Neck pain

1. NECK PAIN AND ITS
HOMOEOPATHIC APPROCH
with Indication of some less
common used drugs
A Short Presentation by
Dr. Madhusudan Sahoo
Medical officer (H)
Dte. Of AYUSH, Govt. of Delhi

2. • Neck pain is the one of the most common
problem that one encounters in day to day life
It is so common as like common cold.
• Most people will experience neck pain at some
point in their life.
• Neck pain, which usually arises from diseases
of the cervical spine and soft tissues of the
neck, is common.
• Also can be caused by an injury, muscular
problem or by nerve compression between
vertebrae.

3. Common causes of neck pain
• Cervical spondylosis
• Trauma to cervical spine (fractures, atlantoaxial subluxation)
• Whiplash injury (from automobile accidents)
• Herniation of cervical inter-vertebral disk
• Postural (prolong work in front of computer)
• Vertebral artery dissection
• Osteoporosis
• Osteosclerosis (paget’s disease)
• Rheumatoid arthritis (RA) of the cervical apophyseal joints
• Ankylosing spondylitis
• Infections (osteomyelitis and epidural abscess)
• Torticolis
• Fibromyalgia
• Referred pain from other visceral disease

4. • Neck pain arising from the cervical spine is
typically precipitated by movement and may be
accompanied by focal tenderness and limitation of
motion.
• Pain arising from the brachial plexus, shoulder, or
peripheral nerves can be confused with cervical
spine disease, but the history and examination
usually identify a more distal origin for the pain.
• The nerve roots which are most commonly
affected are C6 and C7.

5. CERVICAL
NERVE ROOTS
INVOLVEMENT
AREA OF DISTRIBUTION OF PAIN
COMMONLY SYMPTOMATICALLY
INDICATED MEDICINE
C5 Lateral side arm, medial side of scapula CHEN ANT. HEL (Rt side)
CHELIDONIUM (Rt side)
JUG. CINE (Rt side)
OLEUM ANI (Rt side)
CHEN GL. AP
ONOSMODIUM (Lt side)
ZINC CHROM (Lt side)
C6 Lateral side of forearm, thumb, index finger GYMNOCLADUS
ANAGALIS
C7 Posterior side of arm, dorsal side of forearm,
lateral side of hand
PARIS QUAD
KALMIA
RHODIUM
C8 4th and 5th finger, medial forearm PARIS QUAD,
LACHANTHES
KALMIA
RHODIUM
T1 Medial side of arm, axillary region GUAICUM,
INDIUM
ASPARAGUS
SANG. CAN,
STRON. CARB
FERR MUR
PALLADIUM

6. • Cervical spondylosis is a ‘wear and tear’ of the
cervical vertebrae and cervical intervertebal discs is a
common degenerative condition of the cervical spine
and is the most common cause of neck pain.
• Inappropriate working like doing desk work or sitting
for hours in front of computer in one posture or
sleeping posture can also be the cause of neck pain.
Mobility of the spine is dependent on several small
joints, the derangement of the functioning of any one
of them cause neck pain and reduced movement of
neck.

7. • Pain in the neck may spread to the base of the skull and
shoulders. Movement of the neck may make the pain
worse (Bry). The pain sometimes spreads down to an
arm, to a hand or fingers. This is caused by irritation of a
nerve which goes to the arm from the spinal cord in the
neck (Sang., Kalmia) . Sometimes neck stiffness
occurs(Strych.) , particularly after a night's rest.
• Headaches from time to time. The headaches often start
at the back of the head just above the neck and travel
over the top to the forehead.
• Numbness, pin pricking or weakness may occur in any part of
the arm or hand. These symptoms may indicate a problem
with a 'trapped nerve'.
• The presence of neurologic symptoms (e.g., weakness,
numbness, clumsiness, long-tract signs, or evidence of
bladder and bowel dysfunction) requires expeditious
investigation.

8. • A complete physical examination is essential for
evaluation of the patient with neck pain. Inspect
neck region for normal characteristics as well as
pathology, including masses, muscular asymmetrie
scars, discolorations, and cutaneous lesions. On
Physical exam, the physician may identify tender
spots along the neck and evaluate ability to move th
neck in various directions. The function of the
nerves and muscles in the arms and legs may be
tested.
• Imaging like X-rays and MRI studies may be used
to show any other abnormalities and reveal the
extent of damage to the cervical spine.

9. Goal of treatment.
• Relief of pain, prevention of recurrence, and
improved neurologic function
• Rest to neck – there may be need to wear a soft
cervical collar to limit neck motion to relieve
nerve irritation.
• Physiotherapy - Hot and cold cervical traction or
active exercise program to relieve pain
symptoms.
• Lifestyle modifications are needed in some cases.

10. Homoeopathic approach to patient
suffering from neck pain
Medicines are prescribed on basis of.
• Constitutional Picture :- GOOD PRESCRIBING SYMPTOMS like
Prominent modality RELATED TO WEATHER, POSTURE,
MOVEMENT, generalities etc available.
• Location wise specific drugs :- POOR PRESCRIBING SYMPTOMS lack
of prominent modalities
But constitutional medicines are very effective in treatment of neck pain.
• Common polychrest medicines that are frequently used in case of neck
pain are Bryonia, Rhus tox, Kalmia, Cal. carb , Ruta, Cimicifuga, Arnica,
Medorrhinum, Thuja, Tuberculinum, Syphilinum, Graphites, Nat mur,
Causticum, Sycotic co. etc.

11. 5 most common medicines which cover
majority of Neck pain cases are
Rhus tox
Cal carb
Medorrhinum
Sycotic co.
Syphilinum

12. RHUS TOX CALC. CARB / SYCO. Co.
Commonly indicated - Calc. comes when Rhus tox. Fails(Nash).
Rhus tox Very often abused, hence fails in 70% of cases.
So intercurrently - Rhus.t Calc. carb / Syco co. Rhus.t
– may be helpful.
DEPTH OF ACTION OF CALC. & SYCO.CO IS MORE THAN
RHUS.TOX
If RHUS.TOX INDICATED but failed in chilly patient think of
Calc Carb and Syco. Co.

13. Medorrhinum
• When indicated drugs fail
with Sycotic history.
• > -Sea shore, damp weather.
• Craves alcohol.
• Desire -salt, sweet, ice.
• Intense thirst.
• Forgetful, weeping, hurried.
• Intense burning sensation
in hand wants to covered
and fanned.
• Pain in back between
scapulae, spine sore to
touch
• When indicated drugs like
R.Tox., Ferr.m., Thuja fails.
• Chilly patient, covers always
• < -1st motion, rest, night,
cold weather.
• > - heat, motion.
• Eggs nauseates.
• Desire - Salt ,Sweet, Sour.
• Mental :-Tense, Restless,
fearful .
Sycotic co.

14. Cimicifuga
• Rheumatic pain in muscles
of back & neck.
• Feels stiff, lame contracted.
• Using piano, typing &
sweeing.
• < - morning, cold, mense.
• Depressed.
• With menstrual abnormality.
• Desire - Cold milk
• When indicated remedy fails
with F/H of Syphilis
• Insertion of Deltoid muscle
• Raising arm laterally.
• <-night, summer, sea shore
• >- day, moving slowly
• Washing mania.
• Craves alcohol.
• Pain appears gradually &
disappear gradually.
Syphilinum

15. • Neck drawn to rt. side with
stiffness extends to head upto
nose.
• Sensn. of sprain
• < - turning to side & back.
• Chill between scapula.
• With sorethroat
Lachnanthes
Graphites
• Pain in nape of neck,
shoulders & limbs.
• Left hand numb
• < - looking up
• Constipation
• Aversion - meat &
sweet
• Chilly patient

16. PAIN IN NECK EXTENDS TO ARM & FINGERS
RIGHT side
• SOLANUM LYCO.
• FERR. PIC.
LEFT side
• PARIS QUAD
• KALMIA
• RHODIUM
MOST COMMON INVOLVEMENT C6, C7, C8 & T1 SPINAL
NERVES
SOLANUM
LYCOPERSICUM
Rheumatic pain in rt. Elbow,
wrist & hand, RT deltoid,
pectoralis region
< open air, motion, jar, noise.
• > warm room, tobacco
• With dust allergy.
FERRUM PICRIC
* Spondylosis due to over
exertion in the aged.
* Dark haired plethoric
person.
* Associated with B.H.P.
* Right side neck pain and
down right arm

17. Pain in neck
Nape of Neck
•Radium Brom
•Fagopyrum
•Menyanthes
•X-ray
•Lachnantes
•Fel tauri
Extends to Occiput
• Chin sulph
• Latrodactus Mactans
• Eup. Purp.
• Zinc phos.
NECK PAIN WITH RADIATING SHOULDER REGION
Left shoulder Right shoulder
* Guaicum, * Indium
* Asparagus
* Sang. can, * Stron. carb
* Ferr mur * Palladium

18. GUAICUM
Pain - shoulder, arms &
hands
* < - heat, pressure,
cold weather, motion.
INDIUM
• Stiff neck & Lt. Shoulder down
left arm.
• Violent pain in head when
straining at stool.
• Frequent seminal emission.
ASPARAGUS
* Pain in shoulder, left
acromian process, clavicle
down the arm
* < -motion, with heart &
bladder symptoms.

19. Besides these medicine Few Rare medicines used
with very excellent result in case of neck pain :-
AZADIRCHTA INDICA FOLIA :-
Stiffness of shoulders < morning. Pain in left
forearm & fingers <left side, pressure, on
waking, movement, raising arm, picking
things up, > by pressure. Pain extends to
palm. Excellent remedy in frozen shoulder of
left side. Sudden cramping pain in right side
of neck which extends to right shoulder &
arm < walking while.
VISCUS ALBUM :-
Pain in cervical region with stiffness <
movement, radiating to both arms with
numbness of fingers < exertion, > rest. Pain
in right shoulder joint < 1st movement, > hot
fomentation. Shooting and tearing pain in
both shoulder joint < raising head, <
movement, with difficulty in taking hand
back. Shoulder pain < raising arm and at
night.
TARENTULA CUBENSIS :-
Pain in upper limb and right shoulder,
as if carrying a heavy load, <
movement, bending forward, morning
till night, > lying down, standing erect.
Pain in cervical region < turning head,
jerking, evening.
LAPIS LAZULI :-
Pain in cervical region when
turning the head to right side.
Cramping pain in scapular
region < motion. Stiching pain
in cervical region extending to
head. Stiching pain in right
shoulder with coldness feeling in
hand.

20. CASSIA SOPHERA :-
Lightening pain in cervical region especially
on moving head to left side. Numbness and
stiffness of right shoulder, upper arm,
middle finger < movement, cold application >
rest, warmth. Pressing pain in right upper
arm, fingers and thumb < movement, cold
application, > pressure, massage, rest,
warmth. Tearing pain in left arm <
movement, raising the arm.
PARIS QUADRIFOLIA:-
• Sensation of weight and weariness is
mostly marked in nape of neck.
Stiffness and numbness in upper
arm and fingers. C4 supply , Lt.
Intercostal region extending to Lt.
arm.
• Numbness of fingers & arms
• < -exertion , evening, touch. > -
Open air, rest.
STRYCHINUM :-
Rigidity of cervical muscles is
prominent. Sharp pain in nape of
neck and cervical spine along with
stiffness and jerking.
XANTHOXYLUM :-
Pain in nape of neck extending downward.
Numbness of left arm with papalysis.
Associated Occipital headache.
PSILOCYBE SEMILANCEATA:-
Numbness and tingling in upper arm
especially right forearm. Parasthesia
affecting the left arm, but without associated
weakness. Tremor of triceps muscle is
prominent.

21. FAGOPHYRUM: -
Shoulder pain radiating to fingers with
occipital headache. Stiffness and bruised
sensation in muscles of neck with sensation
as if nape of neck could not support head.
NICOTIANA RUSTICA :-
Aching pain and stiffness in cervical region
extending to shoulders. Tingling sensation in
hand. Weakness and trembling of shoulder
and hand. All complaints < in morning while
waking.
RADIUM BROM :-
Soreness and pain in cervical vertebrae <
bending head forward > standing or sitting
erect
ORYCTOLAGUS CUNICULUS :-
Soreness of neck , aching across shoulder.
Numbness and tingling in arm with
sensation as if arms are not there. Stabbing
pain between shoulder and neck with
bruised feeling. Coldness of hands.
GYMNOCLADUS
* Violent pain lt. Forearm in radius &
index finger as if bones are crushed.
* < cold & walking
* > leaning against something & rest.
ANAGALIS
* Pain in shoulder, arm with
cramps in balls of thumb &
fingers.
* < touch

22. Bibilography
• Fauci, Longo et all; Back and neck pain; 18th
edition; Harrison's Principles of Internal
Medicine The McGraw-Hill Companies.
• Boericke W. A. ;Pocket Manual of
Homoeopathic Materia Medica; New Delhi, B.
Jain Publishers
• Allen H.C. Keynotes Of Materia Medica; New
Delhi, B. Jain Publishers
• Personal PG Class Notes