Treatable Conditions
It is important to understand that this is only a partial list. The best way to determine if prolotherapy can help is to register for an evaluation with Dr. Thomashefsky or another physician trained in orthopedic medicine and specializing in prolotherapy.
Lower Back Pain
Low back pain can be due to relaxation or looseness in the ligaments surrounding the lower vertebral segments and/or in the sacroiliac joint. This is often not a pinched nerve. Prolotherapy can help to tighten the ligaments and stabilize the lower back.
Neck Pain
In a whiplash injury from an automobile accident or a fall, ligaments can be torn and not heal back to their normal length and strength. The neck gets out of alignment and muscles may spasm trying to support the loose vertebrae. The patient experiences a chronic low grade, nagging pain, muscle tightness, or spam. Prolotherapy can help tighten the ligaments and allow the muscles to relax.
Shoulder Pain
Shoulder pain, especially rotator cuff strains, partial tears or dislocations, can be treated by prolotherapy. This strengthens the tendinous or ligamentous attachments to improve the function of the shoulder joint and decrease pain.
Wrist and Ankle Pain
If one sprains the ankle or wrist and the ligaments don't heal back to their normal length and strength, joint dysfunction will result causing an decrease in grip, strength, function and stability. Prolotherapy can help to restore the normal function of the wrist and ankle joints.
Knee Pain
The most common source of knee pain in runners is chondromalacia patellae. This is a tracking abnormality often caused by a pronated foot. Looking at the “whole patient” is essential. Hip problems often present as knee pain.
An accurate diagnosis is important before one can do the correct treatment. Ligaments, tendons, busrsae or cartilage can cause pain and prolotherapy can help.
Hip Pain
Hip arthritis is quite common. What comes first is a relaxation of the ligaments around the hip, allowing too much "rock and roll" in the joint. The joint wears away more quickly.
Also very important, is the stability of the sacro-iliac joint in stabilizing the pelvis. The iliac wing is the bone that contains the “socket” for the hip joint. If the pelvis is rotated, hip dysfunction and arthritis will result. Prolotherapy, especially with the addition of glucosamine and other growth factors, can help grow new hip ligaments and cartilage and reduce arthritic dysfunction.
Foot Pain
Foot pain can be due to multiple factors. The easiest “fix” is to get shoes that are appropriate to the sporting activity. Orthotics may be needed to support certain conditions. The ligament in the foot and ankle can be torn easily in a sprain injury. If not healed to their normal length and strength, the foot and ankle will be unstable and require prolotherapy and/or orthotic support.
Sciatica
Sciatica is due to a pinched nerve from a herniated disc or a bone spur. This may require surgery. Often, however, relaxation of the lumbar ligaments can allow too much motion in the lumbar segments, which may "tweak" the nerve and cause pain down the leg. This can very easily be treated by prolotherapy to tighten the ligaments and stabilize the vertebral segments.
Tennis Elbow/Tendonitis
In the first six weeks of an overuse injury, like tennis elbow or tendinitis, cortisone can be used to decrease inflammation. After six weeks, however, the process turns from being an inflammatory process to a "degeneration" of the tendon attachment known as tendinosis. This cannot be successfully treated with cortisone, which may reduce pain for a week or two but then the pain will return. Tendinosis can easily be treated by prolotherapy to strengthen and tighten the tendon attachment. (See the Mishra article on the PRP tab from Stanford about PRP treatment of tennis elbow)
TMJ
Temporomandibular joint dysfunction is the same as any other joint dysfunction. When ligaments are torn either from an injury or from an automobile accident, the joint can be loose. The looseness allows too much "rock and roll" in the joint, causing the cartilage to wear away. The result is arthritis in the jaw joints or TMJ. Prolotherapy can help tighten the TMJ ligaments to restore normal function to that joint. Sometimes after an automobile accident or severe injury the cartilage in the TMJ joint is disrupted and a MRI scan may need to be done to evaluate TMJ integrity.
Whiplash from falls or automobile accidents
Whiplash is the tearing of muscle and ligament attachments. After a whiplash, eighty percent of people are completely pain free in three months. However, if the patient continues to have dysfunction or chronic pain in their joints (neck, low back, shoulder, etc.) from a whiplash that means there is incomplete growth of the torn tissue. These tears can be easily treated with prolotherapy. About 80% of people suffering from an injury resulting from whiplash get 80 to100 percent better after a course of prolotherapy.
Headaches
Headaches are very often due to muscle tension. The high neck ligaments are loose when those joints are unstable. The muscles contract causing tightness up into the crown of the head and temples. This muscle spasm is a result of instability in the neck vertebrae. This can be treated with prolotherapy to restore joint function to the vertebral joints of the upper neck.
Painful joints
The most common scenario is “overuse”. Joints respond to pounding and too much pressure by becoming painful and sometimes swollen. Looseness of the supporting ligamentous structures can allow too much “rock and roll” in the joint. This accelerates the wear and tear on cartilage and premature arthritic changes which can be effectively treated with prolotherapy.
Torn cartilage
We all have heard of a torn knee cartilage. However, every joint is cushioned by cartilage. Cartilage is like spongy tissue. When a sponge is new, it is very cushiony. Cartilage gets dried out and crumbly as we age. For all of us, the aging process makes the cartilage more vulnerable to a degenerative tear.
In younger people with spongy cartilage, a tear can be very painful. Surgery does not repair or fix cartilage tears; it removes the torn cartilage and files it down to create a smooth surface. While pain may be reduced surgery also results in there being less cartilage than there was initially. Loss of cartilage—via surgery or degeneration—can lead to the need for a joint (e.g. knee, hip, etc.) placement.
Dextrose based proliferant, PRP and glucosamine injections have been shown in controlled studies to reverse this degenerative process. (See Physician’s tab for articles.)
Torn ligaments and tendons
Ligament holds bone to bone (as in joints) and tendon hold muscle to bone. These are called connective tissues since they “connect” structures.
What is common about ligaments and tendons is that they have limited blood supply and when injured, heal poorly. When torn, the natural healing process usually takes about six to eight weeks. Complete healing of connective tissue restores normal length and strength to the injured site and the patient experiences full recovery.
If the tissue does not heal back to its normal length and strength, then the muscle or joint becomes weak or loose. Connective tissue cannot be strengthened with exercise of vitamin therapies. Once that initial eight-week healing cycle is over, there is no more natural potential for growth.
Regenerative Injection Therapy (RIT) or prolotherapy creates a micro injury to induce a healing response.
Sprains and Strains
Classically, a sprain is a term indicating torn ligament and a strain is a term indicating torn muscle. The connections of tendon (muscle to bone) or ligament (bone to bone) combine common fibers that connect at the same place. This is the “fibro-osseous junction.
A “sprain/strain syndrome” usually indicates that soft tissue is torn. This term is most often used in a whiplash or automobile accident report.
Sprains and strains that have not healed well by “mother nature” after that initial six to eight weeks, may be very effectively treated with prolotherapy.
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