Prolo Therapy - UPDATE - Thursday

Discussion in 'Fibromyalgia Main Forum' started by KayL, Apr 28, 2003.

  1. KayL

    KayL New Member

    and I'm having mixed feelings.....anticiptation and dread. I'm really hoping this will help me but I'm completely dreading any more pain, and my elbows are hurting so much the skin is even sensitive to touch.

    I do have Emla cream to rub on my skin 2 hours before my appointment, so hopefully that will help.

    This is my first experience with Prolo Therapy, so wish me luck!

    [This Message was Edited on 04/30/2003]
    [This Message was Edited on 05/01/2003]
  2. selma

    selma New Member

    I never heard of it. Love, Selma
  3. klutzo

    klutzo New Member

    I've read about using this for fibro, and talked to people who've had it with great results, but not for fibro.
    Hope it helps you.
  4. Mikie

    Mikie Moderator

    Good luck with this. I'm not familiar with this therapy, but keep us up to date.

    Love, Mikie
  5. KayL

    KayL New Member

    and I'm a hurtin' puppy right now. The anesthetic cream definitely helped, and the actual injections didn't hurt as bad as cortison injections, which didn't help me at all. But my elbows are swollen, have about 2 dozen or so needle sticks in each one and wrapped. Apparently the next couple days may be pretty painful, and the elbow that was hurting me SO bad is hurting a LOT right now - I can't bend that arm.

    I'm scheduled for another round of this in 4 weeks. Apparently, for smaller areas, if you haven't improved after 4 - 6 treatments, it's not worth pursuing. I'm going to give it a shot. I've got so many things going on with this medical train wreck body of mine. The elbow thing is apparently actually chronic tendonitis I think. But it's to the point where I cannot lift a pot of coffee with one hand. Pathetic, huh? Anyway, I sort of figured that any relief, anywhere would be a blessing. If that can be one less place I have chronic pain, then hopefully I can better deal with the rest of the body.

    I took this from a website, it explains a lot about Prolotherapy - it's long, but if you're interested, here it is.


    "Prolotherapy is a unique, time-tested injection method used to treat chronic pain. It is defined by Webster's Third New International Dictionary as "the rehabilitation of an incompetent structure, such as ligaments or tendons, by the induced proliferation of new cells." Pain from auto accidents, athletic injuries, and overuse injuries often arise from injury to the soft tissues in the body. These soft tissues which include ligaments, muscles, tendons and joint capsules are also called "connective tissues" because they connect to bones, thereby supporting the bony skeleton. Prolotherapy causes these connections to be repaired rebuilt and strengthened. It is for this reason that prolotherapy has also been called ligament reconstructive therapy or stimulated ligament repair.

    Typical soft-tissue injuries include:

    ¨Whiplash Injury to the Neck, Upper Back, Shoulders and Low
    Back as a Result of a Car Accident.
    ¨Headaches and TMJ Syndrome
    ¨Low Back Pain from Lifting orWork-Related Injuries.
    ¨Postural Strain of the Neck and Back.
    ¨Overuse Injuries Such as Tennis Elbow, Shoulder
    Tendinitis, and Carpal Tunnel Syndrome.
    ¨Fibromyalgia and Myofascial Pain.
    ¨Muscle Tightness, Strain and Spasm.
    ¨Arthritis Pain.
    ¨Herniated and Degenerative Discs in the Neck and Back.
    ¨Pinched Nerves and Sciatica.
    ¨Weak, Loose, and Unstable Joints
    ¨Athletic Injuries, New and Old.

    These constitute soft tissue injuries which can often become chronically painful. Normally, these injured muscles, tendons, and ligaments go through a repair and healing process which takes about four to six weeks. But, what happens when the low back pain, neck pain, and headaches from a whiplash injury, just will not get better? Or, the athletic injury that continues to cause nagging pain and is preventing you from staying active, especially keeping you from the sport you enjoy the most? What about the pain where you cannot pinpoint a specific injury, but think it may be due to some repetitive tasks at work, or from overdoing it while working around the home. Anti-inflammatory and pain-killer drugs are often given to treat these injuries, but they may actually slow or stop this healing process. And besides, are you really suffering from a drug deficiency?

    When rest and pain medications fail, and usually they do because they only mask or cover up the underlying problem, other types of treatment are often tried. One method of treating these kinds of injuries is a specific flexibility and strengthening program, tailored to the individual and the areas of weakness. A physical therapist can administer therapeutic treatment, teach an exercise program, and provide the education to the individual to allow them to follow their program at home, giving them independence in their recovery.

    Another type of treatment is manual therapy, in which a therapist uses his hands to break up or release adhesions, muscle spasms and restricted fascia (connective tissue). Acupuncture and chiropractic treatments may only give temporary relief. Furthermore, high velocity spinal adjustments which are done too frequently or for too long may weaken the joints more and worsen the condition.

    In a significant number of cases, despite a reasonable treatment plan and consistent effort from the individual, residual pain and dysfunction may persist. Chronic pain is often quite disabling and may affect job performance, recreational activities and activities of daily living. Along the way a doctor may state that "you just have to live with it... there is nothing you can do about it" or say that surgery is the only option. That news is frustrating and discouraging!

    Although you may not have heard about prolotherapy until now, it has been around for more than sixty years and treatment results have been amazing. Up to 85-90% of patients have received good-to-excellent results in pain relief and improved function. Just as importantly, pain medications can be greatly reduced or even eliminated. This is good news, because pain medications can be costly and have potentially serious side effects. But, the best part of all is that prolotherapy produces long-lasting relief...naturally. Most other types of treatment provide only temporary relief. Prolotherapy is an alternative to surgery in many cases, thereby avoiding disfiguring scars and lengthy rehabilitation. George Hackett, M.D., a prolotherapy pioneer, proved that strengthening connective tissue relieves soft tissue pain and a research study in the respected medical journal Lancet demonstrated the effectiveness of prolotherapy.

    Prolotherapy works on a very simple principle: injecting the prolotherapy solution at the sites of pain and weakness stimulates the body's own healing mechanism to repair and rebuild injured tissue into a stronger, more supportive, less painful tissue than it was before.

    When injuries to the connective tissues (ligaments, tendons, and muscles) occur, the normal healing process may be incomplete, usually due to lack of proper treatment. This incomplete healing process is revealed under microscope by a deficiency of connective tissue cells called fibroblasts. The lack of fibroblasts leads to loose ligaments and weakened tissues. As a result, the normal supportive function of the ligaments which was present prior to injury is lost. Joint stability is therefore reduced.

    Small pain fibers in these damaged ligaments transmit pain impulses to the brain when stretched. Through a subconscious reflex, the surrounding muscles go into a tight and painful spasm in an attempt to stabilize the joint. This causes the region to feel tight, stiff, achy, burning, tingling, numb, fatigued, and painful. The individual will often notice painful knots in the affected muscles. These muscles become tight and painful as they try to compensate for the weak and damaged underlying tissue structures. The muscle spasms reduce blood flow, causing even more pain. Not only are these symptoms local, but they are often referred (transmitted) through nerve pathways into the legs and feet, arms and hands, and head (headaches). In other words, pain felt in the head, arms, or legs may be due to instability in the neck or back.

    For example, weakness or injury to the ligaments in the neck may interfere with the sympathetic (automatic) nervous system, causing a group of symptoms called Barré-Lieou Syndrome. This syndrome consists of one or more of the following: dizziness, visual blurring, loss of balance, ringing in the ears, runny nose, salivation, trouble swallowing, hoarse voice, nausea, vomiting, nervousness and headaches. These symptoms are caused by instability in the neck and can be eliminated by prolotherapy.

    Medications and other forms of passive treatment such as ultrasound, ice, heat, massage, acupuncture and manipulation may give minimal lasting benefits because the primary problem is not being addressed - the loose and injured ligaments. Stretching and strengthening exercises usually can provide some relief from chronic pain, but this is often only temporary. When these exercises have failed to increase the support sufficiently to diminish pain and improve function, the chronic pain cycle ensues. Prolotherapy should be initiated as soon as possible, before the problem becomes wide-spread.

    The most basic prolotherapy solution contains a naturally-occurring sugar (dextrose) derived from corn plus an anesthetic (lidocaine). Other common natural substances can also be used effectively. This solution does not contain cortisone, which is known to decrease inflammation, but will also slow or stop the healing process. Acute pain may be relieved with cortisone, but repeated use causes a weakening of the tissues and chronic pain develops.

    When the injured tissues are injected with small amounts of the prolotherapy solution, a reaction begins, starting a three-stage healing process (see stages to right).

    Prolotherapy initiates the first stage (Inflammation). Stages two (Fibroblastic) and three (Maturation) follow automatically. In stage one, the body sends in special cells which help to clean up the debris, much like a cleanup crew at a construction site. These cells respond as if another injury has occurred resulting in a controlled inflammation. This process takes a week. In stage two, the body begins the process of repair and healing. This is accomplished by the addition of a unique cell called a fibroblast which is deficient in the injured tissue. Fibroblasts increase in number at the sites of injection, and over the course of four to six weeks secrete a substance called collagen, which is a very strong and relatively inelastic substance and the most abundant protein in the body. The new collagen makes the ligaments thicker, denser and stronger, providing more support to your joints primarily where the ligaments anchor or attach to bone. The strength of the injected ligaments can increase up to 40% above normal. Stability is increased as pain and muscle spasm decrease. In stage three, the newly formed tissue continues to mature for 1 ½ years. Improvement, therefore, continues for a year and a half after the last treatment. If, during the three stages of the healing process, anti-inflammatory drugs, ice, compression and/or immobilization are used to reduce pain and inflammation, complete and normal healing will be inhibited. Most people are taught that inflammation is bad and don’t realize that, without inflammation, no healing will occur.

    So, in essence, prolotherapy strengthens ligaments and decreases pain by stimulating the body's own repair and healing mechanism to go into action. There is no masking of pain, tissues heal naturally and become stronger, without the formation of scar tissue. It is for this reason that prolotherapy gives long-lasting relief measured in months to years. Several treatments spaced apart by about four weeks are usually required to get the full benefit from prolotherapy. When a house is built, as each support is added the structure becomes more solid, giving more strength to the house. The same is true for joints. As each treatment strengthens the ligaments, more strength and support is added to the joint structure. No treatment other than prolotherapy is able to increase the strength and stability of joints.

    Prolotherapy is a very safe procedure when performed by a trained and highly skilled physician who has an in-depth knowledge of anatomy and experience using this injection technique. The use of needles involves risks, but complications from prolotherapy are rare. The solutions used have been shown to be safe and, as stated previously, do not contain cortisone. The most common side effect is discomfort due to the injections, as well as temporary soreness and stiffness. Although injection discomfort cannot be eliminated, it is well-tolerated in most cases. If necessary, it can be reduced by the use of prescription oral medications for pain control and sedation taken prior to the treatment. Most patients prefer not to be sedated because it makes them feel groggy and because a driver is required to and from the appointment. Topical freeze sprays or anesthetic cream can also reduce needle discomfort.

    Depending on the area treated and the number of injections, which is usually just a few for small areas or many for larger areas, one may return to usual activities the next day or two. The treatment session may last anywhere from a few minutes if there is only one site of tenderness such as the elbow, to fifteen minutes, if a large region such as the back and neck are being treated together. Thesoreness following the injections is normal and gradually lessens over several days. Approved, prescribed drugs or plain Tylenol may be taken for this pain. However, no anti-inflammatory drugs may be taken during the treatment period because these will interfere with the healing process that prolotherapy initiates. A goal of prolotherapy is to get the patient off all pain medications. Specific natural supplements may be recommended to enhance healing and alleviate pain

    Prolotherapy is not an overnight cure. It cannot “cure” every condition, nor always eliminate 100% of one's pain. There are some areas that the prolotherapist cannot safely reach with a needle. The vast majority of patients completely treated by prolotherapy (usually two to ten sessions) will receive at least 50% relief of their pain. Some even report complete resolution. These results are excellent, considering that chronic pain is exceedingly difficult to treat by any means. Combining other treatments, such as muscle therapy, physical therapy, electrotherapy, oral supplements, and exercise, further enhance results. It is also important to know that prolotherapy only strengthens tissues. No structures are weakened and no scars are formed. Therefore, no bridges are burned.

    A good history and a thorough examination are necessary to select the best candidates for prolotherapy. The motivation to want to get better and complete the necessary treatments is vital. Patience and time are important to reap benefits from prolotherapy. Chronic pain problems do not occur overnight and they do not heal that way ither. If the pain is not enough to affect one’s life, then prolotherapy isn’t indicated. Individuals who smoke, drink excessively, have unhealthy lifestyles or poor fitness, are obese, have underlying diseases or are under stress may not heal as well, decreasing the effectiveness of treatment. It also should be noted that people who regularly take narcotic painkillers receive far less benefit from prolotherapy because these drugs suppress the body’s immune system. Tolerance, physical dependence and addiction are
    consequences of habitual narcotic use. Weaning off narcotics greatly improves the results of prolotherapy.

    Prolotherapy is an effective treatment for a multitude of conditions. There is no other treatment that replaces prolotherapy for strengthening weakened ligaments. It works by stimulating the body's own healing process at the sites of injection. Healing occurs slowly but surely, and naturally. Multiple treatments are usually necessary to achieve maximum joint stability and long-lasting relief from pain. The goals of prolotherapy are to decrease pain and to improve the patient’s overall ability to function at work, at home, and during usual activities."

  6. KayL

    KayL New Member

    TRULY not fun. I did not sleep. The later it got, the more my arms hurt. I *think* this is normal for the first couple days, but man, am I in some pain this morning.

    I really HOPE this helps.

  7. sofy

    sofy New Member

    Is this done by a regular MD and will your insurance pay for it.
  8. JLH

    JLH New Member

    does this therapy?
  9. marilew

    marilew New Member

    I was seeing a Physiatrist, and he wanted to try Prolotherapy on me. He did some initial testing, and the reverse of what he expected happened, so I did not have the treatments.
    I sure hope that it helps you.
  10. KayL

    KayL New Member

    is a physiatrist or osteopath, pretty much the same thing. He's a former physical therapist.

    It's covered by my insurance, don't know if every ins. co. covers it.

    HINT: *IF* you do end up getting this done, be sure to get some anesthetizing cream to use on your skin prior helps a LOT. I've had cortisone injections a number of times in the past and the actual injections hurt a lot more than this did. However, I'm hurting a lot today and have already had 2 10/500 Lortabs this morning. Unfortunately, the cream, which is lidocaine & prilocaine ISN'T covered by insurance and it's expensive, moreso through the pharmacy. My doctor sells it direct from his office and it was $49 for a 30 g tube. I covered a larger area than was necessary yesterday, just because I was unsure how much to use, but I think I could get 2 treatments on both elbows out of one tube, which would amount pretty much to what my co-pay would have been if it were covered.

    Like anything else, there's no guarantee that after going through all this, it will work, but I'm hopeful.
    [This Message was Edited on 04/30/2003]
  11. KayL

    KayL New Member

    I was actually feeling better about 3 hours ago. But after working all day, I'm in a lot of pain again.

    This is pretty morbid - I took the bandages off and actually counted the needle sticks on each elbow. Sick, huh? Maybe I'm too overly curious..........LOL

  12. upinarms

    upinarms New Member

  13. KayL

    KayL New Member

    and....Upinarms, we have a bit in common, I too have worked since I was 16 and I am 47, almost 48. I've got a long history of back problems/surgeries and have had my back injected many times. Funny thing is, the cortisone injections helped my back and didn't hurt that much. BUT, they were extremely painful when I had them in my elbows, hips, etc. and they never helped those areas.

    Anyhoo, I know there are a few others who have posted in past months about having had prolotherapy, and this is my first shot with it. I'm having some high hopes that it will help, at least the elbow thing.

    So if it won't bore you guys too much, I'll let you know how this progresses.

  14. KayL

    KayL New Member

    My left elbow is hardly hurting at all. Although the right one (the BAD one!) is still stiff and is definitely still very sore, it's feeling much better than yesterday. This is a positive sign, IMO. There's still swelling and now bruising, but the pain is actually less, particularly the left one. This is wonderful; it's definitely lifted my spirits. Maybe this will actually work! I feel like *if* I can improve one area that's been causing me some major pain, I can concentrate on all the other stuff and be better equipped to deal with that.