Homeopathy Enters Contemporary Pain Practice
History of Botanicals and Homeopathy
Classical homeopathy utilizing botanicals has been used as a remedy since the 18th century and is known to Western civilizations, principally through the work of Samuel Hahnemann. Naturopathic physicians have been well trained in the selection of herbal remedies, although this topic is usually omitted in conventional medical curriculums. Administration of a homeopathic medication containing a very small amount of active substance can produce different effects based on the concentration (or dilution) of the substance. This principle is known as hormesis—whereby very low doses produce a beneficial effect and higher doses produce a harmful effect. From the conventional medical perspective, this effect can be observed in an inoculation when the introduction of a minute amount of a substance (that in larger doses is harmful) stimulates the beneficial production of antibodies and does not overwhelm the immune system. The appropriate prescribing of homeopathic preparations allows for the selection of a remedy based on the patient’s specific symptoms and constitution.
A significant opinion from our perspective as pain practitioners should acknowledge that the option of homeopathy is safe, cost-effective, and can be utilized in combination with modalities and/or medications already in place. Measured outcome studies utilizing objective nationally standardized variables against which subjective responses can be compared are a desirable determination of efficacy.1
Bioregulatory Medicine and Research
Bioregulatory medicine (BRM) is an emerging field of medical care that targets the body’s normal maintenance of homeostasis through auto-regulation. When we painstakingly memorized the components of the Krebs’ cycle or the electron transport chain, the study of physiology explained our (then) more limited understanding of the extraordinarily complex choreography undertaken by the body when addressing a straightforward chore—e.g., building the right protein for increasing muscle bulk, combating a foreign protein invasion, precisely regulating serum osmolarity to remain within specific set points, or alternatively warehousing and degrading cellular waste products for elimination. It should come as no great surprise that subsequent research now reveals much more complex and elaborate interrelationships among body systems than had been previously appreciated. Biological response-modulating substances influence these systems, not by ablating the reaction completely but by allowing the body to restore its normal auto-regulation through the practitioner’s administration of infinitesimal dosages of substances that gently dislodge an abnormally functioning system back toward normal oscillation around a set point. Even ultra-low doses of medications such as seen in homeopathy can produce a significant impact on the body, by a principle known as “hormesis”—where differing concentrations of the same medication produce divergent results.2,3
Research published on hormesis has underscored its validity.2 Hormesis addresses the phenomenon that the intake of a very small amount of a substance which, in large doses, can be toxic or damaging to the person, serves a protective function.5,6 Modern medicine has taken advantage of this phenomenon with vaccinations, for example. Another example is caloric restriction as a pro-longevity strategy.3,4 The beneficial physiologic response to a transiently-manifested form of stress (or toxin) that induces the development of tolerance to low oxygen states, toxins, and dietary restriction has been observed.2,3
The understanding and acceptance of hormesis is critical to the practitioner’s understanding of the research and efficacy of homeopathic medicinal products in concentrations that radically differ from the dosing for conventional medications. For example, some homeopathic medications show an impact at concentrations in the range of 10-3 to 10-6.
A Brief Explanation of Homotoxicology (HTX)
Homotoxicology is a therapeutic modality within integrative medicine. In this system, a medical diagnosis is made then followed by an individualized assessment according to the severity of the patients’ disease. This takes into account the burden of exogenous and endogenous influences on the patient’s self-regulatory mechanisms. Treatment is then given, predominantly using homeopathically-prepared medicines, to support the inherent self-regulatory ability of the patient by means of detoxification and drainage, immunomodulation, functional organ support and support of the cellular metabolism. Research on combination homeopathic products has helped reveal their mechanisms of action on targeted portions of bioregulatory systems that helps to explain their efficacy.8,9
The therapeutic goal of the practitioner is the appropriate assignment of homeopathic products that support the specific physiologic detoxification systems associated with the known disease state. Progress can be slower than with conventional medications but results can be rewarding because the underlying physiologic reactions can begin to function normally and optimally.
How HTX Differs from Conventional Medicine
Conventionally-trained medical physicians have been taught the actions of conventional medications and developed expertise in avoiding side-effects while these medications impacted targeted end organs. In large part, our medical responsibility consisted of trying to avoid the adverse effect of those medications’ doses upon interrelated body systems between the median lethal dose (LD50) and the median effective dose (ED50). Those far-reaching “associated organ system impacts” were known to account for the bulk of side-effects arising from our armamentarium of conventional medications. While these medications can be very effective, side effects are well documented.
We know that the use of medications designed to address disease states could include stopping an otherwise auto-regulatory physiologic system—such as the impact of steroids on the cyclo-oxygenase pathway. Most of us involved in the conventional medical educational process did not receive education about alternate medication options (such as homeopathic medications) which possessed significantly less side-effects than conventional medications. Homeopathic medications utilize doses that are significantly smaller than milligrams to accomplish this gentle effect and, in this regard, are very different from conventional medications. Homeopathic doses are measured in nanograms or picograms and these low doses very subtly encourage the normal auto-regulation of a dysfunctional body system to get back on track.
Pain practitioners will readily recognize the cyclo-oxygenase cascade, which is frequently invoked by chronic disease states and responds by producing substances that result in cell inflammation and further painful sensations (see Figure 1).