Management of Fibromyalgia in rheumatoid arthritis with homoeopathic treatment : A case report.

Author

Dr. Arulraj Antony Cruz , Dr. Manasi Ghosale

Abstract

 Background: Fibromyalgia (FM) is a chronic pain condition characterized by widespread pain, fatigue, sleep disturbance and increased pain sensitivity. It may coexist with rheumatoid arthritis (RA), making assessment of persistent pain and functional impairment more complex.

The term "fibromyalgia" was derived from Neo-Latin fibro-, meaning 'fibrous tissues, Greek μυο- (myo-, 'muscle')  and Greek άλγος (algos, 'pain'), thus, the term literally means muscle and fibrous connective tissue pain. People with the disorder have an increased sensitivity to pain along with multiple painful tender points, which are widely and symmetrically distributed. It is one of the type of soft rheumatism .

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by inflammatory arthritis and extra-articular involvement. RA is a chronic inflammatory disorder caused in many cases by the interaction between genes, environmental factors including tobacco, that primarily involves synovial joints. It typically starts in small peripheral joints, is usually symmetric, and progresses to involve proximal joints if left untreated. The joint inflammation further leads to the destruction of the joint with loss of cartilage and bone erosions. Rheumatoid arthritis is a chronic disease that causes inflammation around the body and commonly presents with pain in the joints .

Homoeopathy offers a gentle way towards the health of entire individual. The selection of remedy is based on the theory of individualization, miasmatic approach, personal constitution & symptoms similarity by using constitutional approach.

Case presentation: A 54-year-old female homemaker with a six-year history of rheumatoid arthritis presented with generalized body pain, multiple-joint pain and stiffness, morning stiffness lasting more than one hour, fatigue, non-refreshing sleep and generalized tenderness. The pain was aggravated by cold, rainy weather and initial movement after rest, and was relieved by continued movement and warmth. Pre-treatment WPI was 15 and symptom severity score (SSS) was 7, giving a combined score of 22. Based on the recorded symptom totality and repertorial analysis, Rhus toxicodendron 200C was selected.

Intervention and outcome: Rhus toxicodendron 200C was prescribed with supportive measures including warm bathing, gentle stretching, sleep hygiene, stress-management counselling, balanced diet and regular walking. Serial follow-ups documented progressive reduction in pain and stiffness, improved sleep and fatigue, and improved ability to perform household activities. At the final recorded assessment, WPI was 4 and SSS was 3, with a combined score of 7, compared with 22 before treatment.

Conclusion: This case documents clinical improvement in a patient with fibromyalgia associated with rheumatoid arthritis following individualized homoeopathic treatment. 

Keywords

Fibromyalgia; rheumatoid arthritis; homoeopathy; Rhus toxicodendron; Widespread Pain Index; symptom severity score; case report.

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References

This case report describes a 54-year-old woman with rheumatoid arthritis and clinically documented fibromyalgia symptoms who received individualized homoeopathic treatment with Rhus toxicodendron 200C together with supportive lifestyle measures. Progressive clinical improvement was recorded over approximately six months, with the combined WPI + SSS score decreasing from 22 to 7.

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