From Pain to Relief: A Shingles Victory with Homeopathy

Michael Knapp, ND, DHANP

How a 51-Year-Old Female Achieved Fast Relief from Shingles Using Classical Homeopathy

Abstract

This case illustrates the successful treatment of shingles with individualized homœpathic medicine in a 51-year-old female. The outcome is noteworthy because the expected course of illness stated by the CDC is that “blisters … typically scab over in 7 to 10 days and fully clear up within 2 to 4 weeks.” In this case, the duration of illness was considerably shortened, with scabbing of lesions occurring within 48 hours of beginning treatment, neuralgic pain extending down the leg resolved after the second dose of the remedy. It decreased pain overall, starting with the first dose. The patient did not experience any postherpetic sequelae, which occur in 10-18% of people.² §2 of the Organon of Medicine (6th ed.) states, “The highest ideal of cure is rapid, gentle and permanent…” These objectives align with the practice of classical naturopathy. As with all HANP case articles, this case is presented with the reader in mind to provide a clear methodology, reliable tools, and a transparent thought process so you may apply it successfully in your clinic. 

Initial Case History

A 51-year-old female presents with acute shingles. She takes a methylated B-complex, internal CBD that “takes the edge off,” and an antiviral herbal tincture containing Lomatium, Saint John’s Wort, Cayenne, and Echinacea. She has also received IV infusions of Vitamin C and lysine without benefit and is scheduled for IV ozone the following day.

Symptoms began 10 days ago with tingling in the left thigh. She has been experiencing stress from work, traveling to visit family, and especially the recent illness of her son, who was out of school with the flu. She feels significant stress when he is ill due to his history of seizures and the fear that they may return.

The tingling sensation has intensified into pain shooting up and down the leg, accompanied by numbness. After five days, blisters appeared on the outer thigh. The friction from clothing and dressing aggravates the blisters. Getting up in the morning or from bed at night is extremely painful. The blisters burn and tingle, and sharp pain is experienced upon first movement, which eases as she continues to walk. The cool air is painful, and she begins to shiver; however, she starts to feel better once she warms up. She wishes to have the heating pad in bed. 

Her entire spine aches when she walks. “It feels like a heavy sensation moving downward with each step, almost like the pounding of each step vibrating through it.” Today, the itching from the blisters has intensified, and she has a new achy headache at the back of her head and cervical pain that worsens with noise.

Sleep is fitful, with tossing and turning and bizarre dreams. “If I can lie in one place, then I feel good, but I have to move. It’s like I need to move and stretch and roll over.” She gets deep chills to the bone, shivers, and needs blankets. She frequently thirsts for cold water, even after drinking. She also experiences mild nausea in the epigastric region after eating.

She experiences symptoms of menopause, such as hot flashes, but has no other medical diagnoses. Additionally, there are no relevant psychosocial factors, review of systems findings, past medical history, or family history related to this acute condition. 

Objectively, I note the presence of many red singular vesicles along the entire surface of the left lateral thigh from hip to knee, with larger coalescing grayish vesicles. There is no discharge and no surrounding discoloration of the skin. Regrettably, an initial photo was not taken, but the lesions and area affected were impressively extensive.

Case Analysis

Despite the current therapies she has undergone, which include more invasive procedures and medications with strong pharmacologic effects, the vital force still manages to express a clear symptom profile on which to base the homœpathic diagnosis. This indicates a very good prognosis. Often, these interventions can complicate a case because key symptoms necessary to select the best remedy are altered or obscured. The fact that the pain continues to increase suggests that the disease is still in its ascendancy and that proper homœpathic treatment should significantly and rapidly shorten the course of illness without postherpetic sequelae.

Homeopathic case-taking in acute diseases emphasizes changes from a previously healthy state. The primary complaints and sensations described as “as if” are examined thoroughly. Specific anatomical locations and affected tissues are documented. Natural factors causing slight increases or decreases in symptoms, even minor relief, are known as modalities and receive special attention because they often represent the most individualized symptoms. The same approach is applied to all secondary or accessory complaints, referred to as concomitants. While the information necessary for diagnosis is important, identifying specific details about this individual case that distinguish it from generic medical diagnoses is vital for finding the best homeopathic remedy. This also includes the patient’s overall condition and sensitivity, such as their perceptions of temperature, thirst, and mood, to name a few. If symptoms diverge from the normal baseline state, they should be considered significant for individualizing the acute disease. For instance, if someone usually feels chilly but experiences heat during the acute illness, or if they typically have low thirst but suddenly become very thirsty, these changes are noteworthy. The greater the change in these symptoms, the more likely there is a syndrome shift and they need a genuine acute remedy rather than the chronic remedy that addresses their long-standing health issues.

In this case, the vesicular eruptions are located on the left lateral thigh and are accompanied by a burning and tingling sensation that worsens with cold air and initial movement. Additionally, the case is marked by a concurrent feeling of heaviness in the lumbar spine that increases during stepping. She is shivering, experiencing chills, and has a strong craving for cold drinks.

Repertorization was completed using The Bönninghausen Repertory (TBR2). Some commonly indicated remedies for shingles, like Ranunculus bulbosus and Mezereum, are underrepresented in this repertory. If the best options identified through repertorization don’t seem suitable, one can refer directly to the materia medica of these remedies for a quick review.

TBR2¹ – The full rubric breadcrumbs have been left intact for complete reference.

1. General [non regional]{776 1686}; Generals; Eruptions; Vesicles [and bullæ [blisters]] {1511}; zoster [zona, shingles] {1521} (11)

2. General [non regional]{776 1686}; Generals; Eruptions; Vesicles [and bullæ [blisters]] {1511} (77) 

3. Modalities {1687 1694}; Temperature, Seasons, Weather; Warm [& warmth] in general, from [+ amel. Cold in general] {1725}; Covering [warm covers], from {1731} [+ amel. Uncovering]; amel. {1732} [+ aggr. Uncovering] (56) 

4. Systemic {301 775}; Thermoregulatory; Chill; Shivering [shuddering, trembling], with {681} (30)

5. General [non regional]{776 1686}; Generals; Generals; Sensibility altered [paræsthesiæ, pseudoæsthesiæ] {1071}; prickling [tingling, ‘pins & needles’], outer parts {1078}; single parts, as if asleep [‘pins & needles’] {1080} (106)

6. Modalities {1687 1694}; From Situation & Circumstance; Rising, on [on straightening-up, becoming erect] {2120}; bed, on rising from [on getting out of bed] {2122} (76) 

7. Regional {001 300}; Extremities; Lower Limbs; Hip, region of [loins] {275} (111) 

8. Modalities {1687 1694}; From Situation & Circumstance; Stepping [treading] hard, from {2170} (68) 

9. Regional {001 300}; Trunk [torso]; Back; lumbosacral region [small of back] {252} (111)

10. General [non regional]{776 1686}; Generals; Generals; Pressing [& aching], outer parts {1050}; weight, as if from a heavy {1057} (94) 

Differentiating remedies by briefly utilizing both a comprehensive materia medica like Hahnemann, T.F. Allen, or Hering and a summary materia medica such as Phatak or Morrison is an effective strategy to capture both the details and the overall context of how the remedy relates to the case at hand. 

Rhus Toxicodendron

Allen’s Encyclopedia of Pure Materia Medica

1200 – Vesicles, most of which contain a milky but some also contain a clear liquid, become confluent; this condition lasts three days, after which the skin desquamates [4]. 

1201 – A burning eruption of small blisters, filled with water, with redness of the skin of the whole body except on the scalp, palms of the hands, and soles of the feet [23]. 

1410 – While walking in the cold air, he cannot be warmed by any covering; he has a shaking chill in the open air, with violent thirst and mucus between the lips that makes them stick together [1]. 

932 – One hand’s index and middle fingers feel numb and asleep in the morning [1].

1042 – Pain, like a tingling, in the tibiæ at night while the feet are crossed; she is constantly obliged to move the legs back and forth, and on this account, she cannot sleep [1]. 

970 – A pressive pain in both hip joints on every step and a paralyzed sensation in the anterior muscles of the thighs [1].

979 – A left thigh tension extending downward from the hip joint [3].

836 – Heaviness and pressure in the small of the back, as if one had received a blow while sitting (after six days), [3].

Phatak’s Materia Medica of Homœopathic Medicines

Affections of Nerves.

Pains are Tearing, Shooting, Stitching, worse at Night, Cannot Rest in any position.

Numbness.

Worse: Cold air, Uncovering parts, Beginning of Motion.

Better: Continued motion. Heat. Change of position.

Stomach: Craves cold drinks. Great thirst.

Neck and Back: Lumbago.

Extremities: Pains down the back of thighs.

Skin: Skin sensitive to cold air. Eruptions: Vesicular.

Fever: Easily chilled, worse least uncovering.

Morrison’s Desktop Guide to Keynotes and Confirmatory Symptoms 

General aggravation from cold

General aggravation from uncovering

General amelioration from motion

Desires cold drinks

Low back pain

Back pain, better heat

Shingles

He experiences restless sleep, constantly shifts, and can not find a comfortable position.

Cocculus indicus causes numbness but does not prominently exhibit relief from motion as a significant symptom, nor is it highly associated with vesicular or herpetic eruptions. Pulsatilla is well represented in analysis, but many of its symptoms contradict the patient’s condition, such as improvement from uncovering and a lack of thirst. Bryonia alba is considered because of its aggravation from stepping, and while symptoms of vesicles are noted for this remedy, it does not improve with continued motion.

Rhus Toxicodendron is one of the most commonly indicated remedies for acute uncomplicated shingles, but there is no specific homeopathic remedy for any diagnosis. Administering this remedy blindly based on pathology will mostly lead to failure, with occasional success. This particular case involves Rhus-t shingles because the individual symptoms of Rhus-t are clearly present in the patient, unlike the symptoms associated with Arsenicum, Lachesis, or any other common shingles remedy.

Plan: Rhus Toxicodendron 200c in 1oz dropper with 80% water, 20% brandy, one dropperful immediately, succussing 5 times before a dose. Follow-up check in 5 hours to evaluate response to the initial dose.

5 Hours After Initial Prescription: The itching from the lesions has turned into more of a stinging sensation. There is no longer any shooting pain down the legs. 

Plan: There is a clear positive response to the remedy. Repeat if shooting pains return and at bedtime.

Follow-up after 24 Hours: The shooting pains, back pain, and chills have improved. Each remedy dose increases the tingling and burning in the blisters, which lasts for a long time. 

Plan: She continues to respond positively but experiences localized tingling and burning sensations in the lesions after each dose. The remedy is adjusted to 1 dropperful in 4 oz of water, stirred gently, and one teaspoon is taken from the glass. Repeat if symptoms worsen and at bedtime.

Follow-up Day 2: The blisters are scabbing. There is no headache or back pain, and the burning pain does not aggravate after a dose.

Plan: Adjusting the dosage alleviated therapeutic aggravation, and she still responded positively to the treatment. If symptoms recur, repeat the treatment as needed. Call if there is no further improvement.

Follow-up Day 7: Nausea woke her in the middle of the night, so she took charcoal. A new symptom, a “heat rash,” has also appeared on her arms, legs, and stomach. Rhus Toxicodendron does not relieve either of these issues. Mild tingling is present in the shingles lesions, which are improving slightly each day.

Plan: She is no longer responding to Rhus toxicodendron; her symptoms have changed, and a new remedy is needed to complete the cure. She is advised to monitor any modifying factors in her symptoms until the next day to provide additional clarity for the second prescription. Clear modalities often serve as significant indicators that help determine the best remedy choice (§133).

Follow-up Day 8: She reports her energy is back to normal, but her appetite is low. She is very thirsty. The pain in the shingles is gone, and there is very slight itching. The heat rash is a bit better but very itchy. She is no longer cold. 

Case Analysis

The case was re-repertorized based on the new symptoms and remedies complementary to Rhus Toxicodendron. 

Sulfur

Allen’s Encyclopedia of Pure Materia Medica

3414 – Rash over the whole body, with itching sticking [1]. 

3416 –  *Nettlerash, with fever (twenty-sixth day), [1].

1289 – Great thirst, always more thirst than hunger [3].

1399 – At night, qualmish nausea and working at the pit of the stomach, as in waterbrash [1].

Arsenicum album and Nux vomica rank higher than Sulphur in the repertory chart, yet intense coldness or aggravation from cold accompanies nearly all the complaints associated with these remedies. Additionally, Sulphur causes skin eruptions with itching and may present with increased thirst and reduced appetite. It is also frequently indicated to address lingering symptoms following acute illness.

Plan: Sulfur 200c in 1oz dropper with 80% water and 20% brandy, one dropper immediately, succussing 5 times before a dose, and to be repeated if symptoms relapse.
The patient reported a complete resolution of the remaining symptoms with Sulphur 200c.

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References

1. Dimitriadis, G. (2010). The Bönninghausen Repertory: Therapeutic Pocketbook Method (2nd ed.). Hahnemann Institute.

Centers for Disease Control and Prevention. (n.d.). Shingles (Herpes Zoster). U.S. Department of Health & Human Services. https://www.cdc.gov/shingles/about/index.html