– THOMAS E,SPORTS MEDICINE
Oral NSAIDs and injected steroids are often bought over the counter or prescribed for tenosynovitis in the extensor tendons of the wrist. Gripping and grasping with extension of the wrist often induces this kind of tenosynovitis. Its symptoms often fit the remedy Rhus Tox., as in the following case.
CASE 28
Judy is a rock climber, aged 26. She complained of an intermittent pain medially in her right elbow and wrist. This was worse after a session on the climbing wall. Sometimes it prevented her training. The onset had been insidious and gradual.
She described the pain in her wrist as aching. It usually came on at night, and sometimes woke her after she had been lying on her arm. I noticed that as she told me about it she constantly moved her arm and wrist. The stiffness was, she said, worse when she got up in the morning, whether she had been on the climbing wall or not. When she had ‘got it going’ it improved and did not bother her. She felt that her hand was getting weak. She was worried that a climbing trip she had planned would have to be cancelled. She was due to leave in three weeks’ time.
I gave her one Rhus Tox. 200c to take three times daily for three days, and advised her to stop training and to consult a physiotherapist colleague, who later diagnosed medial epicondylitis. He prescribed ultrasound and confirmed the need to rest.
She reported after a week to the effect that she felt much better. Her arm was not painful in the morning and she wanted to start climbing again. I advised against it. The improvement continued well enough for her to take the trip and enjoy it.
Tenosynovitis produces pain, weakness and stiffness in the wrist and hand. Frequently synovitis arises in the tendon of the extensor carpi radialis longus and of the pollicis muscles. It can also arise in the tendons running through the carpal tunnel, and result in carpal tunnel syndrome.
From a homoeopathic point of view one takes the symptoms as they are described or observed, and chooses a remedy that fits those symptoms. Fortunately only a few remedies cover the common symptomatology of conditions affecting the tendons of the forearm and wrist.
Plumbum Metallicum
This remedy, derived from lead, will be useful when there is painful weakness of the wrist and hand. The wrist feels paralysed and may be dropped. There is difficulty in grasping objects. The symptoms appear very slowly and insidiously. There may be a sensation of a string pulling the wrist into extension or flexion. There may also be violent contraction of the fingers. The person definitely avoids being touched because it hurts. He may also avoid exertion, but likes massage because it makes him feel better. He may be a taciturn sort of person who is not keen on company.
Dosage: One Plumbum 30c daily for pain during recovery, for not more than two weeks.
Rhododendron
The wrist feels bruised and sprained. The pain is tearing, and there is a sensation of boring. There is stiffness, paralysis and weakness in the wrist and hand. The pain is worse at night and at rest. Unlike Rhus Tox., which is painful on first movement, Rhododendron is better as soon as movement begins. The person who needs Rhododendron will dislike storms and rough, windy weather. He will enjoy the sun.
Dosage: One Rhododendron 30c daily during recovery, for not more than a month.
Rhus Toxicodendron
Rhus Tox. will help this condition is the pain if worse when resting and on first movement, but relieved by continued movement. The player moves his arm, wrist and hand constantly. The pain can be in either wrist, is tearing, shooting and stitching and makes him nauseous.
The wrist and hand are stiff and weak. His hand feels shaky. He is worse from exposure to cold and wet, and at night, and better from heat.
Dosage: One Rhus Tox. 30c daily as often as necessary for the pain. Be sure to stop the remedy when the condition eases.
Ruta Graveolens
Wrenching pain in the wrist that is worse when the arm hangs down, and when resting on them. There will be a dull tearing pain in the wrist, which feels bruised. The wrist may be rigid, and the hand very weak. He feels worse when cold, damp, sitting and lying. He may be anxious, nervous, restless and depressed in the late evening. Because of the damage to tendons Ruta should be given regularly during recovery. The pains are sore, bruised and aching and the arms are restless.
Dosage: One Ruta 200c daily for two weeks.