Prolotherapy for Chronic Back Pain

I am a chronic back pain sufferer. I have ligament laxity. Ligament laxity is a term that refers to ligaments in the body that can move more than usual. Doctors can also call these looser than normal ligaments hyper mobile; they do not generally refer to lax ligaments as a condition. Chiropractors tend to use the term to describe a potential cause of chronic joint pain or sprains.

For me exercise does not improve ligament or tendon laxity. When exercising here is a point of diminishing returns. I realized as muscle strength increased there was a corresponding tendency to tendonitis and ligament strain. Seemingly my muscle strength over powered my ligaments. Physical trainers and even physical therapists that have the “boot camp” mentality and harass one to work through pain often frustrate me. Pain is a symptom of something wrong, not something good.

Yes weight-bearing exercise is healthy, while running faster and longer builds muscle as well as a stronger heart and lungs. However this does me no good if I end up with sprained ankles and I can’t walk at all. Swimming is the best exercise foe me to keep up muscle strength, flexibility and cardiovascular health.

Hyper mobility is genetic. An estimated 5% to 12% of the adult population has some degree of generalized joint hyper mobility associated with ligament laxity. Marfan or Ehlers-Danlos are recognized syndromes, which are generally rare syndromes, and are characterized by ligament laxity and other determinants.  Hyper mobility syndrome appears to be familial with a clear-cut female predominance. Typically symptoms first appear in children or young adults. Although hyper mobile individuals have a potentially heightened aptitude for activities such as gymnastics, dancing, and playing musical instruments, they also have an increased susceptibility to dislocations, traumatic joint pain, tendonitis, and overuse injuries. These problems may present as a fibromyalgia-like syndrome triggered by exercise.

Chronic back pain can be a symptom of underlying structural problems, or it may be a symptom of an underlying condition. It is essential to have an appropriate physical exam to rule out kidney stones or kidney infection, prostatitis, chronic diverticulitis, cancer of the pelvis, endometriosis, ovarian cysts, fibroid tumors, shingles and circulatory deficiency from hardening of the arteries.

Your back supports your entire body, using a complex interconnecting network of nerves, joints, muscles, tendons and ligaments. All these components are capable of producing pain in the back, low back and surrounding areas. Because the back is connected to the rest of your body, back pain can be an early warning of underlying conditions elsewhere in your body.

Large nerves that originate in the spine and go to the legs and arms can make pain radiate to the extremities. The pain may be felt in the neck (or might radiate into the arm and hand), in the upper back, or in the low back (and radiate into the leg or foot). Other symptoms may include symptoms weakness, numbness or tingling.

If left untreated, most back problems only worsen as time and gravity take their toll on our bodies. After falling hard on my knee and twisting and torqueing my pelvis I had excruciating lumbar pain for nearly five years. I had sciatic pain shooting through my buttocks and down my leg into my foot. I could walk for about fifteen minutes at a moderate pace but could not tolerate standing after five minutes.

I started with physical therapy and back strengthening which created minor improvement but the PT became a treadmill sadist and I felt myself regress. I saw an orthopedic surgeon who requested I get an MRI. Although, I did have two slightly herniated discs, very slight spinal stenosis, and mild lateral arthritis, I did not meet his criteria for surgery because the pattern of symptoms did not indicate a diagnosis remediable by surgery.

My chiropractor told me about prolotherapy an injection technique that stimulates growth of cells and tissue that stabilize and strengthen weakened joints, cartilage, ligaments and tendons.

The injected solution intentionally causes controlled irritation in the tissue. This irritation is an inflammatory response, which increases the blood supply and thereby stimulates the tissue to heal and regrow new tissue. Typically prolotherapy involves the injection of natural substances such as dextrose into the tissue to initiate the healing process. Dextrose is the most studied substance worldwide and is extremely safe and effective. 

My initial prolotherapy, which occurred 1 ½ years ago, created a 20-30% improvement. (I have not lost any of this improvement.) I also worked with a Rolfer (Structural Integration therapy) and Sacral-Occipital Therapy Chiropractic. I would say I had another 30% improvement. Because I still have a tendency to extreme muscle tension in the lumbar, I felt that the pain had decreased significantly but not enough.

Recently, I attended a Dr. Norm Shealy workshop on wellness protocols. He described sacral shear as the cause of low back pain. This happens when the sacrum become hyper mobile and presses on the sciatic nerve. The sacrum is a small triangular bone located at the bottom of the spine and between the hips. I realized I had originally because I had only addressed half of the hyper mobility affecting my sciatic nerve. I am seeing a local osteopath for prolotherapy injections to strength the ligament laxity around the sacrum.

Prolotherapy was the innovation of Dr. Earl Gedney, an osteopathic physician and surgeon. In the early 1930s, Dr. Gedney caught his thumb in a door thereby stretching the joint and causing severe pain and instability. He was told that nothing could be done for his condition and that his surgical career was over. Gedney knew of a group of doctors that used irritating solutions to stimulate the repair of the distended connective tissue ring as treatment for hernias. He extrapolated this knowledge and utilized it to inject his injured thumb. He was able to fully rehabilitate the thumb. In 1937, Gedney published “The Hyper-mobile Joint,” the first known article about Prolotherapy. The 1937 article gave a preliminary protocol and discussed two case reports, one of a patient with knee pain and another with low back pain who were successfully treated with this method. Prolotherapy is practiced by physicians in the U.S. and worldwide. It is effective in treating many musculoskeletal conditions such as tendonopathies, ligament sprains, back and neck pain, tennis/golfers elbow, ankle pain, joint laxity and instability, plantar fasciitis, shoulder, knee, and other joint pain.  C. Everett Koop, the former US Surgeon General has endorsed prolotherapy, was helped by it, and practices it.

I view this odyssey as a life lesson; it took sixty years to get to this point I cannot expect to reverse the damage quickly. The alternative approaches I have chosen have been researched; they are not paid for by health insurance but they should be. Health insurance should pay for therapies that promote health, not pain killer medication addiction and steroids that cause physical deterioration.

http://www.medscape.com/viewarticle/413950

http://www.prolotherapy.com/Prolotherapy.php

http://www.getprolo.com/tag/sacroiliac-pain/#sthash.BYAO8X00.dpuf

http://www.getprolo.com/prolotherapy-after-back-surgery/