Prolotherapy on Lower Back

It is now Monday making it four full days since receiving neuro-prolotherapy injections to relieve sciatica in both legs and nerve pain going down the front of both legs as well. By Thursday afternoon most of the nerve pain had subsided and now that intense pain that incapacitated me from Sunday through Thursday morning, I am pleased to say, is but an awful memory.

I had been scheduled for injections in my lower back as i continue to have sensitivity in the lumbar area of the lower spine. Deep injections help to heal the ligament damage  at the core of this type of pain, but I needed to postpone those injections last week due to the sciatica. I have had excellent success with Neuro-prolotherapy, or prolo injections just below the surface of the skin into the nerves, for relieving both nerve pain and whiplash. Today we were completing the treatments that I had been getting to my spine for several months.

As usual, the doctor starts by identifying the areas for treatment. He does so by pressing on different points and when I tell him it hurts, he marks the spot for an injection. He presses along all spots on either side of my lower spine into my buttocks. Today the pain is limited to an area of three or so vertebrae and spreads out on either side. All told he will do close to 15-20 shots.

After marking the area, the prolotherapy doctor cleans the area with an antiseptic and then injects the entire area with many shots of lidocain, to numb it. The needles are tiny at this point and the injections while unpleasant are not painful. In 5 minutes the area is numb and the Dr returns to begin the deep prolo shots. The needles are long and not small, as they must be placed all the way in against the bone where the ligament attaches to the bone.

As he injects one spot on my left side, a muscle in my lower right back spasms, but it is mercifully brief. Otherwise the injections are not too painful. While I can feel the needle penetrating, it is most often feeling the liquid being injected that causes discomfort. My doctor moves quickly and completes the shots within about 10 minutes. Other than feeling like a pin cushion, my back does not feel bad and a single vicodin in the evening will alleviate additional pain.

C. Everett Koop on Prolotherapy

Former United States Surgeon General, Dr. C. Everett Koop, was a proponent of Prolotherapy. In the preface to a book on the subject he wrote the following:

Prolotherapy is the name some people use for a type of medical intervention in musculoskeletal pain that causes a proliferation of collagen fibers such as those found in ligaments and tendons, as well as a shortening of those fibers. The “prolo” in Prolotherapy, therefore, comes from proliferative.

Other therapists have referred to this type of treatment as Sclerotherapy. “Sclera” comes from the Greek word “sklera”, which means hard. Sclerotherapy, therefore, refers to the same type of medical intervention which produces a hardening of the tissues treated – just as described above in the proliferation of collagen fibers.

Not many physicians are aware of Prolotherapy, and even fewer are adept at this form of treatment. One wonders why that is so. In my opinion, it is because medical folks are skeptical and Prolotherapy, unless you have tried it and proven its worth, seems to be too easy a solution to a series of complicated problems that afflict the human body and have been notoriously difficult to treat by any other method. Another reason is the simplicity of the therapy: Injecting an irritant solution, which may be something as simple as glucose, at the junction of a ligament with a bone to produce the rather dramatic therapeutic benefits that follow.

Another very practical reason is that many insurance companies do not pay for Prolotherapy, largely because their medical advisors do not understand it, have not practiced it, and therefore do not recommend it. Finally, Prolotherapy seems too simple a procedure for a very complicated series of musculoskeletal problems which affect huge numbers of patients. The reason why I consented to write the preface to this book is because I have been a patient who has benefitted from Prolotherapy. Having been so remarkably relieved of my chronic disabling pain, I began to use it on some of my patients – but more on that later.

When I was 40 years old, I was diagnosed in two separate neurological clinics as having intractable (incurable) pain. My comment was that I was too young to have intractable pain. It was by chance that I learned that Gustav A. Hemwall, M.D., a practitioner in the suburbs of Chicago, was an expert in Prolotherapy. When I asked him if he could cure my pain, he asked me to describe it. When I had done the best that I could, he replied., “There is no such pain. Do you mean a pain?” And then he continued to describe my pain much better than I could. When I said, “That’s it exactly,” he said, “I can fix you.” To make a long story short, my intractable pain was not intractable and I was remarkably improved to the point where my pain ceased to be a problem. Much milder recurrences of that pain over the next 20 years were retreated the same way with equally beneficial results.

I was so impressed with what Dr. Hemwall had done for me that on several occasions, just to satisfy my curiosity, I watched him work in his clinic and witnessed the unbelievable variety of musculoskeletal problems he was able to treat successfully. Many of his patients were people who had been treated for years by all sorts of methods, including major surgery, some of which had left them worse off than they were before. Many of his patients had the lack of confidence in further treatment and the low expectations that folks inflicted with chronic pain frequently exhibit. Yet I saw so many of them cured that I could not help but become a “believer” in Prolotherapy.

I was a pediatric surgeon, and there are not many times when Prolotherapy is needed in children because they just don’t suffer from the same relaxation of musculoskeletal connections that are so amenable to treatment by Prolotherapy. But I noticed frequently that the parents of my patients were having difficulty getting into their coats, or they walked with a limp, or they favored an arm. I would ask what the problem was and then, if it seemed suitable, offer my services in Prolotherapy at no expense, feeling that I was a pediatric surgeon and this was really not my line of work. The results I saw in those many patients were just as remarkable as was the relief I had received in the hands of Dr. Hemwall. I was so impressed with what Prolotherapy could do for musculoskeletal disease that I, at one time, thought that might be the way I would spend my years after formal retirement from the University of Pennsylvania. But the call of President Reagan to be Surgeon General of the United States interrupted any such plans.

The reader may wonder why, in spite of what I have said and what this book contains, there are still so many skeptics about Prolotherapy. I think it has to be admitted that those in the medical profession, once they have departed from their formal training and have established themselves in practice, are not the most open to innovative and new ideas.

Prolotherapy is not a cure-all for all pain. Therefore, the diagnosis must be made accurately and the therapy must be done by someone who knows what he or she is doing. The nice thing about prolotherapy, if properly done, is that it cannot do any harm. How could placing a little sugar-water at the junction of a ligament with a bone be harmful to a patient?

C. Everett Koop, M.D., ScD
Former United States Surgeon General
Dr. Koop passed away February 2013 at age 96

Neuro-Prolotherapy for Sciatica Follow Up

It is late on Saturday night and it has been two and half days since my nuero-prolotherapy injections to alleviate my intense sciatica and nerve pain in my legs. I’m pleased to say that the pain has not returned at anywhere near the levels I was experiencing it before. neither the sciatica nor the nerve pain down the front of my legs has returned intensely and the there has been no pain in the front of the legs at all. The sciatica has returned slightly necessitating taking Vicodin during the day, which eliminates the pain.

Overall, I could not be happier with the success of the prolotherapy treatment to alleviate the sciatica. It pain was intense and unmanageable before the prolotherapy and after it has been very manageable. As my doctor noted, I ahve a fairly high tolerance for pain, so for me to complain it must have been bad. It was. And now I am pleased t say it is not. Let us hope the success continues a few more days.

Prolo in Shoulder Follow Up

Five days since prolo therapy injections in my right shoulder and there is little pain and full range of motion. Prior to the injections I could not sleep lying on my right side, either with my arm up or tucked under as the pain in the shoulder was too great. Already I am sleeping on my right side with arm raised.

It is pretty impressive how quickly the injections can work. He did at least 6 shots in the front of my shoulder and another 6 in the back with an additional one right into the joint. For two days the inflammation prevented full range of motion and now in the fifth day motion is not only restored but already greater than before the shots.

The prolotherapy injections may not be pleasant, given the size of the needles and the fact that the protocal calls for the needle to be touching the bone, but it is certainly effective. I can’t recommend it enough. I have had bad pain in my shoulder for at least 4-5 months and within 5 days it is gone. I don’t care how painful the treatment for shoulder tendonitis is, and it was not that painful, it is certainly worth a half hour of pain for such a quick cure.

Prolotherapy for Achilles Heel

My heel had been killing me for months. So many pains throughout my body had come from my car accident and early on the doctor had treated my foot. I was a bit surprised that foot pain could have been caused by the accident, but when he explained the impact of a foot on the floor of a car and the frame being hit at 30mph or so, it became clear that easily could have caused it. As the spasms in my neck released and my back began to heal, other pains in my body became much too prominent.

An achilles tendon injury can also be caused in exercise or sports. Too often the tendon is strained and ligaments injured. Prolotherapy helps the body strengthen the weakened or injured ligaments and tendons using the body’s own repair mechanisms. If the damage is severe enough, such as the tendon separating from the bone, only surgery can repair it. But most injuries in this area are strains and can be helped dramatically with Prolotherapy.

At this point I have had two treatments, a month apart. The first consisted of several shots on either side of the achilles tendon. A month later the doctor increased the potency of the “medicine” from 15% glucose to 25% glucose and injected directly into the insertion point at the back bottom of the heel. Since that was a single shot, and he had just given me shots elsewhere complete with numbing with lidocaine, he did that single shot without anesthetic. It was not pleasant. Still, I would do it again, for the pain has subsided substantially. I’m looking forward to one more shot in that area to complete the treatment as it appears to be one of the more stubborn injuries. I’ve felt the imporvement, but it is not yet healed.