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AVN (Avascular Necrosis), also known as osteonecrosis, bone infarction and ischemic bone necrosis/aseptic necrosis, refers to a condition that leads to the death of bone cells due to interruption in blood supply. Avascular Necrosis can be a cause of intolerable pain in the bones. Since the blood supply to the bone is disrupted, the bone breaks and finally collapses. AVN could damage almost any bone in the body, but it mostly has an effect on the hip joints, knees and shoulder joints. One or more bones may be affected at a given time.
Homeopathy provides a very effective and safe treatment to manage cases of AVN. Homeopathic remedies halt the further damage of bones among the patients of avascular necrosis that is cause due to interrupted in the blood supply. It also reduces the pain in the bones because of bone damage. There are several natural remedies in homeopathy that can help relieve pain and stiffness, and improve the range of movements of the joint. These medicines use the body’s own restorative process to fight back against the disease.
How Homoeopathy Treats Avascular Necrosis
1. Safe and Free from Side-Effects: Homeopathy helps treat AVN very safely. It uses naturally obtained medicines and helps in the healing process with no side effects. Homeopathy provides relief to patients suffering from AVN in the hip joint or any other joint. Conventional treatment usually recommends the use of painkillers (NSAIDs), which can provide short-term symptomatic relief but may have side effects and may even be habit-forming. On the other hand, homeopathy ensures long-term relief without any adverse effects.
2. Individualized Prescription: The homeopathic medicines are prescribed after evaluating the case history of the patient. The medicines are administered based on the bone involved, the type of bone pain and other peculiar symptoms in each case. The duration of homeopathic treatment for AVN varies from several months to a year or two, depending on the stage, chronicity, and severity of the complaint.
3. Non-Invasive and Gentle Treatment: Homeopathy can be a great alternative to surgery in AVN cases. Surgery should be the last option when all the alternative treatment methods have been exhausted. Although homeopathic medicines will not reverse the changes that have already taken place, they can surely provide remarkable symptomatic relief. The results of homeopathic treatment vary according to the intensity and stage of AVN. Unfortunately, AVN is not curable and there is no current treatment method available in any system that claims to reverse pathological changes that have already taken place in AVN cases. But with proper homeopathic treatment, the progression of bone changes in AVN can be slowed down and symptoms can be eased to a great extent.
4. Effectiveness of medicines in different Stages of AVN: Homeopathy brings significant improvement and great results in grade 1 and 2 cases. It has a limited role for grade 3 AVN patients and a very minimal role to play in cases of Grade 4 AVN. All the cases in these stages might not respond equally well to treatment. In these stages, homeopathic medicines can be considered along with other treatment options to provide a collective relief to whatever extent in a given case.
Top 10 Homeopathic Medicines For AVN
The top recommended homeopathic medicines for treating AVN are Syphilinum, Strontium Carbonicum, Natrum Sulphuricum, Fluoricum Acidum, Asafoetida, Silicea Terra, Symphytum Officinale, Phosphorus, Calcarea Fluorata and Aurum Metallicum.
1. Syphilinum – Top Grade Remedy for Bone Pains at Night
Syphilinum is a well-known remedy that benefits the body tissues wherever the destructive process is ongoing. Due to its universal healing properties that halt the destruction of body tissues, Syphilinum is of great help in treating bone necrosis.
The most dominant feature for administering Syphilinum in any given case of AVN is the worsening of bone pains at night. The patient experiences pain throughout the night and is unable to sleep due to intense pain. The pain may compel the patient to walk, which brings relief. However, such patients remain comparatively well the whole day. Another marked symptom that can help in selecting Syphilinum for AVN cases is a specific pattern regarding the appearance and disappearance of pain. The pattern followed is a gradual rise in bone pain and, in the same way, a gradual disappearance. The third symptom that may be present in a few AVN patients who need Syphilinum is worsening of pain because of heat and some relief by applying cold water. A history of excessive alcoholism may be present among the patients who need this medicine.
When to use Syphilinum?
Syphilinum is a top medicine prescribed for managing AVN cases when bone pains aggravate at night and due to heat.
How to use Syphilinum?
Its use is recommended in high potencies like 200C, 1M, though in infrequent doses. Initially, one dose can be used in 200C potency only once in 15 days or after a gap of at least one month. For any changes in dose or potency, consulting a qualified homeopath is a must.
2. Strontium Carbonicum – For Avascular Necrosis of Femur (Bone In Thigh)
Strontium Carbonicum is a natural remedy recommended for cases of AVN of the femur bone. Those who need it report worsening of pain in cold air. Besides AVN, it is a key medicine to deal with cases of weak and brittle bones prone to breaking easily.
When to use Strontium Carbonicum?
This medicine is suitable for managing AVN of the femur bone when pain aggravates from cold air exposure.
How to use Strontium Carbonicum?
This medicine can be administered in 30C potency one to two times daily for the best possible results.
3. Natrum Sulphuricum– For Hip Joint Necrosis
Natrum Sulphuricum should be the top consideration in cases of AVN of the hip joint. Natrum Sulph is one of the most beneficial medicines when dealing with hip joint AVN. The patient mainly complains of pain during movement or while stooping.
When to use Natrum Sulphuricum?
This medicine can be administered in cases of AVN of the hip joint when pain gets worse from movement and stooping.
How to use Natrum Sulphuricum?
This medicine is usually recommended in 6X potency (biochemic form). Natrum Sulph 6X can be ingested three to four times daily.
4. Fluoricum Acidum –For Avascular Necrosis Of Long Bones
Fluoric Acid is the most effective for the necrosis of long bones. The bones include the humerus (bone in the upper arm), the femur (bone in the thigh) and the tibia (bone in front of the leg). Fluoric Acidum is mostly used to halt necrosis that surfaces in the long bones. Those who need it usually have excess body heat; on top of that, any external heat worsens the condition. Apart from long bones, necrosis of the bones of the ear (which is rarely the case) is also covered under Fluoric Acid, which helps in improving the blood circulation and preventing further necrosis of bones.
When to use Fluoricum Acidum?
This medicine is mostly indicated for AVN affecting long bones, such as the upper arm, thigh and leg, when pain in general aggravates from the application of heat.
How to use Fluoricum Acidum?
This medicine can be administered in 30C potency one to two times a day as per the intensity of the symptoms.
5. Asafoetida – For Necrosis Of Tibia Bone (A Bone In Leg)
Asafoetida is a wonderful remedy for AVN of the tibia. There is worsening of pain at night along with over-sensitivity in the bones. The pain in the bone can be darting, sharp or stitching in nature.
When to use Asafoetida?
Its use is advised when AVN involves the tibia bone in the leg with pain at night along with marked sensitivity to touch.
How to use Asafoetida?
Though this medicine may be used in different potencies, it is best to begin with the 30C potency one to two times daily. Higher potencies like 200C and 1M can also be considered afterwards, but only under the supervision of a qualified homeopath.
6. Silicea Terra – For Bone Pains Worse From Cold Air Exposure
Silicea is considered among the best natural medicines for necrosis (premature death of cells) of a variety of bones, ranging from long to small bones. If one is afflicted with the necrosis of wrist, jaw bones, bones of the hands, feet, ankle, knees and long bones —including humerus (bone in the upper arm), femur (bone in the thigh) and tibia (bone in front of the leg) —Silicea Terra is the remedy to go for. The general symptom for using Silicea is sensitivity to cold air, when bone pain worsens even from the slightest exposure to cold air. Warmth brings relief.
When to use Silicea Terra?
This medicine can be administered for AVN with prominent bone pains that worsen from exposure to cold air and one gets relief from warm applications.
How to use Silicea Terra?
It can be used in 6X potency three to four times a day for the best possible results.
7. Symphytum Officinale – For Managing Bone Fractures
Symphytum can be administered in all cases where there is a bone fracture. It helps in proper bone knitting. It helps provide the necessary callous material needed for bone reformation. So, in every case of fracture where Symphytum is used, it acts as a preventive agent against necrosis, as the bone is very neatly and efficiently woven by this medicine.
When to use Symphytum Officinale?
This medicine is of great use to deal with bone fractures in cases of AVN.
How to use Symphytum Officinale?
This medicine is mostly used in Q (mother tincture) liquid form twice to thrice daily.
8. Phosphorus– For Necrosis Of The Jaw
Phosphorus is an effective remedy for treating lower jaw AVN. It is of great help when the lower jaw is affected due to a lack of blood supply. It is pertinent to mention here that Phosphorus is used in match-box making factories, and the workers may acquire AVN in such factories by inhaling phosphorus fumes day in and day out.
When to use Phosphorus?
Its use is highly suggested for managing AVN, particularly of the jaw.
How to use Phosphorus?
Phosphorus 30C can be used once or twice a day for the best possible results.
9. Calcarea Fluorica – For Chronic Inflammation of Bones
Calcarea Fluorica is a deep-acting tissue remedy mainly affecting bones, joints and fibrous tissues. It is especially indicated in hard, indurated swellings, chronic inflammation of bones, exostosis, osteitis and degeneration of bone structure, which makes it very useful in early and middle stages of AVN, where bone nutrition is impaired and gradual structural weakness begins. Patients who need Calcarea Fluorica often have deep-seated bone pain that worsens from rest and at night, but it gets better from gentle motion. There is also stiffness of joints and a tendency for a long-standing condition. It helps in improving bone elasticity and preventing further collapse of the femoral head.
When to use Calcarea Fluorica?
Calcarea Fluorica is administered in early AVN, stiffness of the hip joint, beginning necrosis, post-steroid or post-traumatic AVN, and cases showing slow, chronic progression rather than acute inflammation.
How to use Calcarea Fluorica?
It is commonly used in low potency, like 6X or 12X, two times a day.
10. Aurum Metallicum- For Deep Bone Pains in Advanced Stages of AVN
Aurum metallicum acts profoundly on the periosteum and bones, producing deep, destructive bone pains, caries and necrosis. It is especially administered in advanced bone degeneration, where there is severe pain during the night, unbearable deep bone aching, and marked sensitivity, often associated with mental depression, hopelessness and despair. In AVN cases, Aurum Metallicum is administered when necrosis is progressive, pain aggravates at night, and the patient feels mentally low due to the chronic nature of the disease and movement restriction. It is particularly suited for advanced cases of AVN. Accompanying symptoms are bone destruction, especially when there is noticeable emotional suffering.
When to use Aurum Metallicum?
Aurum Metallicum is administered in advanced AVN, severe night pains, progressive necrosis, and among patients showing marked depression, irritability or suicidal thoughts due to prolonged illness.
How to use Aurum Metallicum?
It is generally prescribed in 30C or 200C potency, once a day or once a week.
Symptoms Of AVN
In the beginning, the patient notices no symptoms. But with more blood cells dying, more pain is felt in the affected joint. For example
1. In case of AVN of the hip joint, pain may be felt in the groin, the thigh or the buttock. Initially, pain is felt when the joint is put under pressure.
2. In case of hip or knee AVN, walking, standing, and stair climbing become difficult. One limps while walking. As the condition reaches the most advanced stage, pain in the affected joint intensifies due to small breaks in the bone and pain becomes a constant feature.
3. Other symptoms include stiffness of the joint and limited range of movement at the joint. When the condition has progressed to an extreme level, the bone collapses and the patient is unable to use the joint. The symptoms of AVN may be noticed on both sides of the body.
4. In AVN of the jaw, pus may be present.
Bones prone to AVN
Avascular Necrosis may involve almost any bone of the body, but it mostly affects hip joints, knees and shoulder joints. Among these, the hip joint is the most commonly involved joint; the bone mainly involved is the head of the femur (a bone in the thigh extending between the hip and the knee). The humerus (bone in the upper arm extending between the shoulder and the elbow) is the second most commonly affected bone. Scaphoid bone (bone in wrist), jaw, ankles, hand and foot may be affected.
Causes and Risk Factors Behind AVN
AVN results from decreased or hindered blood supply to the bone. Reduced blood supply to the bone causes death of bone cells. Under normal circumstances, our body keeps replacing old bone tissue (which gets damaged as a part of daily wear and tear) with new bone tissue to keep bones healthy and maintain their strength. Blood supply to bones provides oxygen and nutrients essential for the regeneration of new bone tissues. If, for any reason blood supply to the bone is hindered, our body becomes unable to make new bone tissue at the right pace. As a result, the old-aged bone breaks down and dies.
AVN may happen for many reasons. Broadly, the causes can be divided into two categories:
1. Traumatic AVN: It occurs after a bone fracture or joint dislocation
2. Non-traumatic AVN: It arises from some medical health problem that is causing obstruction of the blood supply to the bone. In most of the cases of non–traumatic AVN, the same bones on either side of the body get affected, like AVN of the left hip and AVN of the right hip.
The various causes and risk factors are enumerated below:
1. Injury/trauma: Injury or trauma can reduce or halt blood supply to a bone, which is the main cause of AVN. For example, a joint dislocation or a fracture (broken bone).
2. Smoking: Smoking makes the blood vessels narrow, which reduces blood supply to body tissues, including those of the bone.
3. Excessive consumption of alcohol:It is known that alcohol can lead to hyperlipidemia (increased level of lipids means fats like cholesterol, triglycerides, in the blood) and fatty deposits in blood vessels. High levels of fat tend to block blood vessels and reduce blood flow.
4. Excessive use of steroid medication: Steroids like prednisone, for a prolonged period, also makes a person prone to developing AVN. The reason is that these medicines can raise lipids (fat) in the blood, which causes blockage of small blood vessels.
5. Exposure to radiation and chemotherapy used for cancer treatment predisposes a person to AVN.
6. Bisphosphonate therapy used in the treatment of bone cancer and osteoporosis makes a person prone to AVN. It is mainly related to the cause AVN of the jaw.
7. Decompression sickness/caisson disease (a medical condition in which bubbles form in the blood of a person from a rapid decrease in surrounding pressure), and Leg-Calve Perthes disease (a condition that sets in during childhood from interruption of blood supply to the head of the femur of the hip joint).
8. Other risk factors are high cholesterol, HIV infection, rheumatoid arthritis (an autoimmune joint disorder causing inflamed, stiff, painful joints especially starting from small joints and later on may involve large joints as well), high blood pressure, sickle cell anemia (Inherited disorder affecting shape of red blood cells, RBCs become sickle shaped that can slow blood flow), leukemia (blood cancer), Gaucher disease (build-up of fatty substance in certain organs), organ transplant like kidney transplant, pancreatitis, SLE (Systemic Lupus Erythematosus – an autoimmune disease causing inflammation and damage to various organs), and HIV.
9. Sometimes AVN sets in without any cause, for example, spontaneous AVN in the knee (known as SPONK or SONC).
10. In some cases, the reason for interrupted blood flow is not known, for example, in Kienbock disease (breakdown of a bone in the wrist known as the lunate bone from interrupted blood supply) and Preiser’s disease (AVN of the scaphoid bone, which is one of the bones in the wrist).
11. Chances of AVN are higher in men than in women.
12. Those aged between 30 and 60 years are the most at risk, though it can happen to people of any age group.
Pathophysiology Of AVN
AVN begins when there is a decrease in subchondral (bone lying beneath the cartilage) blood supply. It leads to low oxygen (hypoxia) in bone tissue, resulting in death of cells (necrosis) of bone. It is suggested via experimental evidence that bone cells die within 12 hours to 2 days from reduced blood supply and low oxygen levels. With progression of the condition, degeneration and the collapse of the joint occur.
Stages of AVN
There are four stages defined according to the progression of AVN
Stage I: In this stage, X-ray is normal, but in MRI, dead bone can be detected.
Stage II: X-ray can reveal bone damage changes related to AVN. At this stage, the collapse of bone of femoral head has not taken place.
Stage III: X-ray shows a sign of bone collapse (crescent sign).
Stage IV: It is the serious stage. At this stage, X-ray shows bone collapse and significant cartilage damage (osteoarthritis)
Ficat Classification: Four stages classification system of AVN based on standard radiographs
Stage I – Normal radiograph
Stage II – In this stage femoral head contour is normal, but in radiographs, signs of bone remodelling are seen (cystic and sclerotic portions)
Stage III – Flattening of the femoral head occurs in this stage
Stage IV – It is characterized by a narrowed joint space and degenerative signs in the acetabulum.
Frequently Asked Questions of AVN
1. I have hip pain for the last 6 months. Am I suffering from AVN?
Hip pain may arise from various causes. AVN is just one among those causes. Other reasons might be osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. Therefore, hip pain does not confirm AVN.
2. Is groin pain indicative of hip AVN?
Though groin pain can be one symptom of hip AVN, not all those with groin pain are actually suffering from AVN. There could be other reasons, for example, inguinal hernia, kidney stones, sprains, tendinitis, pinched nerve, UTI (urinary tract infection), and certain problems in males like hydrocele, varicocele, epididymitis, orchitis and testicular torsion.
3. I have no pain in my hip, but my MRI shows AVN in the hip joint on the right side. Do I need any treatment?
AVN in the early stages is usually painless. But if left untreated, there is progression of AVN, and the bone damage aggravates and pain surfaces. Therefore, it is advised not to ignore it.
4. Is AVN self-limiting and can it heal on its own?
AVN, unfortunately, is a progressive condition that goes on worsening. In the early stages, if one who consumes alcohol or steroids and then stops doing so, the progression may halt and the healing process may begin with the formation of new blood vessels.
5. Is surgery the only option for AVN?
Not all cases of AVN require surgery. If it is diagnosed in the early stages, it can be managed with medicines. The stage of AVN decides whether surgery is needed or not.
6. Is AVN a serious disease?
Yes, if not treated on time, AVN can lead to collapse of the bone and permanent joint damage.
7. What treatments are available for AVN?
Treatment varies depending on the stage of the disease and may include medicines, restricting weight-bearing capability on affected joints, physiotherapy, core decompression, or joint replacement.
8. Can a person with AVN in the hip run or jog?
In recently diagnosed AVN hip cases, it is usually advised to avoid running, jogging or other activities that put excessive pressure on the hip joint to prevent the collapse of femur head.
9. Can AVN spread to other joints?
Yes. In some patients, AVN may affect both hips and multiple joints.
10. Does AVN require complete bed rest?
Not always. Partial rest and avoiding heavy pressure on the affected joint are usually advised.
11. Can AVN occur in young people?
Yes, AVN can affect young adults.
12. Which investigations can confirm AVN?
MRI and CT scan are the most valuable to check and confirm AVN. A bone scan (nuclear bone scan or bone scintigraphy) is the next recommended investigation. In some cases, a biopsy is advised.
13. Can AVN be prevented?
Avoid unnecessary steroid use, limit alcohol intake, and manage underlying diseases properly.
14. Is AVN reversible?
Early-stage AVN may improve or stabilize, but advanced bone damage is usually irreversible.
15. How long does AVN treatment take?
Treatment is long-term and depends on the intensity, response to therapy, and lifestyle modifications.
Sir i am a avn problem patient
I am in this problem last 5 years.
My age is now 36 year.
My both leg hip joints are frozen not working .
I can not ride a motorcycle even not bicycle.
So please suggested any medicine or any solution
Here I clear that I have no feel any pain in joints
Hello, i am 42 years old male, have avn in both hip joints. Grade 2 in right hip and grade 5 in left hip. I am unable to move out of my house and continued limping. My symptoms aggrevates in cold environment and at night. Dr. Please i need your suggestion and guidance.
I have AVN in the hip bone in right leg. Necrosis of Femoral Head. Group 2. Decompression. C1 to C7 spondilytis and l4 and l5 theca dries. Understanding the limitations of Homoeopathic Treatment suggest medicine. Please be frank. My life is at stake. I am 54 years old.
avn
My Nephew has been diagnosed with necrosis in his hip. The hospital wants to replace his hip but his mother and I are searching for a different remedy. He has a sensitive body to steroids and antibiotics and surgery weaken him. I read here that Natrum may help his hip. Is there more that you may add to this information?
Thank you,
sar muze 2 sal se left hip joynt pen h avn calls c h to kya kre chala fhirna muskil ho gaya h mere umar 32 sal h
Hello, I had a chilectomy on left foot first metatarsal joint. Pain ever since surgery. Even though arthritis removed it is painful in joint area because Cartilage is very degenerated -only 30 percent left in joint. Now MRI shows bone in the area a different color like osteonecrosis may be happening as well as fractures. Please can you advise on which best to help me?
Sir mujko avn ki problem h
Hello sir, I am in 4th Stage of AVN Hip & I am taking following medicines. Is it ok or shall I change combination?
Calc phos 3x 4+4+4
Calc flour 6x 4+4+4
Selicea 3x 4+4+4
Nat sulph 3x 4+4+4
Mam orthopedic doctors say I have avn stage 3 problem in left hip….Can this be solved by homeopathy if yes what medicines should I take
Hi, having you positive results from these medicines??
Dr. i am Sufferin og left hip avn last 2 year , sir, medicine ki dose kaise leni hai sir ur kaun-kaun si medicine leni hai,
Dr I am suffering of Avn stage 3 and Dr has recommend for replacement of hips bone which I do not agree also it’s about money Also I am dabities and kidney effect person so please recommend any medicine that can help me also I can’t able to sleep at night and I can’t able to walk like before
Dang! Does Dr. Sharma ever reply to these poor, people in pain? If s0, I’ve scrolled and I don’t see any answers from him to them. 🙁
Although I have faith in homeopathy, I highly doubt it could correct my Stage III AVN of the Talus (ankle bone). But really, these people here need guidance and feedback!!
Hi,
Where can I find these natural remedies online that can hopefully help repair and heal my avascular necrosis pain in my right hip and osteopenia pain in my right knee? Thanks!
I m 27 year old man from last 6 months going through the pain of avn necrosis hip . I tried all the list of your medicine but still too much pain .plz suggest some medicine I take this medicine in 1m liquid
Dr
am suffering with left femoral head AVN (Mitchell class D). Doctors advising to do total hip replacement surgery. It is possible to cure completely in homeopathy treatment. Pls give your feed back.
Hello sir, this is CM Sharma from Ahmedabad, aGujarat . i am suffering from AVN B/L hip fsince 2009 oct now it increased to 4 th stage but joint movements are very flexible. So what precautuions and cure should be taken by me. Pl sir post your reply at the earlist. Thnking you
I have been consulting a Homeopathy Doctor in Kolkata, India for more than a year for arthritic pain in my right knee. H started with Formica 30C. I am getting very good result using his prescription. But now he wants to change the medication after a year. Unfortunately, I cannot buy that in here. I was searching interment to see whether there is anyone who can sell that medication to me. That is how I found you. He prescribed Sac Lac 30 (only two doses), Formica Rufa 200 (only for 3 days), & Calcerea Fluorica 6X (for another month). I got the 3rd one from Pure Formula, but not the other two. Can I buy them from you? Thanks in anticipation (713-927-6666)?
Res.sir. My son is 5 year old. He is sufferimg from AVN hips.both the legs. Doctors of AIIMS told it incurable. Pl. help me.
Thanks.
Waiting. For positive reply.
Thanks
I am suffering from femer neck avn. Pain is high and unpredictable whether bone or muscle giving pain. Morning is worst in comparison to day. The strength of legs seems reduced. Thigh muscles are also looking reduced. Leg is shorten by 1.5 inch.
Pl suggest medical treatment. I am under treatment of alophatic medicines. Can we partially take homeopathic and alophatic medicines
hello Dr Sharma,
our 16 year old has had AVN for over 6 years in her ankle has had a clean out with surgical operation 2 years ago but in the last 8 weeks can not weight bear at all getting very concerned
Hello Dr. Sharma
This is Tahir from Saudi Arab. The result of my MRI “Findings are impressive of avascular necrosis of both femoral head especially the left with left transient marrow edema.”
Please let me know is there any medication and i can avoid surgical treatment.
Thanks