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Managing Osgood-Schlatter disease in an adolescent with homoeopathy: A case report
*Corresponding author: Dr. S. B. Venkatesh, Department of Practice of Medicine, Sarada Krishna Homoeopathic Medical College, Kanniyakumari, Tamil Nadu, India. sbvenkateshpudukkottai@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Venkatesh SB, Amala M, Ajayan T. Managing Osgood-Schlatter disease in an adolescent with homoeopathy: A case report. J Integr Stand Homoeopath. 2026;9:103-8. doi: 10.25259/JISH_97_2025
Abstract
Osgood-Schlatter disease (OSD) is a common cause of anterior knee pain in physically active adolescents. OSD typically presents with a gradual, non-traumatic onset of knee pain localised to the insertion of the patella tendon at the tibial tuberosity. This self-limiting condition arises from repetitive stress on the extensor mechanism, particularly during activities that involve sprinting and jumping. We present a case of OSD that was managed with homoeopathic medicine. A 13-year-old boy presented with pain and swelling in the right knee joint for 1 month. The case diagnosis was OSD. After case taking and repertorisation, Calcarea phosphorica 200C was prescribed; the patient reported a significant reduction in the pain, which was corroborated by using assessment scales such as the visual analogue scale and the modified Naranjo criteria. From this case report, we understand that homoeopathic medicines can be helpful in managing pain.
Keywords
Calcarea phosphorica
Homoeopathy
Osgood-Schlatter disease
Sports medicine
INTRODUCTION
Osgood-Schlatter disease (OSD) is a common overuse injury affecting the knees of adolescents, particularly those involved in sports that require running, jumping or rapid directional changes. This condition is characterised by inflammation of the patellar tendon at the tibial tuberosity, where the tuberosity attaches to the front of the tibia. Typically, OSD presents as localised pain and tenderness just below the kneecap, which often worsens with physical activity, potentially restricting sports participation.[1] The underlying cause of OSD is believed to be repetitive stress and traction on the growth plate during periods of rapid skeletal growth, especially during the pubertal growth spurt. It predominantly affects boys aged 12–15 years and girls aged 08–12 years.[2] Management typically involves a conservative approach: This includes rest, ice therapy and physical therapy, all of which are aimed at strengthening and stretching the surrounding muscles. Most cases resolve as the child grows and matures, leading to a mostly favourable prognosis for those affected.[3]
CASE REPORT
The patient was a 13-year-old boy from a lower socioeconomic background studying in the 8th standard. He presented to the outpatient department of Sarada Krishna Homoeopathic Medical College Hospital on July 2024, with sudden-onset pain in the right knee joint for 1 month. The patient reported repeated falls while playing football. He was an active football player. The detailed symptom analysis of the case is summarised in Table 1.
| Location | Sensation | Modalities | Concomitants |
|---|---|---|---|
| Musculoskeletal system Extremities Pain in the right knee joint since 1 month | Drawing type of pain | A/F repeated falls while playing <Bending the knees <Getting up from the chair <On contact >Pressure ++ | - |
A/F: Ailments from
Medical history
No relevant medical history. Took the coronavirus disease vaccine (COVID-19) vaccine in 2021.
Family history
Both maternal and paternal grandparents have diabetes mellitus and hypertension. No other significant family history noted.
Personal history
The patient was born and brought up in Kanyakumari, currently studying in the 8th standard. He has a mixed diet and no specific addictions.
Clinical findings
Examination of the knee joint
Inspection: No discolouration/scar marks seen. Mild swelling below the right knee joint.
Palpation: Tenderness present. Swipe test negative. Patellar tap test negative. No crepitus was felt. Mild localised warmth present. Pain is present on flexion and extension of the knee joint.
Visual analogue scale (VAS) score: 8/10
Investigation
Radiographic evaluation of the right knee joint was performed. X-ray findings were consistent with features suggestive of Osgood-Schlatter disease [Figures 1 and 2].
Physical general
Thermal: Chilly
Appetite: Regular, 3 times/day
Thirst: Regular, 4 L/day
Desires: Nothing specific
Aversion: Nothing specific
Stool: Regular, once a day
Urine: 5-7/0-2 Day/Night, no burning while micturition
Sleep: Disturbed, awakes at 1–2 am.
Life space investigation
The patient is a 13-year-old male born into a middle-class family. He has one elder sibling (a brother) and is the youngest member of the family. As a child, the patient had normal milestones and no known complaints. He is a friendly child who loves to be surrounded by many people. He tends to throw minor tantrums for small issues, especially towards his brother. If confronted, he weeps easily but settles quickly when consoled by the family members. He stated that he had a pleasant childhood and recalled no major incidents. He is very affectionate towards others, with whom he is very close. When upset, he expects others to console him. He maintains good relations with friends and extended family.
Mental generals
Affectionate
Desires company++
Weeps easily
Ameliorated by consolation amelioration.
Provisional diagnosis
Osgood-Schlatter Disease. International Classification of Disease -10: M92.52.
Evaluation of symptoms
-
Mental generals
Affectionate
Desires company++.
-
Physical generals
Sleep: Disturbed, awakes at 1–2 am+
Thermal: Chilly
Miasm: Sycosis
Temperament: Phlegmatic. 3. Characteristic particulars
Pain in the right knee joint
Drawing pain in the right knee joint
Ailments from repeated injury
Swelling below the knee joint
Pain < rising from chair
Pain > pressure.
Totality of symptoms
A/F repeated injury
Desires company
Sleep: Disturbed, awakes at 1–2 am+
Pain in the right knee joint with swelling
Drawing type of pain
Pain < rising from chair
Pain > pressure.
Repertorisation
The case was repertorised using Murphy’s repertory which is a modern, practical repertory based on Kent’s repertory. As the case has mental generals, physical generals and characteristic particulars, Kent’s philosophy was considered the most applicable. The repertorisation was conducted using Zomeo software [Figure 3]. Following repertorisation, the remedies obtained were considered as the potential differential field and were further evaluated based on thermal modality, side affinity, miasmatic background, and sphere of action in relation to the totality of symptoms [Table 2].[4,5]
First prescription
Symphytum officinale 200C one dose stat
Placebo in 10 mL aqua,10 gtt. stat
Placebo 4 times a day (QDS) for 4 days
B. Diskettes four times a day (QDS) for 4 days.
Follow-up and outcome
The details of the follow-ups are provided in Table 3.
| Date | Symptoms | Prescription |
|---|---|---|
| 14 July 2024 | Pain in the right knee joint is slightly better but still persistent. Drawing type of pain. Swelling below the knee persists. O/E tenderness present. <bending the knees, < getting up from chair, <contact. >pressure. Generals: Good VAS score: 7/10 | 1. Placebo QDS |
| 15 July 2024 | Complaints still persist. Generals: Good VAS score: 7/10 | 1. Calcarea phosphorica 200C one dose stat 2. Placebo QDS |
| 16 July 2024 | Pain in the right knee joint is still persisting. Swelling below the knee is still persisting. O/E tenderness reduced, no warmth. VAS score: 6/10 Generals: Good | 1. Placebo QDS |
| 17 July 2024 | Pain in the right knee joint increased. Swelling below the knee is still persisting. O/E No tenderness, no warmth. VAS Score: 5/10 Generals: Good | 1. Placebo QDS |
| 18 July 2024 | Complaints better. Pain reduced. Swelling still persists. No new complaints. Generals: Good VAS score: 5/10 | 1. Placebo QDS |
| 19 July 2024 | Complaints better than yesterday. No new complaints. Generals: good VAS score: 3/10 | 1. Placebo QDS |
| 20 July 2024 | Complaints better than yesterday. No new complaints. Generals: Good VAS score: 3/10 Patient was discharged and advised bed rest and to avoid straining the knee joint | 1. Placebo once at night Placebo pills tds for 2 weeks Review after 2 weeks |
| 01 August 2024 | Pain in the right knee joint is better. No swelling or limitation of movements. No new complaints. Generals: Good | 1. Placebo once at night Placebo pills tds for 2 weeks Review after 2 weeks |
| 17 August 2024 | Pain in the right knee joint slightly increased for 2 days. Drawing type of pain. A/F running. <walking, >rest. O/E: Mild swelling, tenderness and warmth. No limitation of movements. No new complaints. Generals: Good | 1. Placebo once at night Placebo pills tds for 2 weeks Review after 2 weeks Advised avoiding over-exertion. Advised rest, ice application and regular knee stretching exercise |
| 24 August 2024 | Pain in the right knee joint is still persisting but slightly better. Drawing type of pain still persists. A/F overstraining. <exertion, >rest. No new complaints. Generals: Good | 1. Calcarea phosphorica 200C 1 dose Placebo pills tds for 1 week Review after 1 week Advised to avoid over-exertion; regular knee stretching recommended |
| 31 August 2024 | Pain in the right knee joint is slightly better than before. No swelling. No new complaints. Generals: Good | 1. Placebo once at night Placebo pills tds for 2 weeks Review after 2 weeks |
| 14 September 2024 | Pain in the right knee joint is better. No swelling, no limitation of movements and no new complaints. Generals: Good | 1. Placebo once at night Placebo pills tds for 2 weeks Review after 2 weeks |
| 28 September 2024 | Pain in the right knee joint is better. No swelling, no limitation of movements and no new complaints. Generals: Good | 1. Placebo once at night Placebo pills tds for 2 weeks Review after 2 weeks |
VAS: Visual analogue scale, O/E: On examination, A/F: Ailments from, QDS: Four times a day, tds: Three times a day, Stat: Immediately
Characteristics of Calcarea phosphorica in bone affections
Non-union of fractured bones and swollen condyles are strong symptoms of this remedy, diseases of bone, complaints are better during rest and greatly < by exertion, sharp pain in the tendons of the lower limbs.[6]
Chronic swelling of the knee, condyles swollen, sharp pain in tendons, exostoses, osteophytes and similar new growths on bone.[7]
Weak bone, pain in joints and bones, growing pain. Osd, calcarea phosphorica lessens the frequency of broken bones and helps strengthen the bones.[8]
DISCUSSION
After the patient’s first visit, the acute remedy Symphytum officinale 200C was prescribed initially. The patient was admitted to the inpatient department for detailed case taking. According to Boger’s synoptic key, Symphytum primarily acts on the bone, periosteum and cartilages; therefore, it was the initial prescription.[5] Following administration of the initial medication, mild improvement in symptoms was observed; however, the primary complaints persisted. After comprehensive case-taking, a single dose of Calcarea phosphorica 200C was prescribed. Post-administration, the patient exhibited significant improvement in pain management. Given the prolonged action of Calcarea phosphorica, which extends up to 60 days, repetition of the dose was not warranted.[9] A single dose proved sufficient for symptomatic relief; a placebo was administered during subsequent follow-ups. as assessed using the modified Naranjo Criteria (Monarch Score), with detailed scoring presented in Table 4.[10]
| Domains | Yes | No | Don’t know or not done |
|---|---|---|---|
| Was there an improvement in the main symptom or condition for which the homoeopathic medicine was prescribed? | +2 | - | - |
| Did the clinical improvement occur within a plausible time frame relative to the medicine intake? | +1 | - | - |
| Was there a homoeopathic aggravation of symptoms? | +1 | - | - |
| Did overall well-being improve? (suggest using a validated scale or mention about changes in physical, emotional and behavioural elements) | +1 | - | - |
| Direction of cure: Did some symptoms improve in the opposite order of the development of symptoms of the disease? | - | 0 | - |
| Direction of cure: Did at least one of the following aspects apply to the order of improvement in symptoms– from organs of more importance to those of less importance?–From deeper to more superficial aspects of the individual?–From the top downwards? | - | 0 | - |
| Did old symptoms (defined as non-seasonal and non-cyclical symptoms that were previously thought to have resolved) reappear temporarily during the course of improvement? | - | 0 | - |
| Are there alternative causes (i.e. other than the medicine) that – with a high probability – could have produced the improvement? (consider the known course of the disease, other forms of treatment and other clinically relevant interventions) | - | - | 0 |
| Was the health improvement confirmed by any objective evidence? (e.g. investigations, clinical examination, etc.) | +2 | - | - |
| Did repeat dosing if conducted, create similar clinical improvement? | - | 0 | - |
| Total score: +7 | |||
Symptomatic assessment was conducted using the VAS, which demonstrated a marked reduction in symptom severity. In allopathic medicine, few treatments are available for OSD; one such treatment is dextrose injection combined with anaesthesia in selected cases.[11] However, homoeopathic medicine, when prescribed according to the individual’s constitutional characteristics, may offer a potential for permanent resolution of symptoms. Further randomised controlled trials are essential to establish the clinical efficacy of homoeopathic medicines in the management of sports-related injuries.
CONCLUSION
OSD is a common condition affecting physically active adolescents during periods of rapid growth. By recognising early symptoms and employing conservative treatments, patients can become symptom free and resume their normal activities. Homoeopathic medicine, along with physical therapy, activity modification and patient education, is crucial for effective recovery from OSD. Awareness and timely intervention remain key to minimising the impact of OSD on young athletes’ lives.
Ethical approval:
Institutional Review Board approval is not required.
Declaration of patient consent:
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given consent for their images and other clinical information to be reported in the journal. The patient understands that the patient’s names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Conflicts of interest:
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation:
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
Financial support and sponsorship: Nil.
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