FOR JOINT PAIN RELIEF
LIGAMENTOUS RECONSTRUCTION BY INJECTION
Information for patients
cause of chronic pain which is often neglected is laxity of the ligament
fibers which stabilize joints. A technique called Prolotherapy utilizes
injection of a stimulant solution into the attachments of these ligaments,
to promote proliferation and toughening of the fibers, reducing the
abnormal laxity of the joints and producing remarkable and long-lasting
reduction in chronic pain. This technique can help correct many common
problems, including NECK AND BACK PAIN, TMJ SYNDROME, SHOULDER MOTION
PAIN, TENNIS ELBOW, CARPAL TUNNEL SYNDROME, SORE WRISTS, KNEES AND HIPS,
ANKLE LAXITY and PLANTAR FASCIITIS (HEEL SPURS).
Prolotherapy has proven to be especially helpful
for LOW BACK PAIN. Prolotherapy treatments are now
available at MINOR PROCEDURES.
= proliferation) involves the injection of irritants into ligamentous
structures in the neck, back or extremities. Ligaments are strong, flexible
connective tissues (like ropes or guy wires) which support the joints
and bind our bones together. These injections cause those structures
to be strengthened, thus improving support and relieving pain. The procedure
originated in the late 1940's and has been refined since.
ppProlotherapy involves carefully placed
injections of a mixture of lidocaine (which temporarily numbs the tissues
to relieve pain) and dextrose (sugar water) in a strength sufficient
to irritate the tissue and cause repair by the body’s own healing mechanisms.
Additional medications may be added to increase the body’s response
ppIt is thought that laxity of the connective
tissues and failure to maintain the original tissue support allows joints
and movements to become mechanically unstable, and that loose, floppy
joint support is a major cause of chronic pain. This looseness is a
result of previous injury, or often accompanies simple ageing. In addition,
it appears that prolotherapy also acts to reset pain nerves that have
become abnormally overactive.
ppExperiments in animals and humans have
shown that ligaments and tendons are strengthened and thickened by prolotherapy.
Studies have shown this to be an effective therapy in relieving chronic
ppThe injections are placed in painful
ligaments or tendon attachments to stimulate the body to heal itself.
The injection of the irritant solution activates a mild inflammatory
response very locally. Weaknesses and faulty structural elements are
thus detected and repaired, and the resulting improvement in function
and relief of pain are very often dramatic. Many patients who have previously
undergone multiple other forms of treatment without pain relief, including
physical therapy, chiropractic adjustments, and even surgery, receive
lasting pain relief after prolotherapy is performed.
involves injecting small amounts of solution into ligamentous structures
that are painful and/or weak. Depending upon the site and size of area
involved, this may necessitate many injections during one office visit.
These injections may be uncomfortable because they require multiple
needle sticks. Tiny injections of numbing medicine are usually given
first, so there is much less pain as the treatment itself is performed.
ppMost patients tolerate this well but
some patients, prior to the procedure, may require some medication for
pain control. Please discuss premedication with the doctor if you feel
you have unusually strong reactions to discomforts that are part of
minor procedures (such as a dental repair in your past.) Apprehension
(fear of needles) can also be eased with premedication if needed, and
if another driver is available to transport you.
ppAfter the injection procedure, most patients
feel fullness and numbness in the areas injected. Most post-prolotherapy
patients fall into one of the following three groups:
In the first, the pain is immediately relieved
due to the injection of the numbing medicine ppppppPinto
the area of pain. Then, during the next 24 to 48 hours, their pain may
return and pppppppmay be, initially, more
severe. The pain will gradually decrease in intensity as healing pppppppand
second group of patients have little or no pain post injection and the
pain stays ppppppprelieved permanently.
ppp pp• pAnother
group of patients finds that their pain is relieved initially but returns
after 2 - 3 pppppppweeks, necessitating
pppppOf course, there are some patients
who do not benefit from these injections.
number of injections to obtain relief varies considerably from patient
to patient and injury to injury. Some people are relieved totally with
one injection whereas others required a series of injections which may
total 15 - 20 or more sessions. Generally, several injection sessions
are done with most patients. If, after 3 or 4 sessions there has been
an adequate inflammatory response but no improvement in pain, prolotherapy
will usually not be continued.
ppIf progress is being made with prolotherapy
injections, the usual time between subsequent injections is 4 to 6 weeks.
Occasionally, injections will be recommended at closer intervals.
ppAfter prolotherapy, patients are encouraged
to do regular stretching exercises but not to over stress the areas
that have been treated - to allow for proper healing and strengthening.
It is important to remember that even if your pain is relieved and structures
strengthened, it is possible to re-injure yourself at some time in the
future, so it is important to take good care of the previously injured
ligaments so as to minimize the risk of re-injury.
ppThere is no known contraindication to
doing prolotherapy on diabetics. The small amount of dextrose does not
affect a diabetic’s blood glucose levels.
Risks and Complications
are potential risks and complications with Prolotherapy. Injections
are carefully placed, which minimizes potential damage to both nerves
and blood vessels, but damage can occur. As with all medical procedures,
side effects must be discussed with all patients considering a procedure.
ppAny medical procedure carries potential
risks and complications. After prolotherapy, these could include increased
pain, numbness (very rarely even permanent numbness), infection, abscess,
allergic reaction to medications injected, weakness, temporary or even
permanent paralysis, headache, pneumothorax (collapse of the lung),
dizziness, nausea and even death.
MINOR PROCEDURES S.C.
Richard L. Owens M.D.
1920 Monroe St.
Madison, WI 53711
Call for Appointment
MINOR PROCEDURES S.C. is a private practice dedicated to providing excellent
quality care, appropriate to outpatients' needs and wishes, at an affordable
cost, in a friendly and efficient manner.
MINOR PROCEDURES opened for patient care May 1st, 1995. Some of the
procedures we currently perform have been available from the beginning.
Others have been added to take advantage of newer technologies and knowledge
from around the world.