A Case of Grade 1 anterolisthesis of L4-L5


The patient complained of severe throbbing biting pain in the left gluteal region with difficulty in walking since the last four months. The complaints got aggravated after a fall in the bath room.

The pain is aggravated by walking +2, Standing and the pain I s ameliorated by lying on the painful side and rest.

He MRI -LS spine shows grade 1 anterolisthesis of L4-L5 mild posterior bulge of desiccated L4-5 disc indenting the thecal sac and the left L5 nerve root. The patient comes from a lower economic background and they didn't have the necessary funds to carry out the surgery that had been advised by the orthopedic.

So the patient was referred to us if we can relieve the pain. So we took the case. The patient comes from a small village .She is very much lively in her talk she said she used to work in the farms since she was young and she enjoyed working in the village. She came to the city of Mumbai after her marriage and here the situation is very different.

They are staying in the slums in a very small room and people around them are not good. She is not happy. Her husband is very dominating and he keeps on commenting about the way she walks due to the pain and insults her often. She feels very bad about it and when insulted she weeps. We asked the husband why he does it he said he had to get married to her against his wish; as in their community what ever parents decide has to be followed.

He is not happy with their marriage so he seldom gets angry on her. He is very dominating and doesn't allow her to talk even when he was there him the consulting room we had to ask him to wait outside to interact with the patient.

The patient then told us there were lot of problems in their martial life and they didn't get along well.Inspite of the fact that she looks well after her in laws and brother in law. She is never appreciated for it. She feels very much neglected as there is nobody on her side. Her father passed away due to tuberculosis at a very young age since that time she is leading a very tough life.

She likes to listen to music very much and she feels relaxed after listening to it. She also sings and which helps her to relax. She is very sensitive by nature and if some says something wrong she cannot forget it broods over it for a long time. But she will express it when she is angry. She says she is not revengeful at all.

Personal history

Thermals

O/E

Date   Prescription
13/4   Rx
Natrum.muriaticum 30
3 powders night
S.L 2 pills 4 hourly for 14 days
22/4 Pain in the back persists
Cannot remember dreams
Sleep is disturbed.
Dreams cannot remember
The biting sensation is better
Rx
Ct all 14 days
3/5 Pain is better
Numbness and biting sensation is better
Sleep is better
Rx
Ct all 14 days
4/9 The patient reported after a period of 6months and we asked was didn't she report as she was getting better.
She told us as there were no complaints she went to the village. She was better all these days but now the pain has started as she had exerted her self a lot in the fields.
We explained her again her condition and she shouldn't exert herself. Same medicine was repeated.
After this the patient reported once on the phone that she is much better. And she has discontinued the medication on her own.
Ct all
14 days

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