Paul C. had been to several Doctors because of persistent neck and lower back pain that started after a car crash about a year earlier. He had been to four different Doctors all of whom gave him a different diagnosis. He had x-rays, lab studies, MRIs and physical examinations. He was given prescriptions for a number of drugs including the typical anti-inflammatory variety, physical therapy which included exercise, epidural injections and other forms of treatment none of which worked. He also saw a chiropractor who was able to provide him with some relief, but the symptoms always returned. After months of treatment and getting nowhere, he was told that he would have to learn to live with his pain. One Doctor even went so far as to imply that he was faking.
Paul C. was not the type of person who wanted to hear these conclusions and he began to search outside the usual channels. He was able to locate a Doctor who claimed to have had significant success with treating lower back pain. He made arrangements to visit this Doctor in spite of the fact that he was over 500 miles away. The Doctor was a specialist in Physical Medicine and Rehabilitation who has a special interest in soft tissue injuries. After examining Paul and reviewing available medical records, he advised Paul that he had indeed sustained soft tissue injuries to both his neck and lower back and recommended Prolotherapy as the treatment of choice. To make a long story shorter, Paul C. chose to follow the Doctor’s recommendations and, after three and a half months of treatment at three week intervals, Paul C.’s pain was gone.Unfortunately, thousands of stories very similar to this one are repeated routinely. You ask yourself why? It is because most Doctors do not realize that this form of treatment is available. Former Surgeon General, C. Everett Koop, suffered with lower back pain and leg pain for several years in spite of attempting a variety of treatment methods. He eventually located Dr. Gus Hemwall, a Doctor who used Prolotherapy to stop Dr. Koop’s pain. Dr. Koop became an advocate of Prolotherapy and said, “I personally know the benefits of Prolotherapy. I had intractable (incurable) pain which traveled down my leg. After a few treatments, it (the pain) was gone. Seeing the benefits of Prolotherapy on myself, I used the technique on the parents of my patients.” (Dr. Koop was a Pediatric Surgeon.)
So you ask yourself, if Prolotherapy is so great, why do more Doctors not know about it? The answer is multifaceted, but primarily the result of Prolotherapy not being taught in medical schools or residency training programs. However, organizations exist that offer courses to interested and qualified Doctors. The premier organization is known as the American Association of Orthopaedic Medicine (AAOM). They offer many courses on Prolotherapy and also sponsor an annual conference in the Spring. With such an effective and proven procedure available, most Doctors still rely upon methods such as drugs, surgery, devices and exercise. While some soft tissue injuries heal without a problem, there remain tens of thousands that don’t.
What are “soft tissue” injuries? Soft tissues are defined as any tissue that is not cartilage or bone, but in reality, soft tissues that can be treated with Prolotherapy are comprised of such things as fascia (tissues that support and hold muscles together), ligaments, tendons and joint capsules. In essence, these are the structures that strongly connect bone to bone or muscle to bone. Without them, the human body would have no support. Injury to these structures can result in various levels of pain from minimal to very severe. They comprise the majority of injuries to the neck and lower back, but they are the least understood. When a ligament or other soft tissue is injured, it is usually referred to as a sprain unless it involves a muscle or tendon at which time it is called a strain. The severity of a sprain or strain can vary widely. A minimal sprain involves stretching of the ligament whereas more severe sprains involve actual tearing of the ligament where it attaches to bone. The severity of the tears can also vary from mild to quite severe with complete tearing which can require surgery. Most ligament injuries are not so severe as to require surgery, but they can still cause a great deal of pain. The key to why soft tissue injuries cause so much pain is because of where the injury usually occurs. The tears normally occur next to the bone. The covering of bone (periosteum) has a rich network of pain sensitive nerve fibers. The longer the injured area remains unhealed, the looser and weaker the ligament becomes which causes the problem to worsen.
Prolotherapy, in most cases, can take care of the problem. It involves injecting a dextrose-based solution next to the injury site where the ligament attaches to the bone. It may take 3-6 such injections at 2-3 week intervals, but the end result is healing and tightening of the ligament, which causes the pain to improve dramatically or go away altogether. Patients usually feel some “soreness” after each injection, but the result is permanent healing with virtually no side effects.Prolotherapy was used originally for the treatment of hernias, but Doctors began to realize that the technique was also an excellent way to treat ligament and tendon weakness. Most Doctors using Prolotherapy see a success rate of 80-90%. Not only can neck and lower back pain be treated effectively, but Prolotherapy can also be helpful with most joint, ligament or tendon problems.
The only caution is to locate a Doctor who has been properly trained to diagnose your problem and treat it with Prolotherapy. There are about 400-500 Doctors in the United States that are qualified to use Prolotherapy, but with its new found popularity, it is a certainty that many more Doctors will seek training.
For additional information about soft tissue injuries and Prolotherapy, contact the American Association of Orthopaedic Medicine at 1(800) 992-2063.
Dr. Ken Knott has a private practice of Physical Medicine and Rehabilitation in Marietta, Georgia.
Courtesy of StemCell ARTS TX26Revised05/01/01