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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