Alternative and Complementary
No Pain, No Gain: Prolotherapy
By: Tracy Zuckerman
The adage, "No pain, no gain," is one people with chronic pain conditions usually shouldn't follow. None of us wants to induce more pain for any reason! But sometimes we must try alternative treatments to relieve the unrelenting pain that limits our ability to function the way we once did, and sometimes new treatments mean a different kind of discomfort or pain.
I have tried various treatments from non-invasive to invasive to relieve my pain from complex regional pain syndrome/reflex sympathetic dystrophy. On the injection side, I have tried electrical stem acupuncture, trigger point injections and many interscalene nerve blocks. After these of treatments, I always had a flare up before I saw some improvement in my pain cycles. What I am saying is that there is a very fine line between "no pain, no gain," especially when it comes to injections. When my doctor mentioned prolotherapy, I really had to stand back and take a long, slow breath and think about the possible benefits. Today I can honestly say that prolotherapy, as a part of a multidisciplinary approach to my pain, has helped give me back quality of life!
Prolotherapy involves the injection of a dextrose solution, usually used in IV solutions, and an anesthetic to reduce pain, such as lidocaine, into a ligament or tendon where it attaches to the bone. Proponents of this type of therapy say that prolotherapy increases the blood supply and flow of nutrients to the affected area, which helps repair the tissue. This can increase strength and stability to a weakened, painful area.
Phototherapy is "the rehabilitation of an incompetent structure, such as ligaments or tendons, by the induced proliferation of new cells."1 The Latin word prolo means offspring and proliferate means to have growth or to produce new cells in rapid succession. The idea behind prolotherapy is that you generate or proliferate new cells to strengthen fibrous tissue by creating inflammation that triggers healing. In other words, you're forcing the body to heal itself in the injected areas.
Medical history tells us how doctors started to develop methods that would allow the human body to help itself heal. Hippocrates, the Greek physician, used his theories to help heal dislocated shoulders of javelin throwers with heated metal probes. This technique was believed to create scar tissue that then caused tightening of the area, which was believed to stimulate the injury to heal and stabilize the joint.
Over time, injuries cause degeneration which may cause individuals to lose their ability to function or perform normally. In, 1939, George S. Hackett, MD, a pioneer in the field of prolotherapy, defined the treatment – when applied in the treatment of skeletal disability – as "the rehabilitation of an incompetent structure by the generation of new cellular tissue." Basically, we need to treat the site of the injury, which can refer pain to another area in the body, in order to restore proper function, therefore eliminating the pain and its source.
Most injuries that lead to chronic pain directly affect tendons, ligaments, muscles, joints and the intricate network of substances that enable the human body to move. Tendons attach muscles to the bone and allow for joint movement. A strain is when tendons get stretched or injured. Ligaments are like structural rubber bands connecting two bones together and are involved in the stability of the joint. When ligaments are strained or injured, it's called a sprain. Muscles are the tissue in the body that can contract, usually in response from the nervous system. Cartilage is a type of fibrous connective tissue. Cartilage is composed of collagen, a naturally occurring protein in the body. Joints are the intersection of bones connecting together which allow movement. Stability, flexibility and pain-free smooth movement occurs only when there is an uninterrupted connection between the inner workings of our bodies.
The fibro-osseous junction is where the tendons and ligaments attach to the bone, creating a site that is easily injured or stressed. The periosteum is the spongy area of the bone where blood supply flows through a tough membrane-like tissue and wraps around the bone. This area is the most sensitive and prone to pain. The connective tissues that surround the muscles are the second in line to produce severe pain. Cartilage has no nerve endings, so there is no sensory response to injury within the cartilage. Ligaments and tendons are weak at the attachments to the bone and have limited blood supply – this inhibits their ability to heal completely after an injury, which results in a taut, tight band of fibrous tissue that can become weakened and cause chronic pain. Understanding these interconnections is critical to the overall performance of the human body and to trying prolotherapy.
If you decide to try prolotherapy, make sure a very qualified therapist and doctor is treating you – one who has experience with your type of chronic pain and its causes. I always disclose all medications and treatments to my doctor – this has been a catalyst for me toward healing and I have gained a tremendous amount of trust and respect for those who treat me because of the honesty we use on both sides of the relationship.
My doctor is very compassionate and patient – he begins by spraying the area with a topical pain-relieving spray to numb the skin. Then he injects a mild solution of dextrose and a local pain reliever like lidocaine, using a thin needle to minimize the discomfort. Usually, I get a few shots in an area. I start to feel achy and stiff afterward, which lasts for a few days. To decrease the intensity of the discomfort, I apply moist heat to the area and take acetaminophen when needed. Within a day or so, I resume physical therapy and am able to increase my exercises and my ability to function. The healing is still going on as I move forward!
Phototherapy promotes a natural response from the body to heal. The inflammation caused by prolotherapy causes our bodies to produce more collagen and form new connective tissue. The result is new tissue growth and better performance by our cells on a molecular level – a more stable environment for the tendons and ligaments. It has worked for me and more than half a million other Americans. Many doctors and clinics are using phototherapy. Even the former Surgeon General, Dr. C. Everett Koop has used it and has said prolotherapy helped relieve his chronic pain.
Rehabilitation of our bodies is essential when you live with chronic pain. Health is a very personal issue to us all and if you want to change your quality of life, then try new treatments. Prolotherapy may be an option for you. Be patient and be aggressive! You are the only one who can make the choice – become an advocate for your own health! Talk to your doctors and therapists, do your research, and find out if you are a candidate for prolotherapy!
http://getprolo.com/introduction_to_prolotherapy.htm
http://clinicaltrials.gov
http://www.prolotherapy.com/prolodefine.htm
http://www.wholehealthmd.com
http://www.medical-library.net
I have tried various treatments from non-invasive to invasive to relieve my pain from complex regional pain syndrome/reflex sympathetic dystrophy. On the injection side, I have tried electrical stem acupuncture, trigger point injections and many interscalene nerve blocks. After these of treatments, I always had a flare up before I saw some improvement in my pain cycles. What I am saying is that there is a very fine line between "no pain, no gain," especially when it comes to injections. When my doctor mentioned prolotherapy, I really had to stand back and take a long, slow breath and think about the possible benefits. Today I can honestly say that prolotherapy, as a part of a multidisciplinary approach to my pain, has helped give me back quality of life!
Prolotherapy involves the injection of a dextrose solution, usually used in IV solutions, and an anesthetic to reduce pain, such as lidocaine, into a ligament or tendon where it attaches to the bone. Proponents of this type of therapy say that prolotherapy increases the blood supply and flow of nutrients to the affected area, which helps repair the tissue. This can increase strength and stability to a weakened, painful area.
Phototherapy is "the rehabilitation of an incompetent structure, such as ligaments or tendons, by the induced proliferation of new cells."1 The Latin word prolo means offspring and proliferate means to have growth or to produce new cells in rapid succession. The idea behind prolotherapy is that you generate or proliferate new cells to strengthen fibrous tissue by creating inflammation that triggers healing. In other words, you're forcing the body to heal itself in the injected areas.
Medical history tells us how doctors started to develop methods that would allow the human body to help itself heal. Hippocrates, the Greek physician, used his theories to help heal dislocated shoulders of javelin throwers with heated metal probes. This technique was believed to create scar tissue that then caused tightening of the area, which was believed to stimulate the injury to heal and stabilize the joint.
Over time, injuries cause degeneration which may cause individuals to lose their ability to function or perform normally. In, 1939, George S. Hackett, MD, a pioneer in the field of prolotherapy, defined the treatment – when applied in the treatment of skeletal disability – as "the rehabilitation of an incompetent structure by the generation of new cellular tissue." Basically, we need to treat the site of the injury, which can refer pain to another area in the body, in order to restore proper function, therefore eliminating the pain and its source.
Most injuries that lead to chronic pain directly affect tendons, ligaments, muscles, joints and the intricate network of substances that enable the human body to move. Tendons attach muscles to the bone and allow for joint movement. A strain is when tendons get stretched or injured. Ligaments are like structural rubber bands connecting two bones together and are involved in the stability of the joint. When ligaments are strained or injured, it's called a sprain. Muscles are the tissue in the body that can contract, usually in response from the nervous system. Cartilage is a type of fibrous connective tissue. Cartilage is composed of collagen, a naturally occurring protein in the body. Joints are the intersection of bones connecting together which allow movement. Stability, flexibility and pain-free smooth movement occurs only when there is an uninterrupted connection between the inner workings of our bodies.
The fibro-osseous junction is where the tendons and ligaments attach to the bone, creating a site that is easily injured or stressed. The periosteum is the spongy area of the bone where blood supply flows through a tough membrane-like tissue and wraps around the bone. This area is the most sensitive and prone to pain. The connective tissues that surround the muscles are the second in line to produce severe pain. Cartilage has no nerve endings, so there is no sensory response to injury within the cartilage. Ligaments and tendons are weak at the attachments to the bone and have limited blood supply – this inhibits their ability to heal completely after an injury, which results in a taut, tight band of fibrous tissue that can become weakened and cause chronic pain. Understanding these interconnections is critical to the overall performance of the human body and to trying prolotherapy.
If you decide to try prolotherapy, make sure a very qualified therapist and doctor is treating you – one who has experience with your type of chronic pain and its causes. I always disclose all medications and treatments to my doctor – this has been a catalyst for me toward healing and I have gained a tremendous amount of trust and respect for those who treat me because of the honesty we use on both sides of the relationship.
My doctor is very compassionate and patient – he begins by spraying the area with a topical pain-relieving spray to numb the skin. Then he injects a mild solution of dextrose and a local pain reliever like lidocaine, using a thin needle to minimize the discomfort. Usually, I get a few shots in an area. I start to feel achy and stiff afterward, which lasts for a few days. To decrease the intensity of the discomfort, I apply moist heat to the area and take acetaminophen when needed. Within a day or so, I resume physical therapy and am able to increase my exercises and my ability to function. The healing is still going on as I move forward!
Phototherapy promotes a natural response from the body to heal. The inflammation caused by prolotherapy causes our bodies to produce more collagen and form new connective tissue. The result is new tissue growth and better performance by our cells on a molecular level – a more stable environment for the tendons and ligaments. It has worked for me and more than half a million other Americans. Many doctors and clinics are using phototherapy. Even the former Surgeon General, Dr. C. Everett Koop has used it and has said prolotherapy helped relieve his chronic pain.
Rehabilitation of our bodies is essential when you live with chronic pain. Health is a very personal issue to us all and if you want to change your quality of life, then try new treatments. Prolotherapy may be an option for you. Be patient and be aggressive! You are the only one who can make the choice – become an advocate for your own health! Talk to your doctors and therapists, do your research, and find out if you are a candidate for prolotherapy!
References
http://getprolo.com/introduction_to_prolotherapy.htm
Resources
http://clinicaltrials.gov
http://www.prolotherapy.com/prolodefine.htm
http://www.wholehealthmd.com
http://www.medical-library.net