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CURING
CHRONIC PAIN WITH PROLOTHERAPY
SCOTT
GREENBERG, M.D.
Have you ever suffered from
chronic musculoskeletal pain? If you have, you are not alone. Statistically
speaking, 75% of Americans will experience chronic back pain in their
lifetime. Unfortunately, a stressful and active lifestyle may not give our
body the chance it deserves to heal. Instead we are prescribed medicines such
as ibuprofen (i.e., Motrin, Advil) and naproxen (i.e., Aleve) that relieve
pain and decrease the inflammatory process.
However, natural healing is
predicated upon inflammation. Your body releases naturally occurring chemicals
known as cytokines, chemotactic substances and vasoactive factors in response
to injury to help repair the body. Drugs such as ibuprofen block these healing
factors resulting in unrepaired microscopic damage to the tendons, ligaments
and joints. When these structures haven't completely healed, the body
compensates and signals the surrounding muscles to spasm. Chronic pain results
from a combination of these factors.
Therefore, without correcting the
underlying problem, your pain will persist. Fortunately, there is a way to
correct the underlying defect by stimulating the body to repair itself using a
technique known as prolotherapy.
Definition and History
Prolotherapy (also called
sclerotherapy) is named for its proliferative effect on tendons and ligaments.
Although the term was coined by an industrial surgeon in the 1950s,
prolotherapy was first used in ancient times. Hippocrates treated injured
rotator cuffs of javelin throwers back around 400 B.C. with hot lances to
create small amounts of scar tissue around the shoulder joint. The technique
evolved in the 1930s and was used to repair hernias before modern surgical
techniques became available. Dr. George Hackett refined the procedure and
described the use of localized injections into the junction between a bone and
tendon, causing a controlled rate of inflammation and healing. Hackett also
described the sclerotogenous origin of pain, that is, pain referred from an
injured tendon, ligament or bone. He had success in relieving headaches and
arm and shoulder pain by treating injuries in the neck. Similar points have
been described in treatment of the legs and hips.
Healing Mechanisms of
Prolotherapy:
The healing process is a
multifactorial event. Healing pathways are multiple and are initiated by
tissue injury. Injury provokes the release of chemotactic factors and
complement, and stimulates processes known as fibrinolysis and coagulation.
Specialized white blood cells, called neutrophils and macrophages, enter the
site to eliminate cellular debris and to release growth factors. These growth
factors tell your body to deposit a new collagen matrix, initiating the
rebuilding and strengthening of the damaged structure.
Several solutions may be used for
prolotherapy treatment. A standard solution will consist of an anesthetic
(numbing agent) combined with an inflammatory agent such as phenol, dextrose,
or sodium morrhuate. This inflammation triggers biochemicals that signal the
beginning of the natural healing process.
Case Histories:
G.A. is a fifty-two-year-old
female who experienced severe pain in her right ankle. Even the simple task of
walking became a painful chore. She was diagnosed with chronic ankle
tendonitis and reflex sympathetic dystrophy. Ankle surgery and physical
therapy did not relieve her symptoms. The severity of pain led her to become
disabled for a period of four months. When she was examined, pain was noted on
palpation of the supporting ankle ligaments, and the ankle joint was
hypermobile. There were no abnormalities appreciated in the knees, hips or
back. After a series of prolotherapy treatments, G.A.'s pain completely
resolved. She was no longer disabled and resumed full time employment.
A.S. is a sixty-two-year-old
female with chronic neck and back pain. She owns a health food store and is
active in all aspects of its operation, including the lifting of cartons. A.S.
had failed to cure her pain with numerous supplements such as MSM, boswellia,
glucosamine, chondroitin, tumeric and SAMe. She was unable to get relief from
acupuncture or chiropractic treatments. Radiographs and MRIs of her spine
taken by her primary physician did not reveal any abnormalities. On
examination, she had full range of motion of her lumbar spine, cervical spine,
hips, and knees. She was tender upon palpation of the sacroiliac joints and
had tension in the muscles that support the spine. Prolotherapy injections
were given to the joints and ligaments of the neck, low back, and sacral area.
After three sessions, her pain had decreased 70-80%. She began to sleep better
and no longer awoke at night from back or neck pain.
Conclusion:
Prolotherapy is a safe and
effective treatment for pain. It presents a superior treatment option for
relieving chronic pain when compared to drugs which interfere with the
inflammatory pathways of healing. Proper and complete healing can only occur
when the natural pathways are left disrupted. As a result, prolotherapy should
be considered a tool in treating chronic pain.
(c) Scott
Greenberg, M.D.
The opinions expressed
here does not necessarily reflect the views of the other member physicians of getprolo.com.
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Non-Surgical
Tendon, Ligament and Joint Reconstruction William J. Faber, D.O.
How Does Prolotherapy Work? Marc
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When Prolotherapy May Not Work David Harris, M.D.
Twenty
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David
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The History of Prolotherapy Ross
Hauser, M.D.
Curing Chronic Pain with Prolotherapy Scott
Greenberg, M.D.
Why So Many Turn To Prolotherapy
David Harris, M.D.
Prolotherapy
and Chronic Pain Ross Hauser, M.D.
Peripheral Joints
& Prolotherapy
Jay W. Nielsen, M.D.
Orthopedic Medicine: A
Non-Surgical Approach to Chronic Pain Lawrence
Cohen, M.D.
The Difference
Between Prolotherapy, Trigger Points, and Acupuncture Marc Darrow,
M.D.J.D.
Prolotherapy: Creating
Inflammation in an Area that is Already Inflamed Marc Darrow,
M.D.J.D.
Growth Factor Basis of
Prolotherapy
David Harris, M.D.
What
Does It Take To Heal Connective Tissue?
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Harris, M.D.
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