Effect of Homoeopathic Medicine Gnaphalium in the Treatment of Lowback pain extending to leg

Phase 4

Recruiting

Conditions: Lumbago with sciatica, (2) ICD-10 Condition: M543||Sciatica,

Registration Number: CTRI/2023/10/059226

Lead Sponsor: Vinayaka Missions Homoeopathic Medical College and Hospital

Brief Summary: Sciatica is a symptomrather than a specific diagnosis. Available evidence from basic science andclinical research indicates that both inflammation and compression areimportant in order for the nerve root to be symptomatic.1

Affected patients experience pain and paresthesias in the sciatic nervedistribution or an associated lumbo-sacral nerve root. Sciatica pain often isworsened with twisting, bending, or coughing. This is often a chronic conditionthat is managed through the use of analgesics to control the pain and NSAIDs todecrease inflammation. This activity illustrates the evaluation and managementof sciatica and reviews the role of the inter-professional team in improvingcare for patients with this condition.2

The lifetime incidence of this condition is estimated tobe between 13% and 40%. Fortunately, the majority of cases resolve spontaneouslywith simple analgesia and physiotherapy. However, the condition has thepotential to become chronic and intractable, with major socio-economicimplications. In about 90% of cases sciatica is caused by a herniated disc withnerve root compression, but lumbar stenoses and (less often) tumours arepossible causes. Epidemiological factors found to influence incidence ofsciatica included increasing height, age, genetic predisposition, walking,jogging (if a previous history of sciatica), and particular physicaloccupations, including driving.

The influence of herniated nucleus pulposus and theprobable cytokine-mediated inflammatory response in lumbar and sacral nerveroots is discussed. An abnormal immune response and possible mechanical factorsare also proposed as factors that may mediate pain. The diagnosis ofsciatica and its management varies considerably within and between countries;for example, the surgery rates for lumbar discectomy vary widely betweencountries. The ongoing issue ofthe role of epidural steroid injection in thetreatment of this condition is also discussed, as well as potential hazards ofthis procedure and the direction that future research should take.3,4

**Gnaphalium â€“ General Literature Review:**

The genus *Gnaphalium*, a herb distributed worldwide, comprisesapproximately 200 species of the Compositae (Asteraceae) family that belongs tothe tribe Gnaphalieae. Some species are traditionally used as wild vegetablesand in folk medicine. More than 125 chemical constituents have beenisolated from the genus *Gnaphalium*, including flavonoids, sesquiterpenes,diterpenes, triterpenes, phytosterols, anthraquinones, caffeoylquinic acidderivatives, and other compounds. The extracts of this genus, as well ascompounds isolated from it, have been demonstrated to possess multiplepharmacological activities such as antioxidant, antibacterial and antifungal,anti-complement, antitussive and expectorant, insect antifeedant, cytotoxic,anti-inflammatory, antidiabetic and antihypouricemic properties.6

**Gnaphalium â€“ Homoeopathic LiteratureReview:**

A remedy of unquestioned benefit in sciatica, when painis associated with numbness of the part affected. Cramps incalves of legs and feet when in bed. Rheumatic pain in ankle joints and legs. Intensepain along the sciatic nerve; numbness alternates with pain. Frequent pains incalves and feet. Anterior crural neuralgia.7 Pains dull ordarting or cutting from Right hip-joint posteriorly downward to foot; <lying down, from motion, by stepping, > sitting in a chair.-Intense painalong sciatic nerve.-Numbness occasionally taking the place of sciatic pains,making exercise very fatiguing.-Cramps in calves; in feet, at night in bed.8

Bibliography:

1.    Valat JP, Genevay S, Marty M, Rozenberg S, KoesB. Sciatica. Best Pract Res Clin Rheumatol. 2010 Apr;24(2):241-52. doi:10.1016/j.berh.2009.11.005. PMID: 20227645.

2.    Davis D, Maini K, Vasudevan A. Sciatica.

3.    <https://www.ncbi.nlm.nih.gov/books/NBK507908/>

4.    Koes BW, van Tulder MW, Peul WC. Diagnosis andtreatment of sciatica. BMJ. 2007 Jun 23;334(7607):1313-7. doi:10.1136/bmj.39223.428495.BE. PMID: 17585160; PMCID: PMC1895638.

5.    Stafford MA, Peng P, Hill DA. Sciatica: areview of history, epidemiology, pathogenesis, and the role of epidural steroidinjection in management. Br J Anaesth. 2007 Oct;99(4):461-73. doi:10.1093/bja/aem238. Epub 2007 Aug 17. PMID: 17704089.

6.    Zheng X, Wang W, Piao H, Xu W, Shi H, Zhao C.The genus Gnaphalium L. (Compositae): phytochemical and pharmacologicalcharacteristics. Molecules. 2013 Jul 15;18(7):8298-318. doi:10.3390/molecules18078298.

7.    Boericke W. Materia medica with repertory.InMateria medica with repertory 1927 (pp. 1049-1049).

8.      Clarke JH. A dictionary of pratical materiamedica. homoeopathic publishing Company; 1902.

Detailed Description: Not available

Recruitment & Eligibility

Status: Open to Recruitment

Sex: All

Target Recruitment: 30

Inclusion Criteria

Sciatica Patients (ICD 11.

Exclusion Criteria

Degenerative conditions of spine.
Vertebral osteochondrosis, Spondylosis, Facet joints, Spondylolysis & spondylolisthesis, Degenerative stenosis, Known Lesions of sciatic nerve Chronic neuropathic pain by any Specific Diseases.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Scoring tool based on model for clinical assessment items and corresponding predicted probability of sciatica Questionnaire	90 Days

Secondary Outcome Measures

Name	Time	Method
A modified Roland-Morris disability scale for the assessment of sciatica	90 Days

Trial Locations

Locations (1): Vinayaka Missions Homoeopathic Medical College and Hospital
🇮🇳
Salem, TAMIL NADU, India
Vinayaka Missions Homoeopathic Medical College and Hospital
🇮🇳Salem, TAMIL NADU, India
Dr Venkatesan H
Principal investigator
9865134561
venkathompath@gmail.com