Cramping from all sides

A case of Cuprum metallicum by Peter Matu published in a prominent International Homeopathic Journal INTERHOMEOPATHY.

A fifty-six-year-old woman has been suffering for two years from chronic muscle cramps in her legs. The doctors recommended taking magnesium supplements but her condition did not improve at all and it was gradually deteriorating. The sudden spasms often occur just when she is falling asleep or they wake her up during the night. She describes the pain as almost unbearable and sometimes she even cries from pain. The cramps started two years ago, at first only twice per month, then increasing in frequency until she woke up every night. The pain is almost paralyzing and she cannot move; nothing seems to ameliorate her condition. She only obtains a few seconds of relief if she draws her toes down, but this only works for the cramps in her feet.  

Initially, the cramps affected only the calf muscles of both legs.  Later on, the cramps moved into her toes and pulled them upwards. Gradually, the attacks intensified and finally also affected the thighs. The pain is described as a drawing pain. The attacks always come in the night around 9 or 10 pm but never in the day.        

Other complaints: bone spurs (osteophytes), bloating after heavy and fatty food, liver complaints (poor liver function test results), thyroid cysts (the patient is monitored by an endocrinologist), recurrent bronchitis, chronic rhinitis, weakened immune system, chronic fatigue, nervousness.


Medical history: pancreatitis, joint pain and musculoskeletal system problems, recurrent bronchitis, herpes, fever of unknown origin 
Family anamnesis: cancer, epilepsy, diabetes, kidney stones, depression

Generalities
Temperature/weather: in her youth she used to be sensitive to cold, but now she is mildly warm and does not cope well with heat.
Time: < evening, < night, < 10.pm
Desires: smoked meat products, potato mayonnaise salad, fried cauliflower, sweets, coffee, cigarettes
Aversions: sea food, tripe, onion!
Menses: no problems
Sleep: in the past, she had good and deep sleep but in the past few years, it is not so refreshing

Dreams: she has a recurrent dream about a house which is not entirely completed and on which she is working and furnishing.
The patient is a smoker and she is overweight.

Mind
The patient lives in a village in the countryside. She comes from a humble background; her parents were labourers. She also works as a labourer in a factory. She likes her job very much. She is hardworking and looks after her family well. She is not very sophisticated and is not interested in spiritual or philosophical issues. She did not continue her studies at a university level.
She has a serious problem in her marriage; she does not get on well with her husband but she has become used to this unpleasant situation and learned to cope day by day. Her husband is seriously ill and the poor relationship with him has now been pushed aside and is not a major issue at the moment.
In the past few years, the most bothersome problem in her life is a long-lasting issue with her parents, who constantly interfere with her life despite her age. Her children are already grown up and have left home.
She is more fearful than courageous and I can sense some kind of anger and resignation because of her family problems. She lacks self-confidence and is somewhat unsure and undetermined.
She loves dogs, looks after them very well and is quite sensitive to the suffering of animals.

ANALYSIS
The fundamental question that must be addressed in every case is whether to prescribe a homeopathic remedy for the recent (or momentary) situation / pathology of the patient or to look for a constitutional remedy. I now had to face the same situation. When we look at the medical history and the number of health problems that the patient is suffering from (not to mention the problems in her personal life) and the number of chaotic and seemingly unrelated symptoms (furthermore, the situation is complicated by health problems related to smoking, being overweight, lack of exercise, and bad diet), I came to conclusion that it is better to look at this case from the perspective of a very clear two-year old physical problem,  the muscle cramps,  and to take it from there. 

The first remedy which comes to my mind is Cuprum. It is one of the most important remedies for violent muscle cramps at night, especially in the calves. We could think of this remedy even without repertorisation, based only on knowledge of Materia Medica, but the repertorization confirmed this remedy with key indications.

Repertorization

Prescription: Cuprum metallicum 30C

My prescription was based on repertorization and key symptoms of Materia Medica. However, when I took a closer look at the psychological situation of the patient, the overall picture of this case emerged. She has deeply suppressed her emotions (this is in accordance with the picture of Cuprum in Robin Murphy´s Materia Medica) and is “under the scrutiny” of her parents, who constantly interfere in her life. Looking at this case from the perspective of Jan Scholten´s system, Cuprum is aggravated by being observed/watched and is sensitive to criticism. The Iron series could be confirmed by her industriousness and village life, and stage 11 could be explained by the patient´s “convulsive” attempts to hold on to her privacy and to keep control over her private life. 

Follow-ups
The first follow up was after four weeks and I was surprised how well the remedy worked. The attacks of cramping subsided swiftly after administering only one dose.
After six months, there still has not been a single night with cramps, though there were a few “attempts”,  which never turned into real cramps, and it was enough for the patient to think of the administered remedy (here, I must emphasize that the patient did not know the name of the remedy given, she only thought of the white homeopathic globules), and the signals of the approaching attack and the muscle tension immediately disappeared, so there was no need to repeat the remedy.  I find this really fascinating and somewhat shocking. Homeopathy never ceases to surprise me. It just shows how little we really know about how homeopathy works and that we are only somewhere in the beginning of our voyage into the depths of homeopathy.

It is possible that I might need to repeat the remedy or change to potency later on, but so far so good and at the moment the patient is happy and satisfied with the results and with the fact that she can peacefully sleep without painful cramps.
She also mentioned that she is no longer so anxious in relation to her parents; she has become much more relaxed and does not take their “caring” approach so seriously. In other words, she is less “convulsive” in her relationship with parents.

Keywords: muscular cramps, bone spurs, thyroid cysts, bronchitis, suppressed emotions, sensitive to criticism

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