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A sprain is the tearing of the ligaments, fibrous structures which support the joints. The most common sprains occur on the limbs, such as sprained ankles, wrists and thumbs, but can affect almost any joint if the ligaments are suddenly or excessively stretched beyond the normal range of movement. ‘Whiplash’, for example is the spraining of the ligaments between the vertabrae of the neck. The joint will swell and often bruise and will be extremely painful.

Initially, sprains should be treated much the same way as bruises. Much of the pain of sprains arises from the swelling and the bleeding in the tissues. Immediately apply ice to the area and elevate the affected limb. Rest as much as possible. Apply arnica as a cream or tincture, or a compress of either arnica or comfrey root, directly on the swelling. Under medical supervision only, arnica can be taken in tablet form to help limit the bruising and Vitamin C and the herb horsetail aid the healing of muscle tissue. Initially, the joint may be strapped firmly to provide support, limit swelling and ease the pain. Soon, however, gentle massage and movement is required to prevent the ligament tissues shortening and tightening as they heal. To begin with, a physiotherapist will only stroke the affected area firmly, progressing to deeper tissue massage with fingers and thumbs only when the injury is healing. Hydrotherapy can also help the patient maintain movement and build up strength in the joint. Note that sprains take longer to heal than fractures do, up to six or eight weeks, and that a joint which has been sprained may be permanently weakened and more prone to dislocation, requiring special care and strapping with elastic bandage when exercising.

Rather than arising from one single over extension of the joints, strains result from the overuse of muscles, through careless exercise or even because of poor work practices. Strained muscles can result in temporary discomfort or the development of more serious nerve and muscle conditions.

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When Greta, a 69-year-old woman referred to Professor Volz by her GP, was asked what was troubling her, depression was the furthest condition from her mind. Instead she complained of many physical ailments – headache, stomach ache, tiredness and an unpleasant taste in her mouth. Her GP had been unable to find any physical explanation for these symptoms and the only abnormality he could detect was a slight problem with cardiac conduction, as measured by EKG. She had complained of sleep difficulties, for which she had been treated with sleeping pills with some success.

When Dr Volz questioned her, it became apparent that her difficulties had begun about two years before, shortly after her husband died unexpectedly of a heart attack. Despite having enough money and a close relationship with her son, who lived in the same town and visited her twice a week, Greta complained of sadness and hopelessness but, she hastened to add, ‘only when I am alone’. Dr Volz tried to explain to her that her symptoms might be due to depression, but she vehemently objected to such an explanation. When he suggested that she might benefit from a drug such as Prozac, she refused to take any synthetic antidepressants, insisting ‘that’s all chemical stuff.’ After two further visits with Dr Volz, he suggested that she might try St John’s Wort. To his astonishment, she immediately agreed to take this because ‘herbs are not dangerous.’

Dr Volz started Greta on St John’s Wort at a dosage of 900 mg per day. He noticed no improvement until she had been on the herbal remedy for six weeks, and it took another 10 weeks before Greta’s symptoms were reduced to a significant degree. Greta remains convinced that the improvement she has enjoyed on St John’s Wort has nothing to do with relief from depression but rather to ‘non-specific’ effects of the herb. Dr Volz feels no need to challenge this belief. She is no longer depressed and her mood has been stable without any adverse effects whatsoever – reward enough for a caring doctor.

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