FEDERAL STATE BUDGETARY EDUCATIONAL INSTITUTION OF

HIGHER EDUCATION "ALTAI STATE MEDICAL UNIVERSITY"

OF THE MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION

Department of Medical Rehabilitation

with a course of additional professional education

Discipline: «Traditional medicine»

«Individual rehabilitation program

using traditional medicine methods»

Topic: Medical rehabilitation of patients with chronic pain

syndrome.

Head of the Department:

Babushkin Igor Evgenievich, Candidate of Medical Sciences, associate
Professor.

Full name of the student, group number:

Nakrani devikaben, 692

Full name of the tutor, post:

Kryanga Alexander Anatolyevich, Candidate of Medical Sciences, Associate
Professor (example).

Barnaul, 2022
I. Definition of chronic pain syndrome
chronic pain as pain that lasts for longer than 3 months. Because this pain
negatively affects an individual's physical, mental, and emotional well-being, they
may develop additional symptoms of depression, anxiety, and more. Healthcare
professionals may then classify this as chronic pain syndrome.

II. Modern ideas about the etiology, pathogenesis and clinical

manifestation of chronic pain syndrome.

1) Etiology.
Sometimes chronic pain has an obvious cause. You may have a long-lasting illness
such as arthritis or cancer that can cause ongoing pain.

Injuries and diseases can also cause changes to your body that leave you more
sensitive to pain. These changes can stay in place even after you’ve healed from
the original injury or disease. Something like a sprain, a broken bone or a brief
infection can leave you with chronic pain.

Some people also have chronic pain that’s not tied to an injury or physical illness.
Healthcare providers call this response psychogenic pain or psychosomatic pain.
It’s caused by psychological factors such as stress, anxiety and depression. Many
scientists believe this connection comes from low levels of endorphins in the blood.
Endorphins are natural chemicals that trigger positive feelings.

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It’s possible to have several causes of pain overlap. You could have two different
diseases, for example. Or you could have something like migraines and
psychogenic pain together.

2) Pathogenesis.
The allocation of this section is due to the fact that chronic pain is currently
considered not only as a syndrome, but also as a separate nosology. This is due to
several factors, and above all, rather common pathophysiological mechanisms of
chronic pain, regardless of its etiology, as well as the significance of this problem
due to the high frequency of chronic pain and its difficult curability. Pain is one of
the most important normal physiological mechanisms, signaling the threat or
presence of damage, it creates a negative biological motivation. Pain plays a
signaling role. The emotional response to pain forms the general affective reaction
of the body, which ensures the elimination of the damaging effect (attack, flight,
etc.), and the motivational state determines the further behavioral reaction aimed
at creating conditions that ensure healing. The obligate emotional components of
pain are: anxiety in the most acute stage and depression in the subsequent stage,
especially when acute pain passes into chronic pain. Long-lasting chronic pain is
associated with a chronic pathological process in a particular organ or other
somatic structures (neoplasm, inflammation, etc.) or with damage to the
somatosensory nervous system itself - peripheral or central (neuropathic pain).

In other cases, the peripheral pain stimulus can be eliminated, but the dysfunction
of these systems acquires independent significance in the preservation of chronic
pain. The most important condition for this process is personality traits (emphasis
on anxiety, depression, low pain threshold, etc., the so-called pain personality). In
this situation, pain phenomena acquire special characteristics. Pain receptors are
represented by free nerve endings of finely myelinated fibers (A-delta) and
unmyelinated glomerular bodies (C-fibers), respectively, innervating the skin, as
well as both ends of the digestive tract and all tissues, with the exception of the
brain. Impulses enter the spinal cord through the medial part of the posterior root
and, after processing in the main relay structure of the spinal cord, the posterior
horn, are conducted as part of the neospinal and paleospinothalamic pathways to
the thalamus, limbic system, and projection sensory cortex. The most important
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role is played by the relationship of impulses entering the posterior horns from A-
delta and C-fibers with deep sensitivity impulses delivered there by thick myelin
fibers (gate control). The second relay structure of the interaction of these
impulses is the nuclei of the thalamus, especially the ventroposterolateral and
ventroposteromedial ones. The main mediators of pain systems are substance P,
calcitonin, gene-linked peptide, intestinal peptide (the latter in pain systems from
the abdominal organs). Pain (nociception) activates the analgesic (antinociceptive)
system, presented at several levels and having its own mediators. Main structures:
arcuate nucleus of the hypothalamus, periventricular and periaqueductal (around
the cerebral aqueduct) gray matter, raphe nuclei. The transmitters of these
structures are endorphins and serotonin, although others also play a significant
role, in particular norepinephrine.

3) Clinical manifestations of the disease.

Aching.Burning.Shooting.Squeezing.Stiffness.Stinging.Throbbing.

Chronic pain often leads to other symptoms and conditions, including:

Anxiety.Depression.Fatigue, or feeling overly tired most of the time.Insomnia, or

trouble falling asleep.Mood swings.

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III. Applied directions, methods, techniques and practices of
traditional medicine in the medical rehabilitation of patients chronic
pain syndrome and their pathogenetic justification.

Methods of traditional diagnostics:

1) The method of electropuncture diagnostics according to R. Voll, H.
Schimmel or I. Nakatani, the method of auricular diagnostics.
Note: Electroacupuncture uses two needles in each meridian point, or acupuncture
point, and then connects to a machine that passes a small electric current through
the needle. ‌ Electroacupuncture helps to block your pain by activating bioactive
chemicals in your body.

Chinese traditional medicine

Neck pain (NP) and low back pain (LBP) are common symptoms
bothering people in daily life. Traditional Chinese medicine (TCM) has
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been used to treat various symptoms and diseases in China and has
been demonstrated to be effective. The objective of the present study
was to review and analyze the existing data about pain and disability
in TCM treatments for NP and LBP.

Methods

Studies were identified by a comprehensive search of databases,

such as MEDLINE, EMBASE, and Cochrane Library, up to
September 1, 2013. A meta-analysis was performed to evaluate the
efficacy and safety of TCM in managing NP and LBP.

Results

Seventy five randomized controlled trials (n = 11077) were included.

Almost all of the studies investigated individuals experiencing
chronic NP (CNP) or chronic LBP (CLBP). We found moderate
evidence that acupuncture was more effective than sham-
acupuncture in reducing pain immediately post-treatment for CNP
(visual analogue scale (VAS) 10 cm, mean difference (MD) = -0.58 (-
0.94, -0.22), 95% confidence interval, p = 0.01), CLBP (standardized
mean difference = -0.47 (-0.77, -0.17), p = 0.003), and acute LBP
(VAS 10 cm, MD = -0.99 (-1.24, -0.73), p< 0.001). Cupping could be
more effective than waitlist in VAS (100 mm) (MD = -19.10 (-27.61, -
10.58), p < 0. 001) for CNP or medications (e.g. NSAID) for CLBP
(MD = -5.4 (-8.9, -0.19), p = 0.003). No serious or life-threatening
adverse effects were found.

Conclusions

Acupuncture, acupressure, and cupping could be efficacious in

treating the pain and disability associated with CNP or CLBP in the
immediate term. Gua sha, tai chi, qigong, and Chinese manipulation

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showed fair effects, but we were unable to draw any definite
conclusions, and further research is still needed. The efficacy of
tuina and moxibustion is unknown because no direct evidence was
obtained. These TCM modalities are relatively safe.

Methods of natural therapy:

1) Phytotherapy.
Capsaicin. Derived from hot chile peppers, topical capsaicin may be useful for
some people in relieving pain. "Capsaicin works by depleting substance P, a
compound that conveys the pain sensation from the peripheral to the central
nervous system. It takes a couple of days for this to occur," says David Kiefer, MD,
assistant clinical professor of medicine at the Arizona Center for Integrative
Medicine.

Ginger. Though more studies are needed, says Dr. Kiefer, ginger extract may help
with joint and muscle pain because it contains phytochemicals, which help stop
inflammation. Few side effects have been linked to ginger when taken in small
doses.Feverfew. 

Feverfew has been used for centuries to treat headaches, stomachaches, and

toothaches. Nowadays it's also used for migraines and rheumatoid arthritis. More
studies are required to confirm whether feverfew is actually effective, but the herb
may be worth trying since it hasn't been associated with serious side effects. Mild
side effects include canker sores and irritation of the tongue and lips. Pregnant
women should avoid this remedy.

Turmeric. This spice has been used to relieve arthritis pain and heartburn, and to
reduce inflammation. It's unclear how turmeric works against pain or
inflammation, but its activity may be due to a chemical called curcumin, which has
anti-inflammatory properties. Turmeric is usually safe to use, but high doses or
long-term use may cause indigestion. Also, people with gallbladder disease should
avoid using turmeric.

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Devil's Claw. There is some scientific evidence that this South African herb may be
effective in managing arthritis and lower back pain, but more research is needed.
Side effects are very rare if taken at a therapeutic dose for the short term, but it’s
not advised for pregnant women and those with gallstones or stomach or
intestinal ulcers.

2) Hirudotherapy.
Leech therapy has been found to be effective in the treatment of a number of
chronic musculoskeletal pain syndromes. Leeches are also often used empirically
to treat chronic low back pain, but data from clinical trials have been lacking to
date.

3) Apitherapy (bee treatment (apitoxin therapy) / bee products).

In a review article published in BMJ Open, researchers found only one randomized
control trial that has tested the effects of bee venom acupuncture on rheumatoid
arthritis.

In that study, people who used bee venom reported fewer swollen joints, tender
joints, and less morning stiffness than those who were given a placebo.

The authors of the review concluded that more research should be done to look
into the use of bee venom to treat different types of arthritis.

4) Animal therapy (hippotherapy, canister therapy, etc.).

Note: How Animal-Assisted Therapy Eases Pain

At this time, it's unclear precisely why therapy visits with a pet can help ease the
pain. Experts have suggested a number of potential links, and it may be a unique
combination of these that leads to pain improvement. For example, visits with a
therapy dog have been found in studies to:3

Reduce stress hormones like epinephrine, norepinephrine, and cortisolIncrease

endorphin levels (endorphins are the body's natural opiates)Increased levels of
oxytocin, a hormone that can alter a person's stress response and pain experience

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(oxytocin is the hormone released during childbirth)Improve mood, which may
secondarily improve pain.

Methods (techniques) of manual practices:

1) Manual therapy.
manual physical therapy techniques are aimed at relaxing tense back muscles and
restricted joints in order to decrease back pain and increase flexibility. In general,
manual physical therapy techniques employ the following types of movement:

Soft tissue work, including massage, which applies pressure to the soft tissues of
the body such as the muscles. This pressure can help relax muscles, increase
circulation, break up scar tissue, and ease pain in the soft
tissues.Mobilization/manipulation, which uses measured movements of varying
speed (slow to fast), force (gentle to forceful), and distances (called 'amplitude') to
twist, pull, or push bones and joints into position. This can help loosen tight tissues
around a joint, reduce pain in a joint and surrounding tissue, and help with
flexibility and alignment.

2) Osteopathy.

Osteopathy takes a holistic, whole-body approach to healthcare.

It uses manual ‘hands-on’ techniques to improve circulation and correct altered

biomechanics, without the use of drugs.

An osteopathic physician does not concentrate only on the problem area, but uses
manual techniques to balance all the body systems, and to provide overall good
health and wellbeing.
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Diagnosing and treating conditions using these techniques is called Osteopathic
Manipulative Medicine (OMM).

Techniques include stretching, gentle pressure, and resistance, known as

osteopathic manipulative medicine.

An osteopathic physician may also issue prescription medicine and use surgical
methods to support the holistic, manual treatment.

Many osteopathic physicians also serve as primary care physicians in fields such as

family medicine, internal medicine, and pediatrics.

Uses

Osteopathy can provide relief and treatment for a wide range of conditions.

These include:

arthritisfoot, ankle, hip, and knee painback pain, neck pain, and sciaticahand,
shoulder, and elbow painheadachestennis and golfer’s elbowpostural problems
due to pregnancy, sports injury, driving or work strain, or digestive issuesneuralgia

3) Applied kinesiology / kinesiotherapy.

Kinesiology is often part of an interdisciplinary biopsychosocial model for treating
chronic pain. Such programs include: physical training via physical therapy;
ergonomic training via occupational therapy; psychosocial pain management;
education on circumstances related to pain; and recreational activities such as
playing games.

One benefit to individuals participating in such programs is that because physical

improvement is quantifiable, participants/therapists are able to monitor patients’
physical progress. The primary outcome goals are to increase physical functioning,
improve pain-coping skills, promote the return to a productive and active lifestyle,
and promote independence in pain management.

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It should be noted that physical therapy/kinesiology are sometimes used as
“stand-alone” modalities for the treatment of pain in general. These health care
providers will take a variety of approaches to treat pain, depending on the
location and cause.

Improving Balance

Fortunately, there are ways to improve balance that can have a direct influence on
chronic pain. The benefits of exercise for improved balance and health in patients
with chronic pain are well documented, including:

Increased muscular strength23FlexibilityMuscular endurance24

These benefits can often extend to pain management. Studies have shown that
activities such as yoga have a positive effect on pain levels in patients with chronic
neck pain,25 and pool-based exercise can improve pain symptoms in fibromyalgia
patients.26

Passive manual mobilization is another technique used to provide short-term pain

relief and restore pain-free functional movements. This technique is geared
toward improving joint mobility and pain relief. In patients with knee
osteoarthritis, strength training alone has shown benefits for pain management,
but this effect is amplified when combined with passive manual
mobilization.27 This approach is effective in 2 ways: it increases strength of
atrophied muscles that may be contributing to pain; and it improves joint mobility.
Improved joint mobility is important in patients with knee osteoarthritis, as joint
mobility can often be a determinant of disability in this population.28

Strength Training

Strength training plays a role in a pain management program, especially when

that training is targeting muscles that have atrophied and are either contributing
to, or are a result of, pain.29 Targeting muscle imbalances is frequently an
effective strategy, as this is often thought to be a contributor to musculoskeletal
pain, especially in the knees30 and lower back.31 For example, an outcome goal
for patients with patellofemoral knee pain might be to restore patellar alignment
through strengthening the quadriceps, stretching, or patellar taping.32
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Given that chronic low back pain has a high rate of recurrence,33 and considering
that atrophy of key muscles in the low back is thought to contribute to low back
pain,15 strength training that focuses on the stabilization of these key muscles can
be a powerful tool in treatment and prevention.

Indeed, muscle-strengthening exercises are commonly used to combat muscular

atrophy and stabilize the trunk. In one study, an exercise approach that focused
on retraining and strengthening the core muscles of the deep trunk—the
transversus abdominis and lumbar multifidus—supported the use of independent
transversus abdominis contractions for the treatment of low back pain and
prevention of musculoskeletal injuries.34 In the study, equipment for progressive
resistance strengthening of isolated muscle groups was used. The training
program differs from the current concept of core strengthening in that it
emphasizes nonfunctional isolation exercises over motor relearning.34

Compared to general exercise, core stability exercise is effective in decreasing pain

and improves physical function in patients with chronic low back pain, but patients
who engaged in core stability exercise versus those who engaged in general
exercise had no significant long-term differences in pain severity.35 Also, research
provides evidence to suggest that lumbar extension exercise is beneficial for
strengthening the lumbar extensor, decreasing pain, and improving psychosocial
functioning in low back pain patients.

4) Massage practices (massage practices other than classical medical

massage).
Swedish massage

Swedish massage is often used by massage therapists and is what most of us

know as ‘traditional’ massage. It typically involves kneading and rolling the
muscles to relieve tension. Often long firm strokes are used and occasionally light
tapping will be utilized. The level of pressure will vary depending on the patient’s
needs and tolerance level. This type of massage may be a little uncomfortable but
is designed to be gentle, and shouldn’t cause pain.

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Hot stone massage

This type of massage is very similar to Swedish massage, but involves the use of
heated stones as well as the therapist’s touch. The heated stones are thought to
increase relaxation and help to relieve pain. In particular, hot stone massage is
understood to improve the quality of sleep in patients.

Deep tissue massage

Deep tissue massage involves a lot more pressure with the therapist really getting
deep into the muscles. This helps to relax really tense muscles. This type of
massage is a lot more firm and so can be painful, but shouldn’t be so painful that
you are crying out. Ensure you communicate with your massage therapist if at any
time you are worried or feel that it’s becoming too much. After a deep tissue
massage you are likely to feel sore for a few days. This isn’t anything to worry
about and your massage therapist should talk you through what to expect.

Trigger point massage

Many points in our body have an effect on other areas of our body. For example, if
our neck is tense it can result in headaches. During trigger point massage the
therapist will put pressure on specific trigger points to release tension and in turn
provide pain relief. Deep, firm pressure is applied to the trigger points until they
release, so as with deep tissue massage this can be a little painful and
uncomfortable.

Myofascial release

The fascia is a thin layer of what is known as connective tissue which covers all the
muscles in your body. The fascia should be flexible. Your massage therapist will be
able to feel if it is not. If there is tension in the fascia, the therapist will focus on
those areas to try and release the pressure. This study on myofascial release and
the effects it had on fibromyalgia patients found that, “anxiety levels, quality of
sleep, pain, and quality of life were improved in the experimental group over the
placebo group. “

Shiatsu
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During a shiatsu massage the therapist will use pulsing, firm pressure across your
body to encourage relaxation. The therapist will often put pressure on acupressure
points, which are thought to increase relaxation. A study on the Shiatsu method of
massage in regards to treating chronic pain found improvements in pain patients
including: “improvement of pain intensity, pressure pain threshold, sleep quality,
and symptoms”.

Thai massage

Thai massage combines gentle pressure on pressure points and tense areas, with
yoga poses. The therapist will stretch and move your body into specific poses
thought to relieve stress and muscle tension. This review on the effectiveness of
Thai and Swedish massage concluded, “Thai and Swedish massages are reported
to relieve chronic low back pain by enhancing physical functions; providing pain
relief, improving disability and range of motion, improving psychological
functions; reducing anxiety and improving mood.”

Foam rolling

Foam rolling is a form of self-massage that you can do at home. All you need is a
foam roller (relatively inexpensive) and guidance on how to ‘roll out’ areas of
stress and tension. Our app for chronic pain (download links below) includes
guided instructionals on foam rolling to help ease .

Methods (techniques) of acupuncture practices:

1) Reflexology.
Reflexology is a therapeutic technique involving massaging and applying pressure
to specific areas of the hands and feet. It's based on the theory that charted
pressure points correspond with different organs and body parts. Specifically,
these points correspond to an increase in blood flow says Dustin Martinez, DC,
owner of Whole Health Chiropractic.

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Relieving migraines and headachesRelieving arthritis
painImproving stroke recoveryRelieving asthma
symptomsBoosting fertilityRelieving peripheral neuropathy — weakness or
numbness in extremities due to nerve damage. 

2) Su-Jok therapy (Su-Jok acupuncture).

Su Jok contains many methods of treatment. One method we experience every day
is by walking on our feet and working with our hands. This gives us constant,
random stimulation on corresponding points; however, purposeful hand and foot
massage (also known as hand or foot reflexology) is even better. There are many
methods of stimulation besides mechanical pressure, including:

Miniature magnets designed both to give both mechanical and magnetic force
stimulation;Moxibustion in the form of: (a) moxa sticks; (b) moxa the size of rice
grains held on the hand or foot by small holders to prevent direct contact; and (c)
direct thread moxa;Massage rollers to stimulate the hands and feet;Soft

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lasers;Miniature hand needles; andColored transparent plastic discs placed
strategically on charka hand points.

4) Acupressure.

1. Joining the valley

Whenever you feel headaches, you can massage the part of your hand between
the thumb and index finger. Massage it gently for a few minutes. This helps in
getting rid of toothaches, neck pain, shoulder pain, arthritis pain, constipation and
hangovers. Also, make sure your hand is in the shape of claw, so that you access
the acupressure point in the best way.

2. The third eye

Often, because of multitasking, overworking and too much stress, you feel a tight
feeling in the middle of your head. To get rid of this pain, press your middle finger
in the area which is right between your eyebrows. Press it for around a minute,
and this will help you feel at ease. This acupressure is helpful in relieving chronic
stress, fatigue, improving memory, concentration and reducing eye strain.

3. Leg three miles

Apply pressure to the point just outside the shine bone right below the knee cap.
This can be helpful in improving digestion, relieving constipation and bloating,
and also boosting immune system.

4. Pericardium

Massaging the point which is at base of the palm can be extremely helpful when
you feel nausea and vomiting. Press the point for a few minutes with your index
and middle fingers, and repeat until you feel relieved. 

5. Sea of tranquillity
This is located at the centre of the breastbone, above the base of the bone.
Massaging this point can help you in feeling emotionally balanced. It will relieve
you of anxiety and depression. Many imbalances of the nervous system can be
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corrected by performing acupressure on this point. It is helpful in boosting immune
system as well. But make sure you're sitting up straight. After being in the right
position, take your palms together in prayer position, and press the knuckles of
your thumbs into your breastbone. Take slow and controlled breaths while doing
this exercise.

6. Sacral points

These points are located right above the tailbone below your spine. Massaging on
this point can be helpful in relieving menstrual cramps and pain the lower back.
For acupressure here, lie down on your back. To increase the pressure, put one
hand on top of the other hand. Gently massage the points below your spine for a
few minutes. Repeat the process until you feel more relieved.

7. Heavenly pillar

This is the point right at the back of neck, slightly above the spine. Acupressure on
this point is helpful in getting rid of stress and disturbances in sleep. It also helps
in reducing pain in the neck, strain and severe headaches.

8. Shen men

This point is located on the upper part of the ear. When you massage at this point,
it will help in getting rid of addictions and bringing back the balance of nervous
system. For acupressure, massage on this point firmly with your index finger. The
thumb your hand should be at the back of the ear.

9. Bigger rushing

This point is located on the top of the foot where the bones of the big toe and
second toe meet. Massaging this point can help in increasing memory and
concentration. Press it gently for a couple of minutes, release, and repeat if
required.

10. Commanding middle

This point is located on the backside of the knee, and is great for relieving back
and knee pain, as well as arthritis in the hips, back, and knees, and even sciatica

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pain. If you massage at this point for a minute every day, it can eliminate pain for
up to 6 months. 

Bioresonance therapy and homeopathy:

1) Bioresonance therapy
Bioresonance Therapy’s Role In Pain Management

When a patient turns to alternative methods to assist them with reducing their
pain symptoms without having to take high doses of pharmaceutical drugs that
are used for pain management, they are often able to experience less significant
side-effects. Bioresonance therapy is often utilized in order to read the body’s
magnetic waves and to interpret them. This may assist a patient with
understanding why they are experiencing pain symptoms, and may also assist
with identifying potential stressors, toxins and other problematic areas of the
patient’s body that needs to be attended to. Bioresonance therapy also has the
ability to adjust the signals that were obtained from the patient’s body in such a
way to better allow their body to heal itself; thus offering a method that can often
assist with alleviating acute pain or reducing the severity of chronic pain

2) Homeopathy.
Homeopathic Medicines for Specific Pain Conditions

A well-known principle of homeopathy is that the medicine must be individualized

to the patient: 10 patients with fibromyalgia or rheumatoid arthritis are likely to
receive 10 different medicines from a professional homeopath because each patient
has a unique pattern of symptoms. However, this primarily applies
to chronic conditions.

In an emergency situation, or in the case of a very virulent infectious disease, the

nature of the trauma or infection imposes the same symptom pattern on nearly
everyone. For example, Arnica is useful in almost all acute cases of soft-tissue
trauma with bruising, swelling, and/or soreness. This makes it possible to create a
standardized protocol using Arnica for post-surgery recuperation or for sports
injuries. Hypericum, with its symptom set of numbness, tingling, other

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paresthesias, and electric-shock sensations along a nerve path—especially after a
blow to the spine or a nerve-rich area of the body—similarly becomes a universal
remedy when an accident or surgery causes acute nerve pain or nerve damage.

When it comes to short-term or palliative pain management (e.g., treating a

sprained ankle or providing temporary relief for arthritic pain), the prescriber
typically chooses from among the homeopathic medicines well known historically
for clinical effectiveness (perhaps 3–20 top medicines for each condition).21–
24 Among them, the choice is then based on individual characteristics: does the
patient find relief from a heating pad or from an ice pack, for example; do they
prefer to limber up an aching joint, or do they need to keep it still? This article will
provide a simplified version for each of several types of pain, differentiating
among just a few of the best-known medicines in order to make homeopathy
accessible for healthcare professionals in other disciplines. This will be followed
by a review of the research and finally by resources for further study.

Back Pain and Other Musculoskeletal Disorders:

Rhus tox‡ and Ruta grav for joint pain with stiffness that is worse in damp
weather, needs to be limbered up, and feels better from the application of heat.
These two medicines are among the most effective and can be difficult to
differentiate. You may observe patients needing Rhus tox swinging a joint to
limber it up (the “rusty gate” syndrome) or restlessly pacing in the waiting room.
Rhus tox is the medicine most often used for fibromyalgia. Ruta grav has
additional qualities of lameness and weakness, for example those whose knees go
out from under them when going downstairs.

• Bryonia is for patients with the opposite symptom: they feel worse from
stretching and in fact worse from the slightest motion, even the jarring motion of a
heavy tread, so they tend to guard or splint their joints. Bryonia is especially good
for the serous membranes. Hence, it is good for bursitis and pleuritis.

• Nux vomica is a top remedy for lower back pain in those with typical Nux
vomica symptoms: competitive, ambitious, driven, irritable, apt to use coffee,
alcohol, spicy or fried foods, sometimes recreational drugs, therefore apt to have a
congested liver.

• Protocol: Using the 30c potency (strength) most commonly available in stores, a

dose of two pellets dissolved in the mouth can be repeated every one to three
hours, depending on the intensity of the pain. In general with homeopathic
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medicines, the medicine is repeated frequently until it starts to take effect, then
slowed down or even stopped until symptoms return, so that the body can heal
itself.

Broken Bones

Homeopathy can speed bone healing, as well as reduce the need for analgesics,
according to a study done in India.25 These three medicines will cover most
aspects of bone healing:

• Symphytum is by far the most common medicine for broken bones. Research
shows that it can promote callus formation and speed the union of fractures.

• Ruta grav is used when there is a contusion or bone bruise, or when the
predominant sensation is soreness rather than sharp pain along the line of the
fracture, as in Symphytum.

• Calc phos is used for growing pains in children and for broken bones that take a
long time to heal.

• Protocol: Using the 30c potency (strength) most commonly available in stores, a

dose of two pellets dissolved in the mouth once a day.

Labor Pains

The research on homeopathy in childbirth is primarily limited to the study of just

one medicine: Caulophyllum.26,27 However, a range of medicines to reduce labor
pains are included here based on 150 years of experience and the need to reduce
the use of epidurals. Epidurals prolong labor and can trigger a “cascade of
interventions” leading to a greater need for an oxytocin injection, a higher rate of
instrumental births, and a higher risk of Cesarean section due to fetal distress.

Tooth Pain and Other Pain Conditions Treated by Dentists

• Hypericum 30c, two to four times a day, whenever there is nerve pain, such as
following oral surgery or in an impending root-canal situation.

• Chamomilla 30c as often as once an hour for excruciating tooth pain in adults as
well as in teething infants.
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• Symphytum 30c, once or twice a day, for pain and swelling after dental implant
surgery (because Symphytum heals teeth and bones), as well as Arnica, which is
always useful for postoperative pain and swelling.

Trigeminal Neuralgia

Trigeminal neuralgia is known as the “suicide disease” because the pain can be so
unbearable and so resistant to treatment that it can drive sufferers to suicide. In one
small study, homeopathic treatment brought 60% relief of the pain after four
months.30

Two of the most common medicines for trigeminal neuralgia can be distinguished
simply by which side of the face is in pain: Sanguinaria is used for right-sided
trigeminal neuralgia, and Spigelia for left-sided neuralgia. The dosage is 200c (a
high potency) every 15 minutes until relief, then wait until relapse before redosing.
Remember that these are only two of the possible medicines for the condition. If
the first one attempted does not work, a professional homeopath may be able to
provide relief with a better-matching medicine.

Headaches

While research shows that homeopathy can treat headaches successfully, such a
wide range of medicines can be useful that it would be impossible to distill them
into just a few recommendations. One leading homeopathic reference work lists
>60 likely medicines for headaches, making a randomized controlled trial difficult
if not impossible.31 Headaches provide an excellent example of how homeopathic
medicines are matched to the individual's symptoms. A homeopath interviewing a
patient with frequent headaches will ask what part of the head is affected; whether
the left side or right side; what time of day they come on, or what triggers them;
whether throbbing or dull; what the pain feels like; and other symptoms specific to
the pain. More importantly, the homeopath will ask what stress or trauma might
have led to the pattern of repeated headaches. Then the homeopath will choose
from among dozens of medicines well known to be effective for headaches.

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Traditional wellness systems:
1) The section describes one of the following traditional wellness
systems, which is optimally suited for a patient with the selected disease:
 Chinese or Tibetan health improvement systems.
 Ayurveda or yoga.
 Onnuri Su Jok therapy.
 Health-improving breathing exercises by A.N. Strelnikova and K.P.
Buteyko.
 The system of psychophysical natural movement "Beloyar".
 Health-improving Qigong gymnastics.
 Health improvement system according to K. Nishi, etc.

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