Sciatica

An excellent treatise on this troublesome condition.

Sciatica is a very well known affection. Its definition can be found in any pathological treatise, so We do not make an attempt to define it. We insist only that one should not make errors of diagnosis. Our therapeutic study is only for essential and old sciatica, which the doctors should not confound with secondary or symptomatic sciatica. If the clinic is not sufficient the doctor must try to diagnose it by all means, by radiography, by lumbar puncture etc. We have not divided our study into chronic and acute forms. The same medicine may suit both the cases. We have given only those symptoms of the remedies that  correspond particularly to both acute and chronic sciatica. We are not discussing here the question of pathology and etiology, not because we ignore their importance but because the study of the ground will help us to deduce naturally the answer to those questions.
Our friends will excuse us for the long list of remedies. We have tried to be complete but it is possible that we may have left
out some of the medicines.

1. Morbid ground:

The knowledge of the ground is an essential factor for the sure success of the treatment. In simple cases the medicines symptomatically used may alone cure the pains but in stubborn Cases constitutional remedies are to be added to them. The constitutional remedies will be very frequently indispensable to avoid relapse.

On what grounds sciatica develops:

Sycotic ground is the most important of all. The subjects are mostly hydrogenoids, sensitive to humidity and to variations.
Agg. While standing, at night, by the heat of the bed, by rest (need for movement). Amel. Moving the feet, to find a cold place, by moderate walking. Piercing, drawing pains with heaviness, numbness from hip to foot.

General: Horror of washing. All-gone feeling in the stomach at 11 A.M. Burning feet, morning diarrhea. Cutaneous eruptions.
Thuja (200. M) – Sycosis. Hydrogenoid.
Left sided (non-exclusive). Agg. By immobility, on bed, by humidity. Amel. While moving constantly. Drawing pain along
the nerve, in the soles.
General: Obsessions. Fixed ideas. Lower lip bluish-white. Sweat of uncovered parts. Genito-urinary affections. Tendency to
proliferations (warts etc.)

Let us then study eight remedies with their indications:

(1) Cimicifuga (30,200,M) – With the preceding it is one of the most important of ground remedies for sciatica. It is useful in
rheumatism pains having a particular affinity for long muscles on which, because of its spasmophile tendency, it produces
cramps. Left sided. Agg. While lying down; should go out of bed. During menses. Amel. by continued movement, by
pressure, in open air. Violent pains with anxiety in legs. Heaviness. Incessant restlessness of the lower limbs, cramps.
Utero-ovarian troubles. Irritability. Fear of becoming mad. Hysteria.

(2) Lycopodium (6,30,200,M)—Insufficient liver. Carbo-nitrogenoid. Cancer state.
Agg. By rest, in bed, lying on the painful side, while standing. Amel. by movement. Chronic sciatica, periodic with remission. Pains after every four days. Weakness and stiffness of the limbs. Cannot stretch the leg. Bad digestion. Face like an old man. Big belly and lean limbs. Horror of solitude. Agg. from 5 to 8 P.M.

(3) Lachesis (12, 30, 200, M)—Endocrinal intoxication, menopause, alcoholism.  Pains going from left to right. Agg. after sleep, standing, by movement, by contract. Amel. by menstruation, by discharges, while lying down, by hot application. Burning pain along the nerve. Loquacity. Jealously. Gushes of heat. Alternate excitation and depression. Bad effect of solar heat.

(4) Nux vomica (6, 30, 200, M)—Hepatic insufficiency. Digestive intoxication. All sorts of abuses.
Agg. by movement, in the morning (4 to 5 A.M.), by clod. Amel. by rest, hot application. Tearing pain from above downwards with spasm. Jerking of muscles, contractions, stiffness. Sensation as if the limbs are paralysed. Abuse of stimulants. Excess of sedentarism. Business cares. Irritability. General amel by wet and mild climate.

(5) Natrum sulphuricum (200, M)— Hydrogenoid. Rheumatism. Congestion of liver.
Agg. by all forms of humidity; lying on the left side. Abuse of quinine. Amel. by dry weather, by pressure, change of position. Disgust of life. Tendency to suicide. Flatulence, thirst, morning diarrhoea. Imflammation of fingers around nails.

(6) Ignatia (30, 200, M0— Intoxication reflecting on nerves. Result of grief and cares.
Agg. by change of position, standing, by walking. At night, in open air. After eating, by coffee and tobacco. Amel. by rest,
by lying down, during eating. Pains with spasms, intense, stiffness, cutting pains in the hips. Sensation as if coxo-femoral
articulation is broken. A remedy for women. Physical and mental hypertension. Paradoxal alternance of gaiety and sadness.
Contradictory symptoms. Never speak about her ennuies.

(7) Causticum (6, 30 200)— Hydrogennoid. Chronic rheumatism. Indifferent literality. Agg. by temperate humid weather;
heat of the bed, by heat. Numbness and restlessness of limbs. Heaviness, weakness, trembling. Sensation as if the tendons
are very short. Chronic rheumatism with crushing pain on the articulations. Sympathy for others. Fear of darkness.
Sensation of an open sore.

(8) Sepia (30, 200, M) – Hepatic insufficiency. Genital affections. Tuberculinism.  Agg. in the morning and in the evening, by humidity and in cold. Amel. by violent exercise, by heat. Weakness and agitation, heaviness of the limbs. Sadness. Indifference. Agg. by consolation. Bearing down. Cannot lie on the left side.

Let us cite here four other remedies that are less frequently used: Calcarea carbonica (psora, sciatica after working in water). In the antecedents we find gonorrhoea, vaccination or serological injections.

(1) Two ground remedies are useful: Thuja and Natrum Sulphuricum. The first one is more important than the second one. The nosode Medorrhinum will give good result..

(2) Psoric ground of arthritis is very favourable for sciatica: Sulphur and Psorinum are the ground remedies, the first one is more important than the second. If there is doubt that tuberculosis is closely connected with psora, Marmoreck and T.R. should be used in oxygenoids and T.R. in hydrogenoids. These will be the remedies.

(3) For syphilitic ground Luesinum is to be used.

(4) The cancer ground, with its deep intoxication, its eliminations or its fixations along a nerve is also a cause of sciatica. The
ground remedies such as Lycopodium, Arsenicum etc. should be carefully individualized because of the morbid transfer. The
most recommendable nosode is heterogeneous or autogenous sanguine therapy (isopathy).

Finally we should recommend not to omit in the interrogatory an enquiry on possible traumatism.

Ground remedies. We are first of all taking up the study of some remedies that we consider particularly as remedies of the ground of sciatica but, if they cover well the cause, may also be used as symptomatic remedies. When they are used as ground remedies, they are to be prescribed in high dilutions (200, M). The most important are Sulphur and Thuja.

Sulphur (30, 200, M)— Psora. Left sided. Graphites (psora, chilliness), Natrum muriaticum (tuberculinics, Agg. on sea side) and Silicea (tuberculinics, extreme sensitiveness to cold) and we will add two nosodes: Medorrhinum and Luesinum.

Medorrhinum (200, M)—  Agg. of all symptoms while thinking about them. Amel. on sea side, at night.
Changing character, impatient, anxious. Time passes very slowly. Fear of becoming mad. Sensation of heat; burning pains in the brain; sweating palms. Conscious of her uterus (Dr. Chiron); bad smell of the skin, of secretions.

Luesinum (200, M)—  Agg. at night, on sea side. Amel. on mountains. Excessive nervousness, anxious for his health, diminution of memory. Continually washes his hands, desire for alcohol. Pains increase and decrease gradually. Bone pains. Headache. Deep longitudinal crack on the tongue (Dr, Chiron) Restlessness of the limbs, which he must move continually. In sciatica movement and walking ameliorate.

Considered as ground remedies, they should be used in high dilutions (200, M) and should be repeated at long intervals (three weeks or one month).

Symptomatic remedies. In sciatica if one wants to be successful one must look for “Simile” or “Similimum”. The result will be as favorable as the medicines are individualized. Two remedies may be repeated alternately, at one interval of two to three hours, when more than one remedies are chosen. In chronic cases, 6 or 30 once or twice. When there is the possibility of finding a single remedy it is then the triumph of unicism and in that case the medicine may be used according to the Kentian fashion, in high dilution and waiting for the results.

We have classified the remedies in three groups: At first three most important remedies, then remedies in alphabetical order, which are frequently used, and finally the exceptionally or rarely indicated remedies.

Bryonia (6, 30)- Agg. by movement, While standing, by superficial contract. Amel. by rest, lying on the affected side, by strong pressure. Drawing pains, lancinating as if from a “sore below the skin”, of which the seat is in the lumbar region and on hips. General agg. by the heat, anger. Dryness of the mucous membranes with thirst for the large quantities of water at long intervals. Constipation.

Gnaphallium (6, 30)—  Agg. by walking; by movement; however feels the necessity of movement and change of position; while lying down. Amel. while sitting, bending the legs. Intense pains, continued pains alternating with numbness. Cramps of the calves and hips. Foetid diarrhoea, with colic, agg. in the morning.

Kali Bichromicum (6, 30)— Left side. Agg. while standing, sitting, lying down (must change position). Amel. by walking, by flexion of limbs. Violent pain, moving along a limb; appearing and disappearing suddenly. General agg. by cold, humid coldness; towards three A.M. Agg. by drinking beer.

Remedies having frequent indications:

Aconite (6, 30)- Agg. at night, by movement, by heat of the room. Amel. by rest and while sitting. Acute sciatica. Sudden attack after being exposed to dry cold. Extreme physical and mental agitation. Intolerance of heat. Fear of death. Hypersensitiveness to contact. Pain with numbness.

Ammonium muriaticum (6, 30)— Left sided. Agg. while sitting down. Slight amelioration while walking, complete while lying down. Chronic sciatica. Sometimes grave form, with tearing pains, stinging pains accompanied by contraction of the limb, which causes limping. Menses abundant at night.

Arnica (6, 30)- Agg. in the evening, at night, by movement. (Should change position), by coldness. Amel. while lying down. Burning, tearing pains. Traumatic sensation, sensation of fracture, numbness. Traumatic sciatica. Creates a scene when the doctor arrives, does not require his service.

Arsenicum album (6, 30, 200)- Agg. from midnight to 2 A.M. by cold and cold application, by violent
movement. Amel. by heat and hot applications. Burning and tearing pains forcing the patient to constantly change position. Prefers to lie down but constantly moves. Restlessness, weakness. Fear of death. Refuses to take medicines because he is hopeless of cure.

Belladonna (6, 30)—  Agg. at night, after midnight. By touch, by the least contact, by sound and light, by gush of wind. Amel. while standing, hanging the affected limb; by half sitting position, by heat. Pains appearing and disappearing suddenly. Periodical attack, beginning in the afternoon and ending at midnight. Alternate restlessness and depression. Hyperesthesia of senses. Tendency to spasms. Dilatation of pupils.

Bufo (6, 30)—  Agg. by heat, in a hot room, during sleep. Amel. by haemorrhage, by putting the feet in hot water. Mental weakness, idiocy in depressed persons, as a result of sexual abuse or of onanism. Sudden anger bites. Epilepsy.

Chamomilla (6, 30)— Agg. at night, in bed, by the least movement, by rest. Amel. when carried, being in a vehicle. Slight amel. by cold. Pain in numbness. Intolerance of pains, with great restlessness, cries, tendency to become angry. Need for movement when suffering. General aggravation by anger and fear. General amel. by humid heat.

Cocculus (6, 30)—  Agg. by contact, by noise, in open air, afternoon. Amel. by rest. Sciatica with weakness and trembling. General aggravation by long privation of sleep, riding.

Colocynthis (6, 30, 200, M)—Right sided. Agg. in the evening, at night, by movement, by the stretching of limbs. Keeps the limbs stretched; by contact, by cold. Amel. by rest, by hot application. Very important remedy. Sciatica with intolerable pains followed by numbness and paresis. General agar. By anger.

Dioscorea (6, 30)—Right sided. Agg. when getting up, while walking, by movement. Amel. by rest, by slow extension (contrary to Colocynthis). Cramping pain along the nerve, specially in the hip. Amel. of all symptoms by extension.

Ferrum metallicum (6, 30)  Agg. by rest, at night, being seated. By cold, by air current. Amel. by moderate movement, by heat. Tearing pain. Pale and flushed individual, has gushes of heat, localized on the face. Anaemia, chlorosis.

Gelsemium (6)—  Agg. by rest, at the beginning of movement, at night. Chronic sciatica. Stubborn cases remedy of trembling.

Hypericum (6)— Agg. by cold, humidity, mist, confined air, by touch. Amel. not marked. Hypersensitiveness of nerves, sensation of laceration, drawing pains. Burning pains with numbness. Traumatic sciatica. A remedy of traumatism of nerves. Coccygodynia. Sometimes sensation as if the limbs are detached from the body.

Iris versicolor (6)— Left sided. Agg. at night, by lying on the painful side, by cold, by touch. Amel. by walking, heat, by bending forward. Lumbar neuralgia. Pain in the back, feels the need of a support. Weakness of the lumbar muscles. Sometimes numbness of the limbs. General conditions depressed. General agg. by fatigue, by sexual acts.

Kali iodatum (6, 30) —Right sided (non-exclusive). Agg. at night, by lying on the painful side. Amel. by movement, by walking, in open air.

Syphilitic ground. Mercurial sciaticas. Pain in the posterior part of the hip with contractions and spasms of the muscles. General characteristics: Pains that force the patient to get up at night to move in cold air.

Kalmia (6)— Right sided (non-exclusive), Agg. by bending double, by movement, by cold. General amelioration by eating. Pain from above downwards, lightning like pains. Fulgurating pains. Sensations of weakness and coldness of the lower limbs with numbness.

Lac canimum (6)— Erratic pains passing from one side to another. Agg. at night, by touch, by movement. Amel. by open air. Pain in the sacral region, extending throughout a limb, disturbing sleep and rest. General aggravation during menses.

Ledum Palustre (6, 30)— Left sided (non exclusive). Agg. at night, by heat of the bed, by touch, by movement. Amel. by cold foot bath, by application of cold, open air and rest. Pinching pains, drawing in the whole limb, especially in the posterior face of the hip.
Contraction. Joints of feet painful, deformed, cold to touch. The affected limb is more cold than other parts of the body. Affected joints are white and not red. A good antidote for excess of wine. Rheumatic ground.

Magnesia phos (6) – Right sided. Agg. by immobility, while lying down, by prolonged movement, by cold. Amel. by moderate movement, by heat. Pains coming and going suddenly. Fulgurating pains. Cramps, Paroxysmal attacks which obliges the patient to change position, to stand up, to walk restlessly. Chronic of Colocynthis. Its place is between Arsenic and Colocynthis.

Mezereum (6)—  Amel. in open air, at dawn. Burning, lancinating pains with shivering. Itching, syphilitic ground.

Palladium (6, 30)— Right side. Agg. at night, by cold, by touch, by movement. Amel. by heat and rest. Very acute pains going from toe to the hip. Proud character, irritable, cannot support contradictions. Pain in the right ovary.

Phosphorus (6, 30) – Left sided (non-exclusive). Agg. at night, lying on the painful side, by cold, morning and evening. Amel. while eating; by rest, being magnetized. General Agg. by hot drinks and mental work.

Phytolacca (6, 30) — Agg. at night, after sleep, by movement, by pressure, by humid cold. Amel by lying down, by rest and by heat. Sudden erratic pains, as if from electric shocks, often in the external or posterior face of the hip. Chronic sciatica on a syphilitic ground. Rheumatism.

Plumbum (6, 30) — Agg. at night, by heat, by movement, light pressure. Amel by massage, by strong pressure. Chronic sciatica with muscular atrophy. Cramping and constrictive pains. Syphilitic ground.

Pulsatilla (6, 30)—  Agg. by heat, confined air, immobility. Amel. by movement and open air. Erratic pains. Changing of symptoms. Venous congestion. Mentality: timid, easily weeps with amel. by consolation.

Rananculus (6) —  (predominantly left sided). Agg. in rainy weather and by storm. Morning and evening, by movement, by lying on the painful side. Amel. no clear modality. Complementary Rhus tox. General Agg. by changes of weather and in humid cold.

Rhus tox (decimals, 6, 30, 200) — Agg. by rest. Cannot remain immobile. Constantly changes position at night, by humidity, beginning to move, lying on the back or on the right side; by fatigue, by cooling after sweat. Amel. by dry and hot weather, changing of position, by walk; by stretching, by hot application. Tearing pains with sensation of coldness, numbness, formication. Paralytic stiffness, sensation as if tendons are very short. Sciatica in persons drenched in water after being hot, or who have lain down in humid place. Consequence of overwork. Rheumatic ground.

Ruta (6) — Agg. at night, by humidity, by cold application, while lying own, by rest. Amel. by movement, by walk, by heat. Stiffness and sensitiveness of tendons. Deep seated pains, bone pains. Sensation as if bones are broken. Rheumatic sciatica. Restlessness, should walk continually.

Stillingia (6) — Left sided. Agg. in the evening, by movement, by walking, by cold. Amel in morning, in dry weather, by heat and by pressure. Violent pain from hip to toe.

Syphilitic ground:

Tellurium (6) — Right sided. Agg. by lying on the painful side, by the least contact, by laughing and coughing, by cold. Amel. no clear modality. Pain f the backbone of sacrum radiates through sciatic nerve.

Valeriana (6) —  Agg. by standing or in any position with the feet on the ground; by immobility. Amel. by walking, with the limbs stretched in a horizontal position, by change of position. Acute pain along the nerve.

Veratrum album (6, 30) —  Agg. at night, by the heat of the bed. Amel. by walking, by ambient heat. Cramping pains. General Agg. by cold drinks.

Viscum album (6, 30) —  Agg. by touch, by the least movement, by cold and by lying on the left side. Amel. by rest. Grave, stubborn case; sensation of torsion in the muscles. Limbs heavy as lead. Hypersensitiveness to contract; prostration. Arterial hypertension, arteriosclerosis.

Zincum metallicum (6, 30) — Agg. while sitting, by walk, by noise, by touch. Amelioration by moderate movement (continual movement of the feet), by menstruation, following a discharge. Sciatica with weakness and trembling. Rheumatic ground. General Agg. by wine.

Remedies of secondary importance:

We are going to enumerate briefly and in alphabetical order the last group of medicines which are useful but of less value than those which we have just studied.

Angustura (6) —Agg. by movement. Amel. by cold application. Rigidness of limbs and lameness.

Capsicum (6) —Agg. by movement and cold. Amel. by heat. Preferable left sided.

Carboneum sulphuratum (6) Agg. by movement, by walking and at night.

Coffea (6, 30) —Agg. by emotion, by movement, by noise, at night. Amel. by rest, by pressure. Intolerance of pain. Restlessness. Insomnia. Sensorial hyperesthesia.

Colchicum (decimals, 6)—Agg. by movement, by touch, at night. Amel. by heat and by rest. Arthritic ground.

Drosera(6) —Agg. by walk and by movement. Amel. by rest. Preferably right sided.

Dulcamara —Agg. by humid weather; consequence of suppression of sweat, of discharge. Amel. by mild and dry climate. Rheumatic ground. Sciatica as a result of cold during humid climate.

Eupatorium purpureum (6) — Agg. by movenet. Feeling as if the bones and muscles are bruised. Feels bed very hard. Weak legs, as if paralyzed. Left sided

Euphorbium (6)— Agg. by movement; amel. by rest. Great difficulty to rise from a sitting position.

Ginseng (6)— Agg. at night and by sitting position. Sensation of deep contusion of fracture.

Hepar Sulphur (6, 30) — Agg. by movement, by walk, by the least cold. Amel. by rest and by heat. Extreme sensitiveness to cold, to the least change of weather, to air currents.

Ind. (6) —Agg. while sitting; by rest. Amel. by movement (which is however slightly painful). Preferably right sided.

Kali phos (6) — Agg. by cold and by continued movement. Amel by heat and moderate movement.

Magnesia carb (6) —Agg. at night, by rest, by noise, by touch, by cold and at interval of every three weeks. Amel. by movement, walking, in open air, by heat. Intolerable pains with sweats. Hyperesthesia of the skin.

Menyanthes (6) —Agg. by walking, by rest, by going up. Amel. by strong pressure.

Mercurius (6) Agg. at night, while lying down, by movement. Amel. in open air, in the morning. Tearing pains along the limb.
Sensation of internal heat. Skin cold. Weakness of the limb. Syphilitic and rheumatic ground.

Finally I must say a few words regarding some adjuvant methods whose importance should not be neglected. In spite of the rich therapeutic arsenal of homoeopathy, homoeopaths should not forget the thermal cures that may render good service to the patients of sciatica especially for relapsing cases.

Acupuncture and centro-therapy often, in the hands of masters, give instantaneous results. Finally in all cases of sciatica gymnastic movements, active or passive, are really useful where judicious treatment completely fails, or the amelioration is not satisfactory.

About the author

L. A. Rousseau

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