Sciatica
1. PRELIMINARY DATA
- No.: 231/2026
- Patient's Name: MNO
- Address: Plot 30, Rosewood Society, Pune.
- Occupation: Construction Supervisor (heavy lifting, prolonged standing, bending)
- Religion: Hindu
- Date: 01/08/2026
- Age: 48 Years
- Sex: Male
- Education: Diploma in Civil
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|---|---|---|
| Lower Back & Right Leg | Chronic shooting/burning pain from lumbosacral to right leg (sciatic nerve path), numbness/tingling in foot | < Sitting long, < Bending/lifting, < Cold damp weather, < Night, > Walking gently, > Warm applications, > Lying on hard surface, since 8 years (worse last 3 years, MRI shows disc bulge L4-L5) | Restlessness at night, irritability, weakness in leg |
| General | Heaviness in back | < Prolonged standing | Anxiety about mobility, low mood |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Recurrent back strain from work; suppressed pain with painkillers; occasional physiotherapy; overweight gain after 40; frequent constipation.
- Family History: Father has chronic sciatica. Brother has low back pain. Mother has osteoarthritis.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Normal
- Desires: Warm food/drinks (+++), Spicy food (+)
- Aversions: Cold food
- Thirst: Moderate
- Elimination:
- Urine: Normal
- Stool: Occasional hard
- Perspiration: Profuse on back, sour
- Sleep: Disturbed by pain; wakes with shooting
- Thermal State: Chilly patient (cannot tolerate cold)
B. Reactions - Physical Factors
- Weather: Aggravation in cold damp/monsoon
- Position: Better lying on hard surface or gentle walking
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Irritable, impatient, worried
- Anxiety: About work loss, family support
- Fear: Fear of permanent disability, fear surgery
- Dreams: Falling, being unable to move, job loss
- Other: Suppressed frustration, feels restricted
6. PHYSICAL GENERAL EXAMINATION
- Wt: 84 kg | Ht: 172 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 82 bpm | B.P.: 136/86 mmHg
- Face: Grimacing when moving
- Tongue: Clean
- Nails: Normal
- Skin: Dry
7. SYSTEMIC EXAMINATION
- Musculoskeletal: Lumbar tenderness, positive SLR right at 45°, paraspinal spasm, reduced ankle reflex right
- CVS: S1, S2 Normal
- Respiratory: Clear
- GIT: Normal
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Irritability, anxiety about livelihood, fear disability (Grade 3)
- Physical General: Chilly, desire warm food/drinks, sour sweat, shooting pain (Grade 3)
- Particular: Chronic sciatica right-sided, < cold damp/sitting, > motion/warm/hard surface (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic neuralgic pain with strong Mental Generals (irritability, fears) and Physical Generals (thermal, modalities) dominating; Kent suits back/extremities rubrics for sciatica.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Irritability and impatience
- Anxiety about income
- Fear disability
- Desire warm food/drinks
- Chilly patient
- Profuse sour perspiration
- Sciatica right shooting
- Low back pain radiating
- < Cold damp, sitting
-
Gentle motion, warmth
-
Lying hard surface
- Family back issues
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|---|---|---|
| 1 | Irritability | Mind; IRRITABILITY | 57 |
| 2 | Anxiety livelihood | Mind; ANXIETY; money matters, about | 8 |
| 3 | Extremities pain sciatica right | Extremities; PAIN; sciatica; right | 1064 |
| 4 | Back pain radiating | Back; PAIN; extending to legs | 895 |
| 5 | < Cold damp | Back; PAIN; cold damp agg. | 894 |
| 6 | Motion continued amel | Generalities; MOTION; continued amel | 1374 |
| 7 | Chilly | Generalities; COLD; agg. | 1348 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|---|---|---|
| 1 | Rhus Toxicodendron | 7/7 | 23 |
| 2 | Gnaphalium | 6/7 | 18 |
| 3 | Colocynthis | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|---|---|---|
| Shooting pain, irritability, chilly | Chronic strain, numbness | Family back issues | Destructive fear disability |
Dominant Miasm: Psora-Sycotic
14. FINAL STEPS
- Provisional Diagnosis: Sciatica (chronic, right-sided)
- Differentiation of Remedies: Compared Rhus tox with Gnaphalium. Gnaphalium has more numbness > motion; Rhus tox matches chronic sciatica with shooting pain > continued gentle motion, chilly, < cold damp/rest, > warmth/hard surface, irritability/anxiety. Colocynthis more for cramping > bending double.
- Selection of Remedy (Materia Medica): Rhus Toxicodendron matches chronic sciatica from strain/overuse, shooting pain > continued motion, chilly patient, < cold damp/rest, > warmth/motion (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic neuralgic miasmatic case, sensitive constitution)
- Actual Prescription:
- Rhus Toxicodendron 200 — single dose (one dose only, wait & watch)
- Placebo — 4 pills twice a day for 8 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|---|---|---|
| 20/08/2026 | Shooting pain reduced 60%, numbness milder, better walking | Placebo | Gentle walking, warm compress, avoid heavy lifting |
| 20/12/2026 | Pain minimal, no radiation, full mobility, energy better | Placebo | Core strengthening, posture correction, report flare-ups |