IJFIRH - 2024, Volume - II, Issue - IV [October to December 2024]

e-ISSN No- 3048-6270

Published by Homoeopathic Chronicles

HOMOEOPATHIC PERSPECTIVES ON DERMATOME DYNAMIC: A REVIEW STUDY

Ishwarya.M 1, Sibin R.A2

1Final year BHMS, SaradaKrishna Homoeopathic Medical College, (Affiliated to The TamilnaduDr. M.G.R Medical University, Chennai), Tamil nadu – 629161.

2Assistant Professor, Department Of Organon Of Medicine, SaradaKrishna Homoeopathic medical college, (Affiliated to The TamilnaduDr. M.G.R Medical University, Chennai), Tamil nadu – 629161.

Article Received: 18 November 2024 - Accepted: 22 December 2024 - Article published online: 30 December 2024 

DOI: https://doi.org/10.59939/3048-6270.2024.v2.i4.5

BACKGROUND

Dermatome regions of skin innervated by spinal nerve fibers, are integral to understanding nerve-related and inflammatory conditions1. In homoeopathy, remedies are chosen based on symptomatology and their potential influence on dermatomal patterns. It plays a critical role in understanding how the nervous system communicates with the body. Each dermatome corresponds to a specific spinal segment, enabling precise mapping of nerve function and sensory input. Dermatomes helps in diagnosis of neurological disorders, pain distribution, injury and recovery, referred pain and in therapeutic application2.

By examining existing literature and Materia medica, the review study explores their therapeutic relevance to dermatome dynamics, providing insights to enhance clinical application in homoeopathic practise3.

METHODOLOGY

This article examines the relationship between dermatome and homoeopathic remedies by analysing conceptual frameworks. A systemic review of literature, including clinical studies on dermatome and Materia medica was conducted to evaluate remedies. The focus is on correlating dermatomal symptom patterns with the therapeutic indications of these remedies, providing innovative insights into their application in homoeopathic practise4.

DISCUSSION

DEVELOPMENT OF DERMATOME CONCEPT

The dermatome concept has evolved from early anatomical mappings by Sherrington who linked specific skin regions to spinal nerves roots5. Initially focused on sensory innervation, the concept expanded with advances in clinical research, particularly in understanding pain and nerve pathologies like radiculopathy. Recent developments have integrated dermatomes into therapeutic frameworks, including homoeopathy, where they guide the selection of remedies for specific sensory or pain-related conditions6. This evolution reflects a deeper understanding of both anatomical structures and their clinical application.

IMPACT OF BODY DERMATOME

Dermatome mapping helps identify the location of nerve root compression, injuries, or infections such as in herniated discs, spinal cord lesions or shingles.

Nerve-related pain often follows dermatome patterns aiding in differentiation of conditions, pain radiates along the corresponding dermatome7.

Dermatome explain why internal organ dysfunction can produce referred pain in associated dermatomal region.

Dermatome are reference point for therapeutic interventions, includes nerve blocks, acupuncture and targeted physical therapy and influence homoeopathic remedies aimed at specific nerve-related conditions8.

DERMATOME ACCORDING TO THEIR REGION

CN V1 -  forehead and nose

CN V2 –Skin over the cheek bones and maxilla (upper jaw)

CN V3 – Skin over the mandible (lowerjaw)

C1 – Posterior neck near the external occipital protuberance

C2 – Covers the posterosuperior aspect of the head

C3 – Innervates the anterior neck, posterior aspect of upper neck and head as well as the supraclavicular fossa

C4 – Provides sensation to the shoulder, the skin over the infraclavicular fossa and posterior lower neck

C5- Lateral aspect of the arm

C6 – Radial side of the forearm and the thumb

C7 – Posterior forearm and the middle finger

T1 – Extends along the medial forearm and distal arm

T2 – Covers the medial proximal and continues into the axilla

T4 & T5 – Covers the nipple

T6 – Positioned anteriorly at the level the xiphoid process

T7-T9 – Spaced anteriorly between T6 and T10 dermatome

T10 – Anteriorly at the level of umbilicus

T11 – Anteriorly between the T10 and T12 dermatome

T12 – Located in pelvic griddle

L1 – Lateral skin near the L1 vertebra and anteriorly to groin, pelvic gridle over the inguinal canal

L2 – Covers the anterior thigh below the inguinal canal

L3 – Medial thigh and leg midway between L2 and L4

L4 – Extends from lateral thigh to medial leg and foot, include the knee, big toe and medial malleolus

L5 – Covers posterolateral part of thigh, foot include toes 2-4

S1 – Covers the popliteal region, lateral leg and foot, heel and little foot

S2 – Extends from buttocks to posteromedial thigh includes the pennis and scrotum anteriorly

S3 – Covers the medial buttocks, perineal area and anteriorly penis and scrotum

S4 – Includes the perineal area and genitals

S5 – Covers the perineal skin around the anus9.

HOMOEOPATHIC MEDICINAL SYMPTOMS CORRELATING WITH ACTION OF DERMATOMES

Cervical Dermatome (C1-C8)

Remedies:

1. Abrotanum

Pricking and aching pain radiates to shoulder joints to elbow and to fingers.

Worse by cold air.

2. Aconitum Napellus

Sudden neuralgic pain in the neck and shoulder with numbness

Neuralgic pain worse by dry cold air, sweat and better with warmth.

3. Arnica Montana

Bruised and lame pain in shoulders.

Worse by touch, better by rest.

4. Arsenicum Album

Burning pain radiates from neck to shoulder and down to arms.

Pain worse at night.

5. Belladonna

Shooting and congestive pain radiating to head to neck and to the arms.

Parts felt redness and hot.

Worse from touch and movement.

6. Bromium

Neuralgia and numbness over neck shoulder and upper arm with burning, itching and discomfort in that region corresponds to C5, C6 dermatomes.

7. Bryonia Alba

Sharp pain with stiffness in neck extends to arms.

Worse by motion, better by rest and pressure.

8. Calcarea Carbonica

Itching, eczema occur over upper chest, arms with cold chilly sensation corresponds with T2-T5 dermatome.

9. Carbo Vegetabilis

Cold feeling around the mouth, cheek affects the C2-C3 dermatome it appears pale and cyanotic.

10. Cimicifuga Racemosa

Stiffness and pain along cervical nerves, muscular pain.

Worse with cold and dampness.

11. Conium Maculatum

It involves numbness and radiating pain from neck to shoulder.

Worse by sudden motion.

12. Fluoricum Acidum

Burning and tingling sensation C5 dermatome especially in nerve impingement

Cervical nerve pain as like sharp and stabbing in nature.

13. Gelsemium Sempervirens

Numbness, weakness and tingling in arms.

Worse by emotions and excitement.

14. Hypericum Perforatum

Nerve injuries in the cervical region with burning and tingling pain.

Pain travel along cervical nerve root with sharp and lancinating sensation in neck, arm and hand.

15. Kali Carbonicum

Severe stabbing pain and numbness down the arms radiates from neck to arm.

Worse by touch, difficulty in turning head.

16. Kalmia Latifolia

Sharp and shooting pain from cervical nerves to arms associated with weakness.

17. Rhus Toxicodendron

Cervical nerve pain with stiffness and radiation especially after rest or immobility.

Better by warmth and movement.

18. Ruta Graveolens

Pain radiates from neck to arms may worsen with overuse and cold weather.

Aching pain in neck.

19. Spigelia Anthelmia

Sharp shooting pain in neck radiates to shoulder along nerve pathway.

Worse by motion, and better by warmth and rest.

20. Staphysagria

Pain starts in neck and radiates to the upper limbs particularly with emotional triggers.

A lack of control over the affected limbs.

21. Plumbum Metallicum

Numbness and tingling sensation of coldness in the extremities.

Pain may be severe and is aggravated by motion.

Thoracic Dermatome (T1-T12)

Remedies

1. Abrotanum

Nerves are incapacitated weakness around chest with internal trembling when excited.

Neuralgic pain in thoracic muscles, averse to exercise.

2. Aconitum Napellus

Sudden stabbing pain in the chest, back or ribs often with sensation of tightness.

Pain may radiate to the arms and worsen with cold air and at night.

3. Arsenicum Album

Burning pain along thoracic nerves, especially in chest, ribs and radiates to the arms

Worse at night and with cold air, better by warmth.

4. Baryta Muriaticum

Herpes shingles along thoracic nerves with delay healing.

5. Bromium

Shingles with blistering rash following the T3-T6 dermatome around the chest with burning pain and itching.

6. Bellis Perennis

Bruised pain in the chest, along thoracic nerve root.

Pain radiates to the sides and the person may feel sensitive to touch.

7. Cantharis Vesicatoria

Vesicular eruption in chest along thoracic nerve with itching and dryness.

Burning pain with eruption.

8. Causticum

Paralytic sensation and drawing pain in thorax.

Worse from exposure to cold air.

9. Mezereum

Post-herpetic neuralgia with burning pain and vesicular eruption along course of thoracic nerve.

10. Ranunculus Bulbosus

Sharp, stabbing intercostal pain suited for herpes zoster eruptions.

11. Rhus toxicodendron

Burning, tingling and stiffness along thoracic nerves.

Better with motion.

12. Ruta Graveolens

Pain from thoracic area radiates to arm or sides with deep sensation.

Worse by movement, bending and exertion.

13. Spigelia

Intense, shooting pain along the ribs, chest sometimes radiating to the arms.

It usually accompanied with sense of heaviness or tightness.

14. Sulphur

Itching, crawling and burning sensation especially in chest.

Lumbar Dermatome (L1-L5)

Remedies

1. Aconitum Napellus

Paralyzed sensation with tensive pain in lumbar region.

Worse by cold and damp weather.

2. Aesculus Hippocastanum

Aching pain in lower back radiates to hips and thighs (L4-S1).

Worsen after prolonged sitting and standing.

3. Agaricus Muscarius

Vertebrae sensitive to a hot sponge, paraplegia from congestion of lumbar part.

4. Bryonia Alba

Severe lumbar pain radiates down the legs (L5-S1), stiffness and soreness.

Worse by slightest motion, coughing, deep breathing and better by rest.

5. Bellis Perennis

Bruised, sore pain in the lumbar region extends to legs, often following injury or overexertion.

Pain can be deep and radiating, similar to sciatica.

6. Berberis Vulgaris

Neuralgic pain extending from lumbar region to legs along sciatic nerve sharp and shooting in nature.

7. Causticum

Weakness or paralysis in lower back to legs (L4-L5 dermatome).

Worse by bending back, lifting the legs, particularly after standing or walking for a while. 

8. Colocynthis

Neuralgic, cutting pain radiating down the thigh along nerve course.

Better by pressure and warmth.

9. Flouricum Acidicum

Stiffness and intense pain in lumbar region radiate to legs.

Worsen by movement and cold.

10. Gnaphalium Polycephalum

Sciatic nerve pain with numbness and tingling sensation in lumbar region radiates to lower extremities.

Better by lying down.

11. Nux Vomica

Stiffness, cramping and pain in the lower back with radiation to the legs.

Worse in the morning, after periods of inactivity.

12. Phytolacca Decandra

Dull aching pain in lower back radiates down the legs (L2-L4 dermatome).

Worse by movement and prolong sitting.

13. Rhus Toxicodendron

Pain and stiffness in the lower back, with radiation to legs (L2-L4 dermatome).

Worse with first movement, when still for too long, and warmth.

14. Ruta Graveolens

Bruised pain and paralyzed sensation in lower back after trauma, strain or injury.

15. Sulphur

Burning painful sensation in the lower back that radiates to the hips and legs (L2-S1 dermatome).

Pain worse with warmth, night.

16. Tellurium Metallicum

Shooting pain from lumbar region to thighs often with vesicular eruptions.

Sacral Dermatome (S1-S5)

Remedies

1. Actea Spicata

Bruised pain in sacral region

Worse by open air and debility when walking in it.

2. Agaricus Muscarius

Burning, tingling and spasmodic twitching in sacral region.

Worse from cold air and during winter.

3. Argentum Nitricum

Radiating pain in the lower back and sacrum, accompanied by numbness, tingling sensation in legs (S1-S3 dermatome).

Worse with cold.

4. Aurum Metallicum

Deep aching pain in the sacral area or lower back, radiating into buttocks and legs (S1-S3 dermatome).

Worse by standing.

5. Baryta Carbonica

Numbness in sacral region radiates into the legs in the nerve course.

Sensation of instability.

6. Chamomilla

Severe stabbing pain in sacral area radiates to buttocks (S1-S2 dermatome).

Worse by night and touch.

7. Causticum

Tearing and burning pain with paralytic weakness in the sacral region.

Worse in dry, cold weather, better with warmth.

Weakness and paralysis in lower back, pain radiates to legs (S1-S3 dermatome) and numbness in legs.

8. Cinchona Officinalis

Weakness and aching pain in the sacral region radiate to legs (S1-S4 dermatome).

Worse by touch, better by rest.

9. Dulcamara

Sciatica pain radiates from back to leg especially in sacral region.

Sensitive to weather changes, worse by cold and damp weather.

10. Kali Carbonicum

Neuralgic pain and weakness in sacral area especially after childbirth.

11. Ledum Palustre

Urethral herpes pain S5 dermatome.

Symptoms: Stiffness or aching pain in the sacral region, with a tendency to worsen at night. The pain may radiate down the legs and is often relieved by cold or cold compresses.

12. Phytolacca Decandra

Shooting and aching pain in sacrum to thighs.

Worse in damp and cold weathers.

13. Rhododendron

Pain in the sacrum radiating down the legs, particularly when the weather changes (often worse during cold, damp conditions).

14. Silicea

Numbness, tingling or weakness in S1-S4 dermatomes particularly in the buttocks, thighs or feet.

Worsen by cold weather.

15. Sepia Officinalis

Dragging pain in sacrum along nerve course with weakness and bearing down sensation.

16. Zincum Metallicum

Neuralgic pain, numbness in sacral region.

Worse at night.

Coccygeal Dermatome

Remedies

1. Aceticum Acidum

Diminished sensibility in coccyx region.

Bruised pain in coccygeal region.

2. Cimicifuga Racemosa

Coccygeal pain and stiffness.

3. Hura Brasiliensis

Aching pain in the coccyx, radiates to buttocks or thigh, bruising and fullness feeling in coccygeal area.

Worse in night and cold weather.

4. Hypericum Perforatum

Severe coccygeal pain following fall radiating along nerve pathway.

5. Millefolium

Pain associated with nerve irritation, radiating pain from coccyx to the perineum and thighs

Worsen by sitting and improve with movement.

6. Ruta Graveolens

Sore and paralytic sensation in coccyx after injury or trauma.

Worse from sitting and touch. 

7. Silicea

Increased sensitivity in coccyx after surgery.

8. Spigelia Anthelmia

Sharp shooting pain that radiates along specific nerve path such as coccyx, perineum and legs with neuralgia (S5 dermatome).

9. Staphysagria

Cutting pain in the coccyx radiates to perineum and thighs.

Worse with touch and pressure.

10. Phosphrous

Burning pain radiates in coccyx extend to perineum, genitals and thigh.

It may worsen with lying on the back or sitting for long period

CONCLUSION

Dermatomes are reference point for therapeutic interventions, including nerve blocks, acupuncture, and targeted physical therapy, and also influence homoeopathic remedies aimed at specific nerve-related conditions. In homoeopathy, remedies are often employed to address dermatomal pain and inflammation aligning treatment with the body’s dermatomal patterns for enhanced therapeutic outcomes.

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4.  Kulkarni KV. A Clinical Study on ‘Sciatica’ItsMiasmaticApproch and Homoeopathic Management (Doctoral dissertation, Rajiv Gandhi University of Health Sciences (India)).

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