Wednesday, November 13, 2013

Prolotherapy: Possible Treatment for Unresolved Back Pain


Prolotherapy is a treatment that offers hope to those who feel they've tried everything to relieve back pain. If you suffer from sciatica, sacroiliac joint dysfunction or lumbosacral joint pain, you may be helped by prolotherapy.

Joint pain is often caused by damage to the ligaments that support the joint. Ligaments are connective tissues that band bone to bone in a joint, providing for strength and structural integrity. If a ligament is strained, torn or otherwise injured, its healing time will be slow and it will become weak. This is due to the fact that ligaments receive a very low blood supply. The same is true for tendons, which band muscles to bones.

If the ligaments that support spinal joints or the sacroiliac joint grow weak, they fail to support the joint. This results in abnormal range of motion. In the sacroiliac joint, this results in pelvic instability, localized and referred pain, and sometimes sciatica. In the spine, hypermobile joints can lead to disc herniation, which causes back pain, spinal instability and sometimes sciatica.

Often, the possibility that ligament damage is causing other phenomena like sciatica or disc problems goes overlooked, and so all attempts to resolve back pain fail. The low blood supply to ligaments means that they may never get back to being as strong as they once were. Prolotherapy claims to have an answer to that problem.

This form of treatment involves injecting a solution where the ligament in question meets the bone. The solution is often simple sugar water combined with an anesthetic; other irritants and additives are available. The introduction of a foreign substance sparks the inflammatory response. The body sends inflammatory materials to the injected area, meaning that blood flow is increased.

Inflammation is something we generally try to avoid; the swelling is painful and can actually cause more harm than good if it is chronic. But the inflammatory response is part of the immune system. Its goal is to 1) block perceived threats off from other parts of the body and 2) facilitate healing of the injured area. When it comes to ligaments and tendons, inflammation is needed to increase blood flow to the normally avascular areas. Blood brings with it nutrients and oxygen to rebuild damaged tissue. The "prolo" in prolotherapy stands for the proliferation of new connective tissue.

A local anesthetic makes the injection relatively painless. The inflammation caused by prolotherapy can cause temporary discomfort in the area, but the inflammation caused is generally controlled and does not last long. Most patients need 3 to 10 sessions to build enough tissue to restore ligament and tendon strength.

The downside of prolotherapy is that it is generally not covered by insurance - yet. The criteria for valid scientific study are rigid and have not yet been met by studies of prolotherapy. There is, however, substantial experiential evidence to support the treatment's efficacy. See http://www.dailystrength.org/treatments/Prolotherapy to read what recipients of prolotherapy have to say about it. Each session can cost $250 or more, depending on the joint that needs healing and the specialist you see. While the cost adds up over 10 sessions, it still pales in comparison to that of surgery.

If you think you've tried everything to heal back pain, remember that the field of treatment is vast. Educate yourself on all of your options for back pain management. Prolotherapy may be the overlooked form of treatment that can resolve the source of your back pain.

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