PERIOSTITIS

Bones in an animal have an outer covering of connective tissue which protects the bone and provides surface for the muscles. It is known as periosteum. Inflammation of periosteum is called periostitis. It is generally painful and chronic condition.

Causes – Periostitis is caused by trauma, acute or chronic infection as syphilis, autoimmune disease or genetic disease as primary hypertrophic osteoarthropathy, blood and bone marrow cancer as leukemia. Trauma or overuse of a particular part is most common cause of periostitis. Athletes, players and casual runners get periosteal injury as running, stopping, turning and jumping cause stress on shin bone. Improper running technique adds to stress. The shin bone periostitis is called shin splints. Other common sites of periostitis are femur, clavicle (collorbone) and humerus.

Signs and symptoms – Depending on cause pain may be localized or diffused and severe or dull aching type. The pain may be debilitating. Soreness of the bone is common beside protrusion due to rebuilt of bone tissue under the damaged periosteum. The symptoms improve on rest and get worse on exertion. Periostitis may result in necrosis of bone.

Diagnosis – Diagnosis of periostitis is based on symptoms, physical appearance of affected part and X-ray of bone. Blood tests are done to eliminate cause other than injury as autoimmune disease, infection. Biopsy is taken if blood tests proved inconclusive to rule out cancer.

Treatment – Conventional treatment of injury related periostitis is rest, ice pack application and anti-inflammatory and steroid preparations as medicines. Orthodics are used to support the part and after a month’s rest gradual start of activities as rebuilt of strength allows. For other causes antibiotics, antiviral or immunosuppressant are suggested. Cases of severe pain or fractures may require surgical repair of bone.

Homoeopathic medicines – There are many homoeopathic medicines effective in inflammation of bones and periosteum. Indicated homoeopathic medicine may not always from the list as similia is selected on totality of symptoms and not for pathological symptoms as occurred in the case described below.

INFLAMMATION - Bones; of - Periosteum

Aconit. nap., Agarcus m., Antim.-crud., Apis mel., Aranea di., Arsenicum alb., Asafetida, Aurum met., Aur-ars., Aurum-mur., Belladonna, Calcarea carb., Calcarea-flour., Calcarea-phos., Calcarea-sil., China, Clematis, Colchicum, conium, Conchiolinum, Drosera, Ferrum-iod., Ferrum-phos., Flouric-acid, Graphite, Guajacum off., Hecla lava, Heper sulph., Iodum, Kali-bichrom., Kali-iod., Lachesis, Ledum pal., Manganum aceticum, Manganum-sulph., Mercurius sol., Mercurius-cor., Mezerium, Myristica, Natrum-salicylicum, Nitric.-acid, Phosphoric-ac., Phosphorus, Phytolacca, Platinum-mur., Psorinum, Pulsatilla, Rhododendron., Rhus-tox., Ruta, Sabina, Sarsaparilla, Sepia, Silicea, Staphysagria, Stillingia syl., Sulphur, Symphytum, Tellurium.

Case - This case is important so far the process of cure signifies. The patient had night bone pains, intrauterine death of fetus, an abortion during 3^rd month of pregnancy and then not conceiving due to lack of ovulation. All these represent state of SYPHILITIC MIASM which implies degeneration and non-generation. This state was healed to some extent with anti-syphilitic medicines SYPHILINUM AND KALI SULPH after one year of treatment. During the same period she was trying to conceive but the ovulation was not there as shown by ultra sono-graphic study of ovulation. After giving four doses of MERCURIUS SOL. 200 weekly in December 2011, she conceived in April 2012 and delivered normally, a healthy baby on 8^th December 2012. Important was the shift from destructive SYPHILITIC to constructive SYCOTIC MIASM.

Mrs. Kanchan   34 yrs.    Female    House wife           Non vegetarian

Diagnosis – Periostitis/ chronic osteomyelitis - right Tibia (Radiological).

04/03/2011  X – ray – Right tibia – thickened cortices. CRP – Positive. ESR – 110.

Patient is suffering from pain in right tibia from two years, began six month after delivery. Creeping, sudden shooting, pulsating runs above downward. Restlessness on lying, fidgety in leg while sitting. Better by holding leg, walking. Aggravated at night wakes often with sleeplessness due to pain, cold specially water. Pressure neither aggravates nor ameliorates.

Sleeplessness  since leg pains. Desire to weep during pain but she resists.

She craves salt. Dislikes nonveg., egg, milk after last delivery as took lot of milk during pregnancy and puerperium. Sweat excessive on face and neck, stains yellow. Patient is hot but legs pains are worse from cold, even a drop of water. Sleeps on back.

 Menses regular. The first conceived fetus died in womb due to complications of hypertension and third aborted in December 2010, at 2 ½ month followed by profuse bleeding. Second pregnancy completed and delivered a female child 2 ½ yrs. back.

Patient has problematic interpersonal relation with in laws with grief and mortification. Weeps after anger. Obese, fair complexion, smooth skin.  Weight 68 kg.

Mother has chronic sinusitis and esophagitis. Father is paralyzed after cerebro-vascular ischemia. Brothers have diabetes melitus, gall bladder stone, obesity. 

On examination right tibia was extremely tender to least pressure.

28/03/11 Rx 1. Syphilinum    200 one dose stat

                       2. Rubrum      30  two pills thrice a day

                       3. P. L.         200  two pills once a day

05/04/11 Bone pain almost same. Aggravation in bed, at night.

                  Rx 1. S. L.          1M two doses at 10 minutes interval every week

                       2. Rubrum       30  two pills thrice a day

                       3. P. L.           200 two pills once a day

                       4. Kali sulph     6x  four tablets thrice a day.

20/04/11 Pains relieved more than 50%. Sleep better since last 10 days. No weeping from pain now.

                 Rx 1. S. L.           1M  two doses at 10 minutes interval every week

                      2. Rubrum        30  two pills thrice a day

                      3. P. L.           200  two pills once a day

                      4. Kali sulph     6x   four tablets thrice a day.

20/06/11 Pains relieved to 70% but still sometimes aggravate at night specially 10.30 pm to 12 am, and during rest, better by movement

                   Rx 1. Syphilinum   1M   two doses at 10 minutes interval.

                        2. Rhus tox       1M   two doses at 10 minutes interval on 2^nd July ONLY IF GET NO RELEIF AFTER SYPHILINUM.

                        3. Rubrum        200  once a day for one month.

                        4. Nihil              30   two pills thrice a day for one month.

                        5. Kali sulph      6x   four tablets thrice a day.

19/07/11 Did not need Rhus tox 1M dose to take and the pains were relieved after Syphilinum. Now there occur occasional pain which does not disturb her.

                   Rx 1. S. L.           1M    two doses at 10 minutes interval once in a month.

                        2. Phytum       1M    two doses at 10 minutes interval on 2^nd August.

                        3. Rubrum       200  once a day for 1 ½ month.

                        4. Nihil              30   two pills thrice a day for 1 ½  month.

                        5. Kali sulph      6x   four tablets thrice a day.

02/09/11 No pain for 1 ½ month but pain for last 15 days. Dry cough at night.

                   Rx 1. Rhus tox.     1M   two doses at 10 minutes interval.

                        2. Phytum        1M   two doses at 10 minutes interval on 15^th  day after rhus tox.

                        3. Rubrum       200  once a day for 30 days.

                        4. Nihil              30   two pills thrice a day for 30 days.

                        5. Kali sulph      6x   four tablets thrice a day.

                        6. Carbo an.      30   two pills thrice a day for three days.

03/10/11 No pain in bone of right leg but dry violent cough off and on from dryness in trachea aggravated from cold air with chilliness. Trying to conceive 2^nd child.

                   Rx 1. Rhus tox       1M   two doses at 10 minutes interval once in a month.

                        2. Phytum         1M   two doses at 10 minutes interval on 15^th day after rhus tox.

                        3. Rubrum        200  once a day for 30 days.

                        4. Nihil              30   two pills thrice a day for 30 days.

                        5. Kali sulph      6x   four tablets thrice a day.

                        6. Heper sulph   30   two pills thrice a day for three days.

07/11/11 No pain in bone. For last one year trying to conceive but failed.  Advised X-ray right tibio-fibula AP and LAT. View. Semen analysis of husband and patient’s ovulation study.

                   Rx 1.   S. L.        1M   two doses at 10 minutes interval once in a month.

                         2. P. L.         1M   two doses at 10 minutes interval on15^th  day after S. L..

                         3. Rubrum     200  once a day for 30 days.

                         4. Nihil            30   two pills thrice a day for 30 days.

                         5. Kali sulph    6x   four tablets thrice a day.

07/12/11 X-ray right tibia normal. No more periostitis.  Husbands semen was normal. Patient ovulation study show no ovulation or maturing follicle on 12^th, 14^th and 16^th day of menses.

Both breasts heavy and sore 15 days before menses.

                    Rx 1. Mercurius sol.   200    two doses at 10 minutes interval once in a week.

                         2. Phytum              200    two pills once a day for 30 days.

16/01/12 Breast pain was much less this time. Menses appeared on 2^nd January. No leg pain.

                   Rx 1.   S. L.       1M   two doses at 10 minutes interval once in a month.

                         2. P. L.        1M    two doses at 10 minutes interval on15^th  day after S. L..

                         3. Rubrum     200  once a day for 30 days.

                         4. Nihilinum     30   two pills thrice a day for 30 days.

                         5. L. S.         200    two doses at 10 minutes interval once in a week.

                         6. Phytum     200    two pills once a day for 30 days.

23/4/12 Her right ankle pain was relieved by few doses of Ruta 30. Pregnancy test in urine positive.  8^th December 2012. Content as conceived after 2 ½ yrs. USG confirms single intrauterine gestational sac with good decidual reaction all around. Obstetrician advised torch test but patient refused. Above medicines were repeated.

04/06/12 USG confirms normal pregnancy of 14 week 1 day and normally placed placenta. Advised to report monthly and continue under obstetrician’s supervision.

19/11/12 36 Week normal pregnancy. Both mother and fetus are healthy but obstetrician warned her for caesarian delivery and patient wants to avoid caesarian. Patient was given Caulophyllum 200 two doses to take a one week interval.

27/11/12 Patient took Caulophyllum 200 on 19^th and 26^th. She developed tingling and formication in both the arms, hands and fingers with swelling and stiff feeling aggravated in morning. She was sleepless after 5 a.m.

                    Rx 1. Lachesis    30 two doses at 10 minutes interval.

                         2. L. S.          30 two pills thrice a day.

                         3. Ledum pal 30 if finds no relief within 5 days.

10/12/12 The patient phoned the physician on 9^th night that she has delivered normally a healthy male child on 8^th morning. She informed that the obstetrician had asked her to get admitted on 4^th December and wait for 2 days if pains start otherwise she will be needed surgery. The patient decided to wait for pains to occur and she rushed to hospital on 7^th after pains were started. There she delivered a healthy male child.

Dr. M. K. Tyagi

D.H.M.S., Dip. N.I.H.

Research Officer, Sewa Mandir.

Mobile" 09829157926
Email: 1.sewamandir@usa.net, 2.manju_mkt2003@yahoo.co.in