Why Prolotherapy is a Better Option
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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.
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PROLOTHERAPY AND THE PATELLA
Ross A. Hauser, M.D.
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When there is a problem with this part of the knee it manifests as pain in the front of the knee after strong exertion (running, walking, or stair climbing.) This may be due to erosion of the cartilage on the under side of the patella, poor tracking of the patella in its groove on the front of the knee, or an inflamed tendon on the lower edge of the patella.
The patella is covered on its back side with the thickest layer of articular cartilage of all the joints in the body. Erosion of this cartilage is called "chondromalacia patellae." On x-ray it is seen as a decrease in the amount of cartilage underneath the kneecap. It may be caused by trauma or occur spontaneously. If the patella is fractured, pain may still persist after the fracture heals. Prolotherapy is excellent at relieving all of these pains.
Prolotherapy helps chondromalacia patellae or patellar tracking problems because the pain-producing structure is generally the patellar tendon or the musculoskeletal support around the patella. Prolotherapy for chondromalacia involves intra-articular (inside) injections as well as injections on the outside of the knee, stimulating the growth of many musculoskeletal structures around the patella. It is for this reason the knee gets stronger and the pain of chondromalacia is relieved.
Patellar Tendonitis
Another common condition is patellar tendonitis, which can occur at the sides, the top, or the bottom of the patella. It commonly occurs in athletes who do a lot of jumping, such as basketball players, volleyball players, and ballet dancers. This is why it is also known as "jumper's knee." By injecting the appropriate site with Prolotherapy, these injuries are effectively and permanently treated and the pain is relieved. This is because Prolotherapy helps strengthen the patellar tendon (though some would call this the patellar ligament since it goes between two bones, the patella and the tibia). While Prolotherapy causes a strengthening of the patellar tendon, cortisone and its related anti-inflammatories, weaken it. For this reason patients should avoid cortisone injections into the patellar tendon because of the risk of it weakening and thus leading to rupture of the tendon. This occurs because cortisone weakens the ligament/tendon-bone junction. Cortisone and the other anti-inflammatories have a lot of other bad effects.
Do Not Be Desperate for Surgery or Scopes
Patients with pain often succumb to surgical procedures, even drastic ones. A good example of drastic surgery is the recommendation to surgically remove the patella in order to remove the pain. This sometimes does relieve the pain, but at a significant cost to the body. The strength to extend the knee is reduced by about 30 percent, and the force exerted in the knee is increased. There are a host of other risks associated with surgery. The athlete must realize that with each procedure and each shaving or cutting of tissue, NSAID (non-steroidal anti-inflammatory drug) prescription, or cortisone shot, the odds of developing long-term arthritis are greatly increased. The key to keeping the knee strong is to stimulate the area to heal, not to cover up the pain with a cortisone shot or NSAID. Even worse is to eliminate the painful area by shaving or cutting. This just delays the pain for a few years until the remaining tissue becomes degenerated. The best approach is to stimulate the area to heal. The best way to do that is with Prolotherapy.
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