Abstract
M.Tech. (Homeopathy)
Students of Chiropractic, attending the University of Johannesburg (UJ), start the practical component of their training from their third year of study (Bunge & Tyranes, 2007). Each student must be proficient in 250 adjustments (200 of which must be spinal) by the end of their fifth year of study (Fletcher et al., 2005). As these manual manipulations are complex psychomotor skills, they require a good deal of practice to master (Bunge & Tyranes, 2007). Due to the practical nature of the course, Chiropractic students are required to practice their techniques of adjustment on each other. This places the students under a great deal of physical and mental strain as adjustments and techniques designed to reduce pain and restore normal musculoskeletal and neurological function in the presence of pathology are being consistently and repetitively applied to healthy individuals (Ebrall, 2003). This in turn results in the individuals experiencing various adverse effects such as headaches, muscular pain and joint pain (Bergman & Peterson, 2011; Botha, 2011; Venter, 2011). Conventional treatment for musculoskeletal pain (such as the use of non-steroidal anti-inflammatories and analgesic drugs) can be costly and are known to have potential adverse effects (Neal, 2002). No research has been done to date on the effect of Homoeopathic Similimum treatment on musculoskeletal pain, as a result of practicing adjustments in Chiropractic students.
The aim of this study was to determine the efficacy of the Homoeopathic Similimum on musculoskeletal pain produced in Chiropractic students (attending the University of Johannesburg) as a result of practicing adjustments, by means of a Numeric Pain Scale Rating as well as via a 5-Point (Likert-type) Treatment Satisfaction Scale.
This was a 2 week, randomised double-blind placebo-controlled, matched-pair study using 30 participants (third to fifth year UJ Chiropractic students, males and females, aged 20-35). Participants who met the inclusion criteria were matched according to the body-region affected (i.e. head, upper limb, back, lower limb or whole body) (Appendix C); they were then randomly divided into either the placebo or treatment group. Thereafter, an initial case-taking and focused physical examination (including vital signs) was conducted and the initial Numeric Pain Scores (baseline measurements) obtained (Appendix C) (Cox, 2010). The participant’s case was analysed, repertorised (using the Mercurius Computer Repertory-The Complete Repertory 2012) and the Similimum remedy was selected. The Homoeopathic Dispenser dispensed the medications and participants received either their Similimum remedy (in a 30cH potency to be administered in a dosage of 5 pillules once a day and as needed by the individual participant) or the placebo (composed of unmedicated pillules with identical dosage instructions). A follow-up consultation (on day 7) was conducted to assess progress, obtain the participant’s intermediate numeric pain score and to assess the prescription (Appendix E). After careful evaluation of the case, the researcher considered (depending on the participant’s response to the initial treatment) whether to change the prescription, alter the repetition of the dose, continue the same course of treatment or to stop the prescription altogether. On day 14 a final consultation was conducted (including a final physical examination) to assess overall progress, obtain final Numeric Pain (Appendix E) and Treatment Satisfaction Scores (Appendix F) (Cox, 2010; Pellegrin et al., 2001) and terminate prescriptions.
Data collected from the Numeric Pain Scale Ratings and Treatment Satisfaction Score Sheets was analysed by STATKON. Frequencies, descriptives and cross-tabulations were done. The Shapiro-Wilk test assessed normality. A Mann-Whitney test was used to compare the two groups. Comparisons over time for each group were assessed using a Friedman test and a Wilcoxon Signed Ranks test was done to ascertain where the differences occurred (Smith, 2011).
The Friedman test results showed significant differences in both groups (i.e. the pain scores decreased in comparable increments for both groups over the two-week study period) and the Wilcoxon Signed Ranks test showed that both groups’ pain scores started to decrease at the 2nd consultation (i.e. at the end of week one). The results of the Mann-Whitney test showed that there were no statistically significant differences between the treatment and placebo groups, either in terms of reduction of pain or participant satisfaction with treatment. Therefore it can be concluded that the Homoeopathic Similimum was not more effective than placebo in the treatment of musculoskeletal pain experienced by UJ Chiropractic students as a result of practicing adjustments. However, further research utilising a larger study sample and a longer period of study should be conducted before any definitive conclusions can be drawn.