Prolotherapy, IDET, Epiduroscopy, Back Surgery
| < Back to Prolotherapy Article Index |
No matter how much I write about Prolotherapy, people will ask what are my chances with my particular condition. I tell them that I have been doing Prolotherapy for over 10 years and have only had a handful of clients receive other treatments by my recommendation.
“Yes doctor but what about me and my herniated disc?” In the over 10 years of practice I can only remember two possibly three patients who ended up needing surgery, the rest were treated with medications, nerve block injections, epidurals, exercise, and of course Prolotherapy. I have had acute herniated disc patients back to work in two days. Yes sometimes Prolotherapy, nerve blocks, epidurals, and medications work that quickly to resolve the pain.
“Doctor what about my degenerated discs?” In the ten years I have been practicing I have had only one or two that ended up getting intradiscal electrotheramal therapy (IDET). The rest with exercise, nutritional supplements, and Prolotherapy resolved their pain complaints (or the majority of them). IDET is a treatment that involves frying the disc wall to contract the collagen of the disc to help decrease the pain of degenerated discs.
One person who had the procedure said with hospital charges included the cost was $15,000. Yikes! Prolotherapy for degenerated disc generally runs about 10% of that and is very effective. In regard to other procedures, I have referred nobody for epiduroscopy, the latest back pain treatment craze. This procedure warrants no space here.
“Doctor I have pain down my leg are you sure you have seen this before?” Prolotherapists have seen everything. Prolotherapists understand ligament and nerve referral pain patterns. When needed an MRI or EMG/NCV will be ordered but in general treatment can begin without the necessity of these tests.
For most painful conditions Prolotherapy is very effective. I recommend getting a second opinion before any body is going to undergo disc frying (IDET), back surgery, or back scoping (epiduroscopy). It is probable that a simple procedure called Prolotherapy is all that will be needed to resolve the pain. I have ten years experience at least to go on.
BACK PAIN - SPINAL STENOSIS
Ross Hauser, M.D.
1. Does Prolotherapy help spinal stenosis? It may not make your MRI look better, but in the hundreds of cases we have treated, it is about 90% effective at eliminating symptoms, many times for good.
2. How can Prolotherapy help if the bone spurs are still present?
Prolotherapy helps relieve spinal stenosis symptoms by strengthening the ligaments that attach to the vertebrae and the pelvis. Most of the time the symptoms of so-called spinal stenosis are from the vertebral or pelvic instability and once this is resolved so are the symptoms.
3. Don't you ever recommend surgery for spinal stenosis? We can not honestly remember a case that came to Caring Medical where surgery was recommended. But in the rare instance when it was clear that the persons spinal cord was in jeopardy it would be recommend it.
4. What can a person do if Prolotherapy is not successful for spinal stenosis? There have been instances where the person with Prolotherapy was not responding quickly. In these instances an aggressive natural medicine program including natural hormone replacement, supplements and nerve blocks were warranted. Sometimes osteophytes do encroach on nerves and in these instances nerve blocks are given in the office. These can be of the traditional and nontraditional variety. The most common substance that we use is Sarapin, an extract of the pitcher plant.
For decades now Prolotherapy has been helping patients with spinal stenosis get over their pain. Dr. Hemwall, (for over forty years) and Ross (for over ten years), have been treating spinal stenosis and helping patients recover from their pain without surgery. Dr. Merriman, back in the 1960's, wrote that Prolotherapy was a much better option than surgical fusion for spinal stenosis. His research can be found in the books Prolo Your Pain Away! and Prolo Your Back Pain Away!.
People are generally puzzled when Ross tells them that Prolotherapy can help relieve the pain of spinal stenosis. "How can Prolotherapy help spinal stenosis?" is the normal response. The answer to this question can be found in the following:
Many people with spinal stenosis continue to have pain after the operation, even though the x-ray studies show the nerves have plenty of room. This must mean that something besides nerve impingement from bony overgrowth is the cause of the pain in these individuals.
Spinal fusion operations do help some individuals with spinal stenosis. "Well how does that help your argument that Prolotherapy is a viable treatment option for this disease." Good question. Yes, the main operation for spinal stenosis is spinal fusion. Well perhaps the pain relief from spinal fusion operation isn't because the nerves have more room but the stability in the spine that occurs with the fusion operation. If the later is the case than surely Prolotherapy could do just about the same thing.
No pain at rest. If the spinal canal is so narrowed that the surgeon has to go in there and give the nerves more room, why doesn't the person have back pain (or neck pain) and leg pain (or arm pain) when just sitting or lying down? Surely the space in the canal is not bigger while in the lying down position, so why does the pain go away? Don't you see? People with so-called spinal stenosis have pain with activity which is somewhat diagnostic for ligamentous/vertebral instability. The conditions that Prolotherapy is very good at correcting.
Pain with activity. So called spinal stenosis patients have pain with activity. Typically ligament laxity and vertebral subluxations/instability give pain with activity. For that matter pelvic distortions and sacroiliac problems (laxity) give back and leg pain with activity. So the common conditions that respond to Prolotherapy could more justly account for the symptoms in most spinal stenosis patients.
The response to Prolotherapy. Patients with "spinal stenosis" have relieved their pain with Prolotherapy. It must be that the vertebral ligament laxity is what is causing the persons pain and the bony overgrowth found on x-ray is in response to this. The treatment, thus, should be directed at the cause of the bony overgrowth, not at the arthritic changes themselves. Prolotherapy by strengthening the ligaments and preventing the vertebral instability helps relieve the chronic pain that so many have with spinal stenosis.
Unfortunately for most, one treatment of Prolotherapy is not sufficient to cause enough growth of ligament and tendon tissue to permanently eliminate the chronic pain or sports injury. The typical young athlete requires about two or three treatments, adult athletes typically require anywhere from four to eight treatments.
The inflammatory response typically occurs over a four to six week period, therefore most Prolotherapy physicians see patients for re-evaluation every four to six weeks.
The anesthetic in the solution used during Prolotherapy sessions often provides immediate pain relief. The pain relief may continue, after the effect of the anesthetic subsides, due to the stabilizing of the treated joints because of the inflammation caused by the Prolotherapy injections. This pain relief normally continues for a few weeks after each treatment. Between the second and fourth weeks, the initial stabilization induced by the Prolotherapy subsides, and because the initial growth of ligament tissue is not complete, some of the original pain may return during this "window period" of healing. The patient is typically seen for follow-up four to six weeks after the treatment so progress can be accurately assessed, avoiding evaluation during the "window period." Prolotherapy is performed every four to six weeks because most ligaments and tendons heal over this time frame.
As the healing progresses, the number of injections required per treatment usually decreases. The pain generally continues to diminish with each treatment until it is completely eliminated, often after four to eight sessions. In some cases, athletes or other chronic pain patients will not experience pain relief after their first or second Prolotherapy treatment. This does not necessarily mean that the therapy is not working, but rather it is an indication that the ligaments and tendons are not yet strong enough to stabilize the joints. The amount of collagen growth required for stabilization of the joint is different for each person. A patient who experiences pain relief at rest, but not during activity requires further treatment to strengthen the area. If Prolotherapy treatments are continued, there is an excellent chance of achieving total pain relief with the resumption of all previous activities, including athletics. For the rare person who feels no relief with the third treatment, we do a nutritional assessment to see if there is something impairing the healing process. Some people want to do all of this on the first visit, which is often ideal because all aspects of healing can be initially addressed. Remember that Prolotherapy starts the healing process, the body grows the stronger tissue. The healthier the person, the more the tissue will be stimulated to grow with each treatment. If a person has a depressed immune system because of hormonal problems, nutritional deficiencies, or other medical problems (e.g., diabetes, etc.), these will decrease the body's ability to heal. Smoking and excessive drinking of alcohol have the same effect. This is where techniques like diet typing, nutritional counseling, and overall natural medicine care are encouraged.
< Back to Prolotherapy Article Index
 |
 |
