Rajiv Gandhi University of Health Sciences
BHARATESH HOMOEOPATHIC
MEDICAL COLLEGE & HOSPITAL,
POST GRADUATE RESEARCH
CENTRE, BELGAUM-590016.
KARNATAKA.
Recognised by
CENTRAL COUNCIL OF HOMOEOPATHY , NEW DELHI.
Affiliated to
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BENGALURU.
SYNOPSIS
M.D (HOMOEOPATHY)
HOMOEOPATHIC APPROACH IN THE MANAGEMENT OF PLANTAR FASCITIS
by
Dr . SOWMYA.S
Dr . S. S.DIVATE M.D.(HOM)
Professor and Guide
Department of Materia Medica,
Bharatesh Homoeopathic Medical College &Hospital,
Belgaum.
From,
Dr. SOWMYA. S
To,
Dr. S.S.DIVATE M.D.(HOM)
Professor and Guide
Department of Materia Medica,
Bharatesh Homoeopathic Medical College & Hospital,
Belgaum.
Sub: - Application to accept my synopsis for the dissertation.
Respected Sir,
I Dr . SOWMYA . S would like to forward my Application for the approval of my synopsis under your guidance for the following topic, “HOMOEOPATHIC APPROACH IN MANAGEMENT OF PLANTAR FASCITIS” .
Hope you will approve the same.
Thanking you.
Date:23/10/2009
Place:Belgaum Yours sincerely
DR. SOWMYA.S
Department of Materia Medica,
Bharatesh Homoeopathic Medical
College & Hospital, Belgaum.
From,
Dr. S. S. DIVATE M.D.(HOM)
Professor and Guide
Department of Materia Medica,
Bharatesh Homoeopathic Medical College & Hospital,
Belgaum.
To,
Dr. SOWMYA .S
Sub: Acceptance of synopsis for the dissertation.
Dear Doctor,
I have accepted your topic “HOMOEOPATHIC APPROACH IN MANAGEMENT OF PLANTAR FASCITIS” for the dissertation.
Your synopsis will be forwarded to RGUHS.
Date:23/10/2009
Place:Belgaum Dr.S.S. DIVATE M.D.(HOM)
Professor and Guide
Department of Materia Medica,
Bharatesh Homoeopathic Medical College
& Hospital, Belgaum.
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BENGALURU.
ANNEXURE II
APPLICATION FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
| | | |
|1 |NAME OF THE |DR. SOWMYA. S |
| |CANDIDATE AND |DEPARTMENT OF MATERIA MEDICA, |
| |ADDRESS |BHARATESH HOMOEOPATHIC MEDICAL |
| | |COLLEGE AND HOSPITAL, BELGAUM-16 |
| | | |
| | | |
|2 |PERMANENT ADDRESS |DR.SOWMYA. S |
| | |NO. 512 26TH MAIN IIND STAGE IST PHASE |
| | |B.T.M LAYOUT BENGALURU- 560076, |
| | |KARNATAKA |
| | | |
| |NAME OF THE INSTITUTION |BHARATESH HOMOEOPATHIC MEDICAL |
| | |COLLEGE AND HOSPITAL, BELGAUM-16 |
| | | |
| | | |
|3 |COURSE OF THE STUDY & SUBJECT |M.D.(HOM) MATERIA MEDICA |
| | | |
| | | |
|4 |DATE OF ADMISSION TO COURSE |19-06-2009 |
| | | |
| | | |
| | | |
|5 |TITLE OF THE TOPIC |“HOMOEOPATHIC APPROACH IN MANAGEMENT OF PLANTAR FASCITIS” |
| | | |
| | | |
|6 |BRIEF RESUME OF THE INTENDED WORK: |
| | |
| |6.1 NEED FOR THE STUDY |
| | |
| |Plantar fascitis is one of the commonest painful inflammatory conditions affecting middle aged people and |
| |interfers in their day to day activities . |
| |It is commonly associated with long periods of work-related weight bearing. Among non athletic populations, it is |
| |associated with a high body mass index(obesity). The pain is usually felt on the under side of the heel, often most |
| |intense with the first steps of the day. Another symptom is that the sufferer has difficulty bending his foot so that the |
| |toes are brought towards the shin(decreased dorsiflexion of the ankle). |
| | |
| |Despite considerable research and studies, Plantar Fascitis remains one of the most difficult problems for |
| |treatment in other systems. Homoeopathy has been considered a source for the means of management. |
| | |
| |As Homoeopathy is well known for its vast scope in management of inflammatory conditions, it can be used |
| |as the best source for the management of Plantar Fascitis. |
| | |
| |The present study , “HOMOEOPATHIC APPROACH IN MANAGEMENT OF PLANTAR FASCITIS” is an attempt to study the |
| |pathophysiology and |
| |applicability of homoeopathic treatment in depth. |
| |6.2 REVIEW OF LITERATURE |
| | |
| |“Plantar Fascitis is a painful inflammatory condition of the foot caused by overuse of the plantar fascia.”|
| | |
| |The cause of pain and dysfunction is now thought to be degeneration of the collagen fibres close to the |
| |attachment to the calcaneum.12 |
| | |
| |Incidence : |
| |About 5-6 million people world wide a year develop Plantar Fascitis. 1 |
| |AGE: Middle aged adult between 30-60 years. 1 |
| |SEX: Almost equal in both sexes. |
| | |
| |Common in : |
| |*Athletes -- Runners who over pronate (feet rolling in or flattening) |
| |*Dancers |
| |*Jumpers. |
| |*Obese people. |
| |*Flat feet people. |
| |*High arched feet . 12 |
| | |
| |Pathology : |
| |The lesion affects the soft tissue at the site of attachment of the plantar aponeurosis at the inferior |
| |aspect of Tuberosity of calcaneum. 3 |
| | |
| |Signs and Symptoms : |
| | |
| |Heel pain under the heel and usually on the inside , at the origin of the attachment |
| |of the fascia. |
| |Pain that usually worsens upon arising from bed in the mornings. |
| |Pain increases over a period of months. |
| |Patient has difficulty in bending his foot so that the toes are brought towards the shin. |
| |Tenderness on the medial aspect of the heel at the tendoachilles insertion.12 |
| | |
| |Differential Diagnosis : |
| |Tendoachilles bursitis in adults (Retrocalcanel bursitis). |
| |Calcaneal spur. |
| |Old fractures of Calcaneum. |
| |Subtalar arthritis. |
| |Infections of Calcaneum. 2 |
| | |
| |Diagnosis : |
| | |
| |Detail medical history and foot examination to rule out all possible cause of heel pain other than |
| |Plantar fascitis. |
| |X- ray for heel spurs or Old Calcaneal fractures. |
| |Bone scan. |
| |MRI. |
| |Diagnostic USG. 13 |
| | |
| |Dr.Kent quotes about medorrhinum “Cramps in soles. Weak ankles. Burning feet,wants them uncovered and |
| |fanned. Sore bruised ankles and soles . Soles sore and bruised. He cannot walk on the soles. Swelling and |
| |itching of the soles, it cures tenderness in the soles. Tenderness of soles so that he had to walk on |
| |his knees.” 5 |
| | |
| |Pulsatila – Boring pain in heels toward evening suffering worse from letting affected limb hang down feet |
| |.Feet red, inflamed, swollen.6 |
| | |
| |Valeriana – Sticking pain over left malleolar in region of tendoachilles at 1’0 clock. Sprained pain in |
| |right heel after running upstairs, < standing, > walking sudden pain in right malleous, more when standing |
| |than walking. Pain heels when sitting, more in right heel when sitting with stinging. 7 |
| | |
| |Ruta – Cramp in sole, pain in sole, when sitting, in bones of feet so that he cannot step heavily on |
| |heel , burning and biting in bones of feet durning rest < morning , < pressure. 7 |
| | |
| |Ammonium carbonicum – Swelling as far as calves, < morning on rising and |
| |tenderness as from frost, tearing twitches in right heel, tearing in soles, pain in heel on walking as if |
| |the bone were perforated , sensitiveness to wet and cold. Tingling in left heel with pain when touched , |
| |feeling as if ulcerated. 7 |
| | |
| |Lycopodium – Pain in the soles when walking . Cramps in feet and toes . Swelling of the feet , soles with |
| |shooting pain , coldness of the feet . One feet hot the other cold.9 |
| | |
| |Aranea Diadema - Boring and digging in the os calcis , continuing on moving the foot and disappearing by |
| |continuing the motion . 8 |
| | |
| | |
| |Benzoic Acid - Sharp pain in left ankle , when weight is on foot on walking , severe pain in tendoachilles|
| |close to os calcis when weight on that foot . Tearing and stitches , especially in the metatarsal joints |
| |of the right great toe . 8 |
| | |
| |Cyclamen - Pain in the bottom of foot , as if sprained , more at heel , Burning sore pain in the hels |
| |when walking in open air , also when standing or sitting . After walking toes feel dead .10 |
| | |
| |Silicea - Cramps in soles , cold feet , feet give way under her when walking , itching on soles , driving |
| |to despair . 10 |
| | |
| |Zincum Metallicum - Sole of feet sensitive , steps with entire sole of foot on floor . ulcerative pain in |
| |heel worse walking . 11 |
| | |
|6.3 |OBJECTIVES OF THE STUDY : |
| |1.To study the clinical presentation of Plantar Fascitis. |
| | |
| |2. To study the role of Homoeopathic medicines in Plantar Fascitis. |
| | |
| |3. To learn the scope and limitations of managing a case of Plantar Fascitis. |
|7 |MATERIALS AND METHODS |
| | |
| |7.1 SOURCES OF DATA |
| |Subjects will be collected from IPD, OPD, and peripheral clinics of Bharatesh Homoeopathic Medical College, |
| |and Hospital, Belgaum. |
| |7.2 METHOD OF COLLECTION OF DATA (including sampling procedure, if any) |
| | |
| |Patient will be selected on the basis of Incusion and Exclusion criteria. |
| |Minimum sample size will be 30. Simple Random Sampling procedure will be adopted. |
| |All cases will be taken as per the proforma prepared for study. |
| |All patients registered between the period of 15th june 2009 to 15th Nov 2009 will be selected. No new cases |
| |will be registered after 15th Nov. All cases will be studied from Nov 2009 to Nov 2011. |
| |Follow ups will be seen weekly or fortnightly as per the requirements. |
| |Reference to Materia Medica and its corroboration to reportorial, remedial diagnosis will be done. |
| |Therapeutic plan of the management will be done for each individual case. |
| |Prognosis – Assessment will be on the general and local improvement of the patients. |
| | |
| |INCLUSIVE CRITERIA |
| |Patients suffering from Plantar Fasciitis. |
| |Clinically diagnosed cases of Plantar Fasciitis. |
| |Patients of both the sexes. |
| |Cases within the age group of 30 to 60 years. |
| | |
| |EXCLUSION CRITERIA |
| |Plantar Fasciitis secondary to fractures and tumors are excluded in study. |
| |Cases which need surgical intervention. |
| |Patients with any other immunological diseases are excluded in the study. |
| |Cases with irreversible pathological conditions. |
| |Patients below 30 years and above 60 years are excluded in the study. |
| |7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS |
| |OR ANIMALS? IF SO, PLEASE MENTION BRIEFLY . |
| | |
| |YES, |
| |As per the necessity of Case, the following investigations will be performed. |
| | |
| |1. Radiograph - plain x-ray of affected part (AP & Lateral). |
| |2.Diagnostic USG scan. |
| |3. C.T.Scan. |
| |4.M.R.I |
| |7.4 HAS ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3 ? |
| | |
| |Yes, ethical clearance has been obtained from the institution. |
|8 |LIST OF REFERENCES: |
| |Samuel.L.Turek.M.D, Textbook of Orthopedics and their Application . 4th Edition, Philadelphia: Published by |
| |J.B.Lippincott Company,1472pp. |
| |Natarajan.M, N.Mayil Vahanan, Textbook of Orthopedics and Traumatology.4th Edition, Tamilnadu: Published by M.N.Orthopedic|
| |Hospital, 2001, 162pp. |
| |John Crawford Adams,David.L.Hamblen, Outline of Orthopedics. 13th Edition, Churchill Livingstone Publishers, |
| |Newyork: 2001, 406pp. |
| |Alexander.R.Vaccaro.M.D.,Orthopaedic Knowledge Update. 1st Edition, Published by American Academy of Orthopaedic |
| |Surgeons, 406pp |
| |Kent J T , Lecturers on Homoeopathic Materia Medica. Reprint Edition, New Delhi: B.Jain Publishers Pvt.Ltd, |
| |2001, 731pp. |
| |Boericke William, Pocket Manual of Homoeopathic Materia Medica. 9th Edition, New Delhi: Indian Books and |
| |Periodicals Publishers: 2001, 539pp. |
| |Allen T .F, Hand Book of Materia Medica and Homoeopathic Therapeutics. Reprint Edition, New Delhi: B.Jain |
| |Publishers Pvt.Ltd, 2001, 1130pp,969pp,& 62pp. |
| |Clark J.H, A Dictionary of Practical Materia Medica. Reprint Edition, New Delhi: Indian Books and Periodicals|
| |Publishers, 2002,Vol I, 153pp |
| |Clark J .H, A Dictionary of Practical Materia Medica. Reprint Edition, New Delhi: Indian Books and |
| |Periodicals Publishers, 2002, Vol II, 345pp. |
| |Hering .C, Condensed Materia Medica. Reprint Edition, New Delhi: B.Jain Publishers Pvt. Ltd, 2001, 386pp & |
| |870pp. |
| |Murphy Robian, Homoeopathic Remedy Guide. 1st Edition, New Delhi: Indian Books and Periodicals Publishers, |
| |1882pp. |
| | fascitis |
| | |
|9 |SIGNATURE OF CANDIDATE | |
| | | |
| 10 |REMARKS OF THE GUIDES | |
| | | |
| 11 |NAME & DESIGNATION OF |Dr.S.S.DIVATE M.D.(HOM) |
| |(in block letters) |PROFESSOR & GUIDE |
| |11.1 GUIDE |DEPARTMENT OF MATERIA MEDICA, BHARATESH HOMOEOPATHIC |
| | |MEDICAL COLLEGE & HOSPITAL, DHARWAD ROAD, BELGAUM. |
| | | |
| | | |
| | | |
| | | |
| | | |
| |11.2 SIGNATURE | |
| | | |
| |11.3 CO – GUIDE (if any) | |
| | |------------- |
| |11.4 SIGNATURE | |
| | | |
| |11.5 HEAD OF THE DEPT. |Dr.S.M.ANGADI M.D.(HOM) |
| | |PROFESSOR, GUIDE & HOD, |
| | |DEPARTMENT OF MATERIA MEDICA, BHARATESH HOMOEOPATHIC |
| | |MEDICAL COLLEGE & HOSPITAL, DHARWAD ROAD, BELGAUM. |
| |11.6 SIGNATURE | |
| | | |
|12 |12.1 REMARKS OF THE CHAIRMAN / PRINCIPAL | |
| | | |
| |12.2 SIGNATURE | |
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