum – With this remedy the pain is marked by complete intermissions. It exacerbates every night at a particular hour, and becomes unbearable. It is increased by vigorous and relieved by gentle motion. It is aggravated by cold, but relieved momentarily by warmth. It is a pure neuralgia, neither inflammatory, toxaemic nor reflex. Arsenicum is one of our most reliable remedies in sciatica.
Chamomilla should also be thought of in pure neuralgias of the sciatic nerve with unbearable pains, and the more it pains the hotter the patient becomes.
Rhus toxicodendron – This remedy typifies sciatica with muscular and ligamentous involvement. It is seldom adapted to recent cases, but comes in later. The pains are tearing and burning, worse during rest, alleviated a short time only during motion. There is lameness and a disposition to muscular twitching and the bowels are constipated. It is a rheumatic sciatica, the fibrous sheath of the nerve being involved. It is the best remedy for a combination of lumbago and sciatica. Sciatica arising from over-exposure to wet or from lifting, wrenching and over-exertion. Great relief from warmth.
Arnica is also a remedy for sciatica due to over-exertion. The acute pains are followed by a sensation as if bruised.
Ruta – This remedy also has shooting pains down the back, down the sciatic nerve on first moving or on rising after sitting. The patient is obliged to walk about constantly during the paroxysms of pain. It is worse during damp or cold weather and from cold applications.
Bryonia has shooting pains worse from motion and relieved by hard pressure. It is a valuable drug in the treatment of sciatica of rheumatic origin.
Ledum also has sciatic pains mixed with rheumatism.
Kali iodatum – The pains calling for this remedy are worse at night, and from lying on the affected side, better from motion. When of mercurial or syphilitic origin, it is well indicated.
Kali bichromicum – Darting pains in the left thigh relieved by motion.
Phytolacca – The pains are darting and tearing, aggravated by motion.
Colchicum – Right-sided sharp-shooting pains extending to knee, worse by motion; the patient must keep quiet. The pain is sudden, constant and intolerable.
Ammonium muriaticum – Sciatica, with aggravation of pain while sitting, somewhat relieved by walking and entirely relieved by lying down. Pain in the left hip as if the tendons were too short. The legs feel contracted. Painful jerks, feet feel as if asleep.
Pulsatilla – This remedy typifies a sciatica due to venous stasis and is useful in the milder forms where there is a sense of fatigue and heaviness, flying attacks, aching in loins and hips. Uterine sciatica. Here it is akin to such remedies as Sepia, Belladonna, Ferrum, Sulphur, Graphites and Mercurius.
Lycopodium is sometimes most useful in chronic cases where there are fine burning or stinging pains, or tearing, drawing or jerking pains worse from rest. The lithic acid constitution will decide the remedy.
Aconite – The congestive variety of sciatica from exposure to colds, dampness and from suppressed perspiration indicates Aconite. There is much numbness, perverted sensation, pricking and a sense of coldness in the parts, especially toes. The pains are very severe and worse at night. The patient is restless; there is tingling along the affected nerve.
Glonoine – Hale recommends the 6th of this remedy in cases where there is much throbbing, numbness, heaviness and uneasiness.
Belladonna – Here the inflammation is high and the pains come on suddenly. There is a neuritis, and the course of the nerve is sensitive ; the pain is especially severe at night, the parts are sensitive to the touch, the least concussion or a draft of air aggravates. Severe lancinating pains coming on in the afternoon or evening; has to change position often; worse from motion, noise, shock or contact; cannot bear the clothing to touch him. Relieved by letting the limb hang down, warmth and the erect posture.
Nux vomica – From its action on the spinal cord, Nux is frequently the remedy in sciatica. It has lightning-like pains, with twitching of the parts. Violent pains and has to change position; pains shoot down into the foot, the limb is stiff and contracted and the parts feel paralyzed and cold. Better when lying on the affected side and from the application of hot water. Constipated bowels and sedentary habit.
Plumbum also has lightning-like pains and in paroxysms. Pains and cramps along sciatic nerve, and especially where atrophy is present.
Coffea may also be indicated where there is great hyperaesthesia of the senses and physical exhaustion and debility present.
If the sciatica be in those of a hemorrhoidal constitution, Sulphur may be the remedy. If dependent on vertebral disease then such remedies as Phosphorus, Silicea, Natrum murtaticum and Sulphur will need to be prescribed according to the symptoms. Nor should the tissue remedies be forgotten, as many undoubted cures have been made with Magnesia phosphorica and Kali phosphoricum.