Case of pain in the hip joint

The following is a case of pain in the hip joint presented by Gary Weaver on the main Institute for Homoeopathic Medicine site blog.  I have presented both Gary’s initial case presentation and the follow-up published by Gary the next day.

EdReed_crop_exact_crop_exactI am being kept awake by an aching pain in the left hip joint. It feels like the head of the femur. It extends down the femur to the outside of the knee and the tendon behind the knee. I can’t find a comfortable position, best lying on the back. I change position and it seems a bit better for a few moments then its back. It feels like I strained the hip but I haven’t that I know of. We went out out to dinner with friends, just sat around eating, talking. On the way home almost hit a car that cut in front of us and stopped dead. Maybe I tensed up and strained it? Went to bed at 9pm woke up at midnight with this thing. Pain is a 4 (0-10). Enough that I can’t get to sleep. Constant ache. I took a shower in the late afternoon which I don’t normally do. I always finish hot shower with cold for a few seconds. Went up to get mail with slightly wet hair. I didn’t feel like I got chilled. Not sure of the cause.

(Case notes: Patient USENPASCA5476 Feb/1/2015 acute)

These are everyday events in the life of people. A pain suddenly appears and there may be plenty of ‘causations’ to choose from, and we as physicians have to sort it out.

I have always found it best to look at the case before us ignore what is “not sure”and concentrate on the symptoms that are absolute.

In looking at this case as I received it, I was pretty sure what the remedy to start would be without the use of the repertory. There are certain aspects of medicines that I have learned over the years that when seen in a patient, regardless of the named disease, are representative of the expression of how the ailments are seen in the patient, and also representative of symptoms that are caused by a substance and therefore in the provings.

  • I am being kept awake by an aching pain in the left hip joint.I can’t find a comfortable position,
  • best lying on the back.
  • I change position and it seems a bit better for a few moments then its back.

The above symptoms represent the expression of the disease in its whole extent. It does not mean that this is the final remedy the patient will receive but it does mean that the remedy that has the symptoms is the remedy that will start the process and perhaps will cure it in its entirety but in any event, is the only remedy that covers the initial symptoms of the disorder.

The remedy that was chosen was given in the 200 C  because the patient has an affinity in acute’s for this particular potency. It is interesting to note as an aside, Boenninghausen’s potency of choice was 200 C.

The remedy that was selected for this case, is not one that commonly comes to mind in any school that teaches homoeopathic first-aid as part of its curriculum. This tells me that the emphasis on Kentian philosophy and teachings, along with its offshoots of the sensation method et al, is as far removed from Hahnemannian prescribing as can be. For a practitioner to be of benefit to his patients, we cannot recommend highly enough the return to studying the Organon and its directions for case taking as being the single most important undertaking that any practitioner can do. In needs to be read as is written without any additional overlay or interpretation as given by Kent, as to what the paragraphs or aphorisms actually mean. In needs to be read with the removal of any spiritual inference in the words. Hahnemann was a scientist and a doctor who said exactly what he meant.

So in looking at this case, firstly I need to state that this was received in an email. As long as symptoms are clearly stated, there is no need to go into the whole mental state of the patient unless the mental state has altered significantly in the course of the illness.

The seat of this case was the hip. It was an aching pain, at its best when laying on the back, best from changing position which ameliorated but only for a short time. This is the entire case.

Members of the IHM choose to use the P and W version of the therapeutic pocketbook to analyse all cases. The symptoms were inputted into the repertory to see if my thoughts on the remedy could be justified by a repertorial analysis.

hip1

As you can see, I used the Hahnemannian directions for the location, the sensation and the modalities which characterised the entire expression of the disease. I did not surmise or spend time on the causation simply because it was not clear. I do know however, the results of whatever it was that caused this problem. With the clear modalities affecting the hip I was able to prescribe a medicine for the disorder.

Click on image for full size.
hip

For the practitioner this is an invaluable lesson to get to know the medicines of the materia Medica in the proper way rather than as personalities or mental symptoms only. The materia Medica is a collection of symptoms without interpretation that are caused by substances in both material doses and dilutions.

I received this email 30 minutes after the patient took the dose:

Took the remedy a few minutes ago. Feels like its relaxing a bit. I’ll try going to sleep and see what happens. Thanks!

We will follow this up later and see if we need to repeat the medicine or change it, or if indeed the whole problem is resolved.

——————–

FOLLOW-UP THE NEXT DAY

So I spoke to the patient the following evening to ascertain the effect of taking the remedy. The patient told me that the pain in the hip had subsided and and that pain had appeared in his knee and big toe. As the day had progress the pain eased considerably. He had repeated the medicine in the morning.

He informed me that four days previously he had been in a similar incident travelling in the vehicle where the brakes were applied hard. He said he felt he had something similar to minor whiplash, but that passed off after a few hours. In rating the pain he was currently experiencing it was put at about 80% better. I asked the patient to to run a couple of tests on himself, and receiving the information I recommended that he saw his chiropractor as soon as possible to do an adjustment on his lower lumbar region as I diagnosed it as a sciatic impairment.

Even though the patient had a maintaining cause, the ability of the medicine to relieve the pain was evident to see. I fully expect the patient to recover within a few days after adjustment to the maximum possible.

The links to the original articles:

https://instituteforhomoeopathicmedicine.wordpress.com/2015/02/01/case-of-the-week-feb-1st-2015/
https://instituteforhomoeopathicmedicine.wordpress.com/2015/02/02/follow-up-to-hip-pain-case-of-the-week/

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