PAIN MANAGEMENT – A NEW APPROACH
Sagiv Ben-Yakir DVM, MRCVS, BSc
The Academic College at Wingate Institute, ISRAEL
Netanya, ISRAEL
Pain is often defined as an unpleasant sensory and emotional experience associated with
actual or potential tissue damage or described in terms of such damage. Pain produces
physical or physiologic changes that are exhibited as mild behavioral discomfort or distress to
acute, often unbearable, agony. Pain may be diffused or localized, and usually produces a
desire to avoid, escape, or destroy (autonomy) the factors responsible for its production.
Untreated or prolonged pain promotes an extended and destructive stress response,
characterized by neuroendocrine, dysregulation, fatigue, dysphoria, myalgia, abnormal
behavior, and altered physical performance ("Handbook of veterinary pain management" eds.
Gaynor J.S and Muir W. 2nd edition, 2009, Mosby Elsevier).
Conventional treatments ensure positive benefits in the short term, but they involve a
complex of serious adverse effects. Moreover, many animals cannot use allopathic medicines
(as NSAIDs), or face time-limited use of these drugs, as they must not be used for long
periods of time. Furthermore, although the main goal is to eliminate the pain, often the causes
that determine it are neglected.
Since pain is a multi-factorial condition there is a need to formulate a remedy that will
negotiate all the different origins of the pain: a hormonal one, an immune source, a
neurological cause, as well as a psychological etiology.
Upon formulation of this kind of remedy we should look for ingredients that –
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Have no local or general allergic reactions
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No adverse side effects in the short and long term
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No contraindications
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Safe to be used during pregnancy
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No interaction with other drugs
We are going to present different remedies to be applied by injections into acupuncture points
based on body location as well as body systems involved.
1) Neck ingredients: Cartilago suis 4X 4 parts, Anti interleukin 1 alpha 4C, Anti
interleukin 1 beta 4C, Beta-Endorphin 4C, Magnesia phosphorica 8X, Nux vomica
10X, Picricum acidum 10X, Silicea 4X 2 parts, Crotalus horridus 10X, Intervertebral
disk of Porcine 4X 1 part all in sterile isotonic sodium chloride solution.
2) Thorax ingredients: Chininum sulphuricum 8X 4 parts, Anti interleukin 1 alpha 4C,
Anti interleukin 1 beta 4C, Beta-Endorphin 4C, Calcarea phosphorica 6X, Cimicifuga
racemosa 4X, Intervertebral disk of Porcine 4X, Spongia tosta 10X 2 parts,
Chelidonium majus 4X, Conium maculatum 6X 1 part all in sterile isotonic sodium
chloride solution.
3) Lumbar ingredients: Alumina 8X 4 parts, Anti-interleukin 1 alpha 4C, Beta-Endorphin
4C, Bryonia alba 4X, Hamamelis virginiana 6X, Natrum sulphuricum 8X,
Phosphoricum acidum 6X, Sepia 4X 2 parts, Anti-interleukin 1 beta 4C, Intervertebral
disk of Porcine 4X 1 part all in sterile isotonic sodium chloride solution.
4) Ischial ingredients: Aconitum napellus 8X, Anti interleukin 1 alpha 4C, Anti interleukin
1 beta 4C, Arsenicum album 6X, Beta-Endorphin 4C, Cimicifuga racemosa 4X,
Gnaphalium polycephalum 4X, Lachesis mutus 8X, Rhododendron chrysanthum 6X,
Rhus toxicodendron 4X 2 parts all in sterile isotonic sodium chloride solution.
5) Shoulder ingredients: Argentum nitricum 8X 4 parts, Anti interleukin 1 alpha 4C, Anti
interleukin 1 beta 4C, Beta-Endorphin 4C, Cartilago suis 4X, Ferrum phosphoricum
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8X, Sanguinaria canadensis 8X, Tendon of Porcine 6X 2 parts, Iris versicolor 8X,
Ranunculus bulbosus 10X 1 part all in sterile isotonic sodium chloride solution.
Hand and foot ingredients: Arnica montana 4X, Viola odorata 6X 4 parts, Anti
interleukin 1 alpha 4C, Anti interleukin 1 beta 4C, Beta-Endorphin 4C, Caulophyllum
thalictroides 12X 2 parts, Benzoicum acidum 6X, Cimicifuga racemosa 10X, Ledum
palustre 6X, Mercurius solubilis 8X 1 part all in sterile isotonic sodium chloride
solution.
Hip ingredients: Arnica montana 8X 4 parts, Anti interleukin 1 alpha 4C, Anti
interleukin 1 beta 4C, Beta-Endorphin 4C, Calcarea fluorica 6X, Cartilago suis 4X,
Colocynthis 8X, Rhus toxicodendron 10X 2 parts, Argentum metallicum 6X,
Formicum acidum 8X 1 part all in sterile isotonic sodium chloride solution.
Polyarthritis ingredients: Salicylicum acidum 2X 4 parts, Aconitum napellus 6X, Anti
interleukin 1 alpha 4C, Anti interleukin 1 beta 4C, Beta-Endorphin 4C, Drosera 8X,
Ledum palustre 8X, Viscum album 10X 2 parts, Colchicum autumnale 10X,
Guaiacum 10X 1 part all in sterile isotonic sodium chloride solution.
Muscle ingredients: Arnica montana 4X, Colocynthis 4X 4 parts, Belladonna 6X,
Lithium benzoicum 8X, Muscle tissue of Porcine 4C, Procaine chloride 2X 2 parts,
Colchicum autumnale 6X, Cuprum sulphuricum 4X, Hypericum perforatum 4X,
Interferon gamma 4C 1 part all in sterile isotonic sodium chloride solution.
Neural ingredients: Aconitum napellus 8X, Beta-Endorphin 4C, Colocynthis 4X,
Ferrum phosphoricum 2X, Formica rufa 8X, Gnaphalium polycephalum 6X, Iris
versicolor 8X, Kalmia latifolia 2X, Neurotrophin 4 4C, Paris quadrifolia 6X 2 parts all in
sterile isotonic sodium chloride solution.
The remedies ingredients are based according to the different location in the body as well
as systems involved –
For #1 = Neck –
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1st Core – an analgesic core - the concentration of -Endorphin 4C,
corresponding to the physiological concentration of this inhibiting
neurotransmitter – both at central and peripheral levels - is capable of
sensitizing the cell receptors through up-regulation mechanisms resulting in
an enhanced analgesic action of endogenous -Endorphin.
2nd Core – an anti-inflammatory core - the action of Anti IL 1  and  4C
restrains the onset of inflammatory episodes; these two interleukins
representing some of the main factors responsible for the inflammatory
process.
3rd Core – an homeopathic analgesic core - the four remedies of this core
have been selected according to their specific organic tropism for the
different anatomical structures of the neck to modulate pain, especially
myalgic syndrome (Picricum acidum), spastic and/or congestive (Crotalus
horridus and Nux vomica), nerve (Magnesia phos.) pain affecting the neck.
Particular attention should be paid to the analgesic action of Picricum acidum
and the myo-relaxing action of Nux vomica which work in synergy with each
other thus curing acute pain.
4th Core – an anti-degenerative core - rheumatic pathologies are
accompanied by severe tissue degeneration conditions resulting in a
progressive functional handicap. Moreover, as in a vicious circle,
degeneration supports inflammation and vice versa. A correct therapeutic
rationale should stop this mechanism by acting not only on symptoms but
also on the etiological causes. Consider that Cartilago suis, by stimulating
protein synthesis (especially glycosaminoglycans) induces restructuring of
cartilage matrix, which is usually responsible for cervical spine disorders.
Hence, the neck remedy contains Discus intervertebralis disk of Porcine. The
anti-degenerative core also contains the remedy Silicea, which performs a
dual action. First, it stimulates the osteoblast function for bone matrix
metabolism, and secondly it is capable of correcting the constitutional
predisposition of certain individuals, as the Fluoric Constitution, according to
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Constitutional Homeopathy, who are more prone than others to joint
degeneration and ligament loosening.
For #2 = Thorax –
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1st Core – an analgesic core - the concentration of 4C of -Endorphin,
corresponding to the physiological concentration of this inhibiting
neurotransmitter – both at a central and peripheral level - is capable of
sensitizing the cell receptors through up-regulation mechanisms resulting in
an enhanced analgesic action of endogenous -Endorphin.
2nd Core - an anti-inflammatory core - the action of Anti IL 1  and 
restrains the onset of inflammatory episodes, these two interleukins being
some of the main factors responsible for the inflammatory process.
3rd Core – an homeopathic analgesic core - the five remedies of this core
have been selected according to their specific organic tropism for the
different anatomical structures of the spinal column to modulate pain
especially of nerve-muscle origin (Cimicifuga, Chininum sulphuricum, Conium
maculatum), spastic and/or congestive pain (Chelidonium and Spongia
tosta). The remedies of this core have also been selected on the basis of the
localization of their therapeutic effect: they are all active on the dorsal rachis
due to their specific organic tropism, while Chelidonium (specific organic
tropism for the right side of the liver) has a reflex analgesic action on rachis.
4th Core – an anti-degenerative core - rheumatic pathologies are
accompanied by severe tissue degeneration conditions resulting in a
progressive functional handicap. Moreover, as in a vicious circle,
degeneration supports inflammation and vice versa. A correct therapeutic
rationale should stop this mechanism by acting not only on symptoms but
also on the etiological causes. In dorsal pain, an essential role is played by
the intervertebral disk: the pulp core inflammation, which in its protruding
condition results in herniation or degenerative disorders which are often
responsible for spinal column pains. That’s why we have intervertebral disk of
Porcine.
5th Core - a constitutional core- Calcarea phosphorica is capable of
correcting the constitutional predispoision of some individuals, the
Phosphoric Constitution according to Constitutional Homeopathy, who are
more prone than others to structural alterations of the posterior area of the
spinal column (scoliosis, kyphosis, lordosis) that may lead to or be the cause
of pain related to poor posture.
For #3 = Lumbar –
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

1st Core - an analgesic core - the concentration of 4C of -Endorphin,
corresponding to the physiological concentration of this inhibiting
neurotransmitter – both at a central and peripheral level - is capable of
sensitizing the cell receptors through up-regulation mechanisms resulting in
an enhanced analgesic action of endogenous -Endorphin.
2nd Core – an anti-inflammatory core - the action of Anti IL 1  and 
restrains the onset of inflammatory episodes, these two interleukins being
some of the main factors responsible for the inflammatory process.
3rd Core – an homeopathic analgesic core - the remedies of this core have
been selected according to their different action on pain and especially on the
basis of the different origin (neuro-muscular: Bryonia, Alumina,
Phosphoricum acidum; joint pain: Natrium sulphuricum), type (cramps:
Phosphoricum acidum; as a consequence of muscle paresis: Alumina),
localization (lumbosacral rachis: Hamamelis; reflex coming from the
abdomen: Sepia).
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4th Core – an anti-degenerative core - it is well known that the rheumatic
pathology is accompanied by serious tissue degenerative conditions leading
to a progressive functional handicap. Moreover, like in a vicious circle,
degeneration often supports inflammation and vice versa. A correct
therapeutic rationale acting on both symptoms and etiological causes is to
stop this mechanism. In lumbar pain, an essential role is played by the
intervertebral disk: the inflammation of pulp core, and its protruding condition
leading to hernia or degenerative conditions are often at the basis of
lumbosacral pain. Furthermore, we should consider that the main locus
minoris resistentiae of the spine can be localized at the level of L6-L7 and L7S1 vertebra: the aim of a treatment – acting not only on symptoms - of
lumbosacral pain is to protect the disk at this level. Hence, lumbar remedy
contains intervertebral disk of Porcine.
For #4 = Ischial –
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

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1st Core – an analgesic core - the concentration of 4C of -Endorphin,
corresponding to the physiological concentration of this inhibiting
neurotransmitter – both at a central and peripheral level – which is capable of
sensitizing the cell receptors through up-regulation mechanisms resulting in
an enhanced analgesic action of endogenous -Endorphin.
2nd Core – an anti-inflammatory core - the action of Anti IL 1  and 
restrains the onset of inflammatory episodes; these two interleukins being
some of the main factors responsible for inflammatory process.
3rd Core – a primary anti-neuralgic core - the five remedies of this core have
been selected on the basis of their specific organ tropism for the sciatic nerve
(Gnaphalium policephalum, Lachesis muta and Rhododendron chrysantum)
and their functional tropism for the neurogenic phase of the inflammatory
process (Aconitum and Arsenicum album).
4th Core – a secondary anti-neuralgic core - the two remedies of this core can
be considered as analgesic “etiological” remedies as they are capable of
modulating the sciatica pain by acting on the causes of osteochondritis of the
lumbosacral part of the spine (Cimicifuga) and hip arthrosis and lumbar pain
(Rhus tox.).
5th Core – a reflex anti-neuralgic core - sciatica pain often has a remote
cause; either reflex pain that comes from the abdomen (in this case, Lachesis
could be helpful) or a lumbosacral-iliac origin (in this case, Cimicifuga could
be helpful).
For #5 = Shoulder –



1st Core – an analgesic core - the concentration of 4C of -Endorphin,
corresponding to the physiological concentration of this inhibiting
neurotransmitter – both at a central and peripheral level - is capable of
sensitizing the cell receptors through up-regulation mechanisms resulting in
an enhanced analgesic action of endogenous -Endorphin.
2nd Core – an anti-inflammatory core - the action of Anti IL 1  and 
restrains the onset of inflammatory episodes; these two interleukins
representing some of the main factors responsible for the inflammatory
process.
3rd Core – an homeopathic analgesic core - the five remedies of this core
have been selected according to their specific organic tropism for the
different anatomical structures including shoulder-arm joint to modulate pain,
especially of inflammatory origin affecting the whole shoulder. Argentum
nitricum, Ferrum phosphoricum, Iris versicolor, Ranunculus bulbosus,
Sanguinaria canadensis, act not only on pain but also on the other signs of
periarthritis such as arm paresthesia (Argentum nitricum), brachial nerve
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pains (Ferrum phosphoricum, Ranunculus and Iris), and functional handicap
of muscle origin (Sanguinaria).
4th Core – an anti-degenerative core - rheumatic pathologies are usually
accompanied by severe tissue degeneration conditions resulting in a
progressive functional handicap. Moreover, as in a vicious circle,
degeneration supports inflammation and vice versa. A correct therapeutic
rationale should stop this mechanism by acting not only on symptoms but
also on the etiological causes. Cartilago suis, by stimulating protein synthesis
(especially glycosaminoglycans), induces restructuring of cartilage matrix and
its functional recovery. To heal shoulder pain it is essential to support the
tendon-ligament function and structure of the rotator cuff: therefore, shoulder
remedy contains Tendon of porcine.
For #6 = Hand & foot –
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



1st Core – an analgesic core - the concentration of 4C of -Endorphin,
corresponding to the physiological concentration of this inhibiting
neurotransmitter – both at a central and peripheral level - is capable of
sensitizing the cell receptors through up-regulation mechanisms resulting is
an enhanced analgesic action of endogenous -Endorphin.
2nd Core – an anti-inflammatory core - the action of Anti IL 1  and 
restrains the onset of inflammatory episodes, these two interleukins
representing some of the main factors responsible for the inflammatory
process.
3rd Core - an anti-inflammatory pain core - the two remedies of this core have
been selected on the basis of their specific action of pain modulation to
control blood vessel inflammation (Arnica) and acute symptoms of arthritic
origin (Caulophyllum).
4th Core – a degenerative pain core - the remedies of this core (Viola odorata,
Mercurius solubilis and Cimicifuga racemosa) reduce degenerative pain of
the hand and foot joints. The tropism and the anti-inflammatory action of
Viola odorata are considerable, particularly on the wrist joint.
5th Core – a gout pain core - Ledum palustre and Acidum benzoicum reduce
the uric acid crystal deposits due to their draining action. In this way, gout
pains can be modulated by hand-foot formula.
For #7 = Hip –




1st Core – an analgesic core - the concentration of 4C of -Endorphin,
corresponding to the physiological concentration of this inhibiting
neurotransmitter – both at a central and peripheral level - is capable of
sensitizing the cell receptors through up-regulation mechanisms resulting in
an enhanced analgesic action of endogenous -Endorphin.
2nd Core – an anti-inflammatory core - the action of Anti IL 1  and 
restrains the onset of inflammatory episodes, these two interleukins
representing some of the main factors responsible for the inflammatory
process.
3rd Core – an homeopathic analgesic core - the five remedies of this core
have been selected on the basis of their specific organ tropism for the
different anatomical structures of the hip joint and the knee, to modulate pain,
especially that of inflammatory origin. Argentum, Colocynthis, Rhus tox. and
Formicum acidum act not only on pain but also on the other signs of
coxarthrosis and gonarthrosis such as functional handicap, swelling,
reddening and inflammation.
4th Core – an anti-degenerative core - it is well known that rheumatic
pathologies are accompanied by severe tissue degeneration which can lead
to a progressive functional handicap in the long run. Moreover, as in a vicious
circle, degeneration supports inflammation and vice versa. The aim of a
correct therapeutic rationale acting on symptoms and etiological causes is to
stop this mechanism. Cartilago suis, by stimulating protein synthesis
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(especially of glycosaminoglycans) acts on the restructuring of cartilage
matrix, thus helping its functional recovery. The presence of Argentum
metallicum is particularly interesting as it stimulates vascularization in the hip
joint and knee area where blood and lymphatic vessels are particularly
delicate and complex.
5th Core – a constitutional core - the Fluoric Constitution can be affected more
than the other constitutions by the degeneration of mesenchymal tissues,
such as joint tissues. Calcarea fluorica, by acting on the Phosphorus
metabolism, fights against “structure loss”.
For #8 = Polyarthritis –
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

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1st Core - an analgesic core - the concentration of 4C of -Endorphin,
corresponding to the physiological concentration of this inhibiting
neurotransmitter – both at a central and peripheral level - is capable of
sensitizing the cell receptors through up-regulation mechanisms resulting in
an enhanced analgesic action of endogenous -Endorphin.
2nd Core – an anti-inflammatory core - the action of Anti IL 1  and 
restrains the onset of inflammatory episodes, these two interleukins
representing some of the main factors responsible for the inflammatory
process.
3rd Core – an acute anti-inflammatory pain core - the five remedies of this
core have been selected according to their specific action of modulating
acute joint pain: Aconitum and Acidum salycilicum (acute joint rheumatism),
Colchicum autumnale (painful joint inflammation, joint block), Drosera (pain
as a consequence of bone degenerative process affecting long bones and
the spine), Guajacum (joint pains or accompanied by severe hyperesthesia).
4th Core - a chronic inflammatory pain core - both remedies of this core
(Ledum and Viscum album) reduce degenerative disorders affecting joints
(Ledum) and degenerative disorders, in general (Viscum).
For #9 = Muscle –
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1st Core – a bruise pain core - a primary role is played by Arnica and its active
ingredients which work in synergy- thus allowing the inflamed tissues to
stretch -thereby reducing nerve pain and balancing blood vessel permeability,
which in turn reduces incoming Calcium ions which are the initiators of the
inflammation process. Belladonna acts on the blood vessel phase of the
inflammation process specifically and promotes the reabsorption of
hematomas in synergy with Arnica.
2nd Core – a spastic or cramp pain core - both remedies of this core are
characterized by a spasmodic nature of muscle pain. The first remedy
(Colocynthis) acts particularly on the neurogenic aspect of spastic pain while
the second remedy (Cuprum sulphuricum) mainly acts on muscles.
3rd Core – a sprain pain core - the protagonist of this action core is Hypericum
and its specific tropism for the neuromuscular spindle and for its cicatrizing
action.
4th Core – a muscle rheumatism core - both remedies of this core (Colchicum
and Lithium benzoicum) reduce inflammatory episodes by controlling the
hypophysis-suprarenal gland axis and in the case of Colchicum, analgesic
action on chronic muscle rheumatism.
5th Core – an anti-degenerative core - the low dose of Interferon gamma acts
on T lymphocytes by inhibiting their migration and activation and reducing the
production of cytokines involved in the inflammatory process. Muscles are
particularly vascularized, so Interferon has a considerable impact on them.
Procainhydrochlorid has an analgesic action and Muscle tissue of Porcine
fights against fibroses that may occur after severe or less severe muscle
injuries.
For #10 = Neural –
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




1st Core - an analgesic core - the concentration of 4C of -Endorphin,
corresponding to the physiological concentration of this inhibiting
neurotransmitter – both at a central and peripheral level - is capable of
sensitizing the cell receptors through up-regulation mechanisms resulting in
an enhanced analgesic action of endogenous -Endorphin.
2nd Core – an inflammatory etiology - all the remedies selected for this core
(Aconitum, Colocynthis, Ferrum phosphoricum, Gnaphalium polycephalum,
Iris versicolor, Paris quadrifolia, Kalmia latifolia) have a special tropism for the
different peripheral nerves, including the sciatic nerve (Gnaphalium), the skull
nerves (Paris quadrifolia), and in addition, these remedies have considerable
anti-inflammatory activity.
3rd Core – a vascular etiology - the protagonist of this action core is Formica
rufa and its specific congestion action on the nerve sheath, which allows for
the reduction of paresthesia conditions.
4th Core – a degenerative etiology - protagonist of this action core is
Neurotrophin 4, one of the most important nerve growth factors, performing a
specific trophic action on nerve roots and endings damaged due to
degenerative or injury conditions.
5th Core – a rheumatoid etiology - Kalmia, also known as Arnica for tendons
and ligaments, has been selected as an ingredient of the neural remedy due
to its modulating action on paresis and paralysis as a consequence of
inflammatory episodes of nerve origin.
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