WHAT IS BACK BONE/SPINE AND IT’S FUNCTION?
The vertebral column, also called the spine, backbone, or spinal column, makes up about two-fifths of your total height and is composed of a series of bones called vertebrae. The vertebral column, the sternum, and the ribs form the skeleton of the trunk of the body. The vertebral column consists of bone and connective tissue; the spinal cord that it surrounds and protects consists of nervous and connective tissues. The vertebral column functions as a strong, flexible rod with elements that can move forward, backward, and sideways, and rotate. In addition to enclosing and protecting the spinal cord, it supports the head and serves as a point of attachment for the ribs, pelvic girdle, and muscles of the back and upper limbs. The adult vertebral column typically contains 26 vertebrae customized according to the functional requirements of that area:
• 7 cervical vertebrae are in the neck region.
• 12 thoracic vertebrae (thorax _ chest) are posterior to the thoracic cavity.
• 5 lumbar vertebrae support the lower back.
• 1 sacrum consists of five fused sacral vertebrae.
• 1 coccyx usually consists of four fused coccygeal vertebrae
The vertebral column is the central and fundamental support for the musculoskeletal and nervous system. This vertebral column has shown remarkable adaptation through the evolutionary history of man. It is the part of human body that underwent the greatest transformation due
to evolution of man from a four legged to two legged animal. Corporal weight that used to get distributed upon the four limbs is now borne majorly by the spine with the acquirement of erect posture. With the advancement of technology and mobile phone revolution, the spine is getting abused at a much greater level, than ever before. Result is development of spinal maladies due to constant postural distress. The most prevalent spinal malady in common people’s language is “Spondylitis”. Let us look deeper into the causes, course of development and prognosis of Spondylitis.
WHAT IS SPONDYLITIS OR SPONDYLOARTHRITIS?
Spondylitis is a term used in general sense for pain in nape of neck or small of back, the two areas of spine most vulnerable to wear and tear due to postural stress and workplace ergonomics. Basically it is Spondyloarthritis (SpA) i.e. inflammation of vertebral joints and can be grouped in two main ways according to the Spondylitis Association of America.
- The Traditional Spondyloarthritis (SpA) classification system which groups the disorder into six separate pathological presentations.
- The Newer Spondyloarthritis (SpA) classification system categorizing the disorder in two broad categories.
Traditional Spondyloarthritis (SpA) Classification system
Ankylosing Spondylitis : Primarily affects the spine although other joints get involved over the latter course of disease. There is severe chronic pain and discomfort due to inflammation of vertebral joints which leads to “Ankylosis” (new bone formation) in advanced cases. Ankylosis causes fusion and fixity of the vertebrae and consequent loco-motor restriction of the spine reflected as typical symptom of Stiffness which gets pronounced after long periods of rest. The prime target area in Ankylosing Spondylitis is the sacro-illiac joint, but other areas can also be affected such as the shoulders, hips, ribs, heels, and small joints of the hands and feet. Uveitis, Psoriatic patches and Irritable Bowel syndrome can be seen in few cases. The incidence is found to be greater in men than women and the onset is gradual initiating with morning stiffness for almost half an hour after rising. The onset and course of symptoms vary from person to person,
and usually the symptoms start appearing during late adolescence or early adulthood (17 to 45 years of age). Thorough examination along with meticulous case history direct the physician towards the diagnosis, which can be further substantiated with evidence of Human leukocyte antigen (HLA) – subtypes B*2701-2759 (B27) in blood and an X-Ray.
Enteropathic Arthrites : This type of arthrites is associated with inflammatory bowel disease like Crohn’s disease, ulcerative colitis, undifferenciated colitis etc. Along with inflammatory back pain, inflammatory symptoms of intestines such as chronic diarrhea, abdominal pain, weight loss, and/or blood in the stool are also present.Psoriatic Arthrites : Psoriatic patients may develop pain and swelling in back and small joints of the hands and feet. The hallmark sign of this type of arthritis is presence of “sausage digits”, which develop due to the inflammation of subcutaneous tissue of the affected finger or toe. The inflammation gives the digit a swollen and stuffed sausage like appearance.
Reactive Arthrites : If the arthritis develops in reaction to infection in the intestines or the urinary tract then we term it as reactive arthritis. The course of Reactive arthritis is of a few months and usually does not recur. But some people develop a chronic form of reactive arthritis.
Undifferentiated Spondyloarthrites : If the aggregate of symptoms of a case of spondyloarthrites don’t fit in a single diagnostic frame then it is termed as undifferentiated spondyloarthrites.
Juvenile spondyloarthrites : As the name suggests, Juvenile spondyloarthrites is a term for a group of childhood rheumatic diseases, developing before the age of 16 and may affect the person through adult life. The symptoms appear sporadically, without the obvious role of any exciting or alleviating factor.
Axial Spondylo Arthrites: The axial musculoskeletal structures are involved in this type of arthritis, causing inflammatory back pain. It is a broad term covering SpA with or without typical inflammatory changes of Sacro iliac joints seen on X-Ray. Ankylosing SpA can be detected radiographically whereas enteropathic arthritis, reactive arthritis, undifferentiated arthritis, psoriatic arthritis do not show radio graphical changes.
Periphral Spondyloarthritis: This causes inflammation in joints other than spine or sacroiliac joints such as joints of the wrist, hands, elbows, shoulders, knees ankles and feet.
What Causes Of Spondylitis?
Research shows that a patient’s genetics, environment and immune system may be the determining factors for this condition. An individual with a family history of spondylitis or its complications, is far more likely to suffer from spondylitis. Factors associated with development of spondylitis are:
• Previous inflammation in joints and tissues
• Lack of exercise
• Obesity
• Smoking or the excessive use of alcohol
• Already established spinal pathologies, such as degenerative disc disease or spinal stenosis.
What is The Symptoms Of Spondylitis?
Spondylitis is commonly confused with mechanical back pain, occurring after an actual spine injury. In fact, spondylitis is the inflammation in the spinal joints and does not result from a single definitive incident. Patients with spondylitis usually experience:
• Pain and stiffness anywhere from the neck through the lower back and buttocks that lasts for
more than 3 months
• Discomfort that is worse in the morning or after long periods of inactivity and seems to lessen
with movement and exercise
• Progressive loss of spinal flexibility and a sensation of rigidity
• Hunched or stooped posture
• Tendonitis
• Overgrowth of bones, commonly called bony fusion, that may affect daily activities
• Vision problems and eye inflammation, including redness and pain
• Swelling
• Compression fractures
What is The Diagnosis Of Spondylitis?
- X-ray which may show the development of spurs (bony outgrowths) on the vertebrae.
- MRI (Magnetic resonance imaging) can be done to confirm the diagnosis and judge the extent of neural damage if any.
- EMG (Electromyography)
- Myelography demonstrates nerve root lesion.
How Prevent and Relieve Spondylitis?
Postural correction with suitable spinal exercises benefit to a great extent in early stages. Efforts to maintain healthy body weight and replenishing body’s Vit. D and calcium requirements also help greatly. Sitting, standing, stooping, lifting should be correctly done, along with regular physical exercises like aerobics which are of special benefit. Advanced cases with degenerative joint damages, need surgical replacements. Corrective spinal surgeries are done where MRI shows fusion of joints in severely bent positions.
Homeopathic Medicines For Spondylitis Treatment and Relieve.
- Acid phos
• Tension and cramp-like drawing in muscles of neck, esp. on moving head.
• Spondylitis of cervical vertebrae.
• Burning pain in a spot above small of back.
• Lumbar region heavy increases pain in legs.
• Historical dose: Tincture and all potencies, first potency and higher. - Hypericum
• Pain in nape of neck.
• Pressure over sacrum. Spinal concussion.
• Cervical vertebrae very sensitive to the touch.
• Aching pain and sensation of lameness in the small of the back.
• Dose – Tincture, to third potency. - Cimicifuga
• Rheumatic pains in muscles of neck and back; feel stiff, lame, contracted; spine sensitive, from using arms in sewing, typewriting, piano playing.
• Stiffness and contraction in neck and back.
• Pain in lumbar and sacral region, down thighs, and through hips.
• Dose – First to thirtieth attenuation, third most frequently used. - Cocculus indicus
• Cracking of cervical vertebrae when moving head.
• Weakness of cervical muscles, can hardly hold the head up.
• Paralytic pain in lower back with weakness of hips, knees and legs.
• Dose – Third to thirtieth potency. - Conium maculatum
• Tension in the nape of the neck.
• Pain as from excoriation in the vertebrae of the neck.
• Aching and compression above the hips.
• Dose – Best in higher potencies given infrequently, especially for growths, paretic states, etc. – Otherwise sixth to thirtieth. - Lachnanthes tinctoria
• A remedy for torticollis, rheumatic symptoms about neck.
• Chilliness between the shoulder-blades; pain and stiffness in back.
• Stiffness and pain in neck, extending over whole head down to the nose.
• Sensation of spraining in neck when turning or moving head backward.
• Dose – Third potency. - Mezereum
• Pain in neck and back; worse, motion and at night; intolerant of all touch.
• Painful rigidity of nape of neck, and of neck and external muscles; in right side of neck and throat, agg. on motion.
• Contractive and tensive pain in back, extending to sacrum.
• Dose – Sixth to thirtieth potency. - Guajacum officinale
• Aching in nape. Stiff neck and sore shoulders.
• Contractive pains between the Scapulae.
• Sciatica and lumbago.
• Immovable stiffness.
• Dose – Tincture, to sixth attenuation. - Kalmia latifolia
• Pain from neck down arm; in upper three dorsal vertebrae extending to shoulderblade.
• Pain down back, as if it would break; in localized regions of spine; through shoulders.
• Lumbar pains, of nervous origin.
• Dose – Tincture, to sixth potency. - Kalium iodatum
• Spasmodic contraction of the muscles.
• Stitches in the small of the back when sitting.
• Chronic rheumatism of chest and back.
• Dose – Crude drug, in material official dosage, as a rule, the first dilution from 6 to 20 drops a day; if after a week no decided progress is visible, one drop of the tincture of Iodine is added to each hundred of the first dilution.
References:
- Clarke J.H., Dictionary of practical materia medica
- MURPHY R., Homeopathic Remedy Guide
- BOERICKE W., pocket manual of homeopathic materia medica
- ALLEN H. C., Keynotes and Characteristics with Comparisons
- NASH E.B., Nash Expanded Work
- NASH E.B., Regional Leader
- BUCK H., The outlines of materia medica
- LIPPE A.Von., Textbook of Materia Medica
- ROBERTS H.A., The rheumatic remedies
- Principles of Anatomy and Physiology; Gerard J. Tortora & Bryan Derrickson; 13th edition
- Overview of Types of Spondylitis; Spondylitis Association of America; https://www.spondylitis.org/Types-of-Spondylitis;
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