Your Ad Here


Bookmark and Share

Sunday, March 15, 2009

Some aspects of “Housemaid’s knee” with homoepathic mode of treatment-

Also known as roofer’s knee, it is a benign swelling over the knee on account of an enlargement of the bursa named prepatellar bursa in front of the patella, which in turn is due to an inflammation of the said bursa. Housemaid’s knee is so named because of the fact that this health problem was once found to be a major occupational hazard of Housemaid’s knee & was believed to be caused by leaning too much on the knee by them.

Pathology- Prepatellar bursa is a superficial bursa with a thin synovial lining in front of the patella in between the skin & the patella. It is seen in the lower half of patella & upper half of ligamentum patella. The bursa develops after birth within a few years of life as a result of mechanical pressure & friction. It helps in reducing friction on the underlying structures & thus allows maximal range of motion in the knee. The inflammation of the bursa usually due to repeated trauma to the knee with excess fluid causes restricted movement of the joint with pain, swelling & heat.

Age- Any age group can be affected.

Sex- It is more common in males.

Predisposing factors-
(1) Repeated rubbing or pressure on the knees from kneeling on hard surfaces in an occupation.
(2) A direct blow or a fall on the knee causing rupture of blood vessels & subsequent swelling of the prepatellar bursa.
(3) Spread of an infection from a surface injury, such as a skin wound over the kneecap. Infection is usually the main cause of Housemaid’s knee in children. Infection is also the main cause in people in whom the immunity is deranged such as those on steroid therapy or chemotherapy for cancer.

Clinical features-
(1) Swelling over the kneecap.
(2) Warmth over the kneecap.
(3) Limited motion of the knee.
(4) Painful movement of the knee.
Kneeling usually aggravates the symptoms, while sitting still relieves them.

[A] General measures to be taken are-
(1) Avoidance of the aggravating activity.
(2) Wearing of knee pads while kneeling.
(3) Exercise to strength the quadriceps muscle.
(4) Physiotherapy.

[B] Homeopathic medicines to be used are- Specific remedies include Arnica, Bryonia or Ruta graveolens (Ruta)। The potency & frequency of dosage varies with the severity of the condition & the individual। Usually a lower potency is to be used first for thrice daily & to be continued till the persistence of the symptoms। If improvement is seen, the same medicine is to be continued. But if there is no significant improvement or improvement has come to a standstill, the frequency of dosage should be increased. And in cases where there is no response within a reasonable amount of time, the medicine should be stopped & a different medicine is to be started. It is to be kept in mind that Housemaid’s knee caused by infection needs to be recognized quickly & treated promptly.

Prevention- Use of knee pads by those whose work necessitates kneeling for extended periods of time. This is especially true for those who had already an episode of Housemaid’s knee to prevent recurrence.

Prognosis- Housemaid’s knee may interfere with physical activity, but otherwise it is relatively harmless. But if left untreated, there may be associated loss of quadriceps muscle strength which in turn may cause the leg to give out.

In short, Housemaid’s knee manifests itself as a swelling over the kneecap & can be treated by Arnica, Bryonia or Ruta.

But in every case, a doctor should be consulted.

Monday, March 9, 2009

Some aspects of Student’s elbow with homoepathic mode of treatment

Also referred to as Olecranon bursitis, it is a chronic inflammation of the olecranon bursa. It is so called as it is found in students who tend to keep their elbows repeatedly over the table, bench etc over long periods during writing, reading etc & the resulting chronic friction leads to its development.

Aetiology -
(1) Repetitive minor injuries or irritation.
(2) Microcrystalline deposition.

Clinical features-
(1) Usually a swelling on the bony bit at the back of the elbow.
(2) Associated pain if there is inflammation.
(3) Gradually pain at rest & during movement of elbow.
(4) Restriction of elbow movement.
(5) On bleeding into the bursa, the swelling as well as the pain increases.

Investigations-Aspiration & culture of the bursal fluid to exclude the possibility of an infectious aetiology.

(1) Rest & protecting the area from any kind of trauma.
(2) Application of ice.
(3) Immobilization of the arm.
(4) Homeopathic medicines to be used are usually Benzoicum acidum (, Bryonia or Belladonna (Bell) etc. The potency & frequency of dosage varies with the severity of the condition & the individual. Usually a lower potency like 30 C is to be used first for thrice daily & to be continued till the persistence of the symptoms.

(1) Wearing of elbow guards during playing a game in which there is a chance of getting hit on the elbows.
(2) Change of writing or reading habits so that leaning on the elbows for long periods of time can be avoided.

Prognosis- Microcrystalline-induced bursitis has a good prognosis & the symptoms usually resolve after a few days, whether treated or not. But bursitis due to repeated minor irritation is more difficult to treat.

In short, Student’s elbow is a chronic inflammation of the olecranon bursa which manifests as a painful swelling over the tip of the olecranon & is to be treated by Benzoicum acidum (, Bryonia or Belladonna (Bell).

But in every case, a doctor should be consulted.