Prolotherapy Under C-Arm Fluoroscopy

A free full access article discussing Prolotherapy Under C-Arm Fluoroscopy is now available at the Journal of Prolotherapy.

Fluoroscopy is a real time x-ray that helps the physican guide the Prolotherapy injection to an exact spot.

Here is an abstract from the article

Interventional pain management traditionally has focused on the use of C-arm fluoroscopy to inject the spine. Fluoroscopy is a real time X-ray designed to allow the physician to guide a needle into a specific location.  While Prolotherapy has been performed without the use of imaging guidance, our training in pain management lent itself to using this technology for certain Prolotherapy techniques.

Like many physicians practicing regenerative medicine, our interest in Prolotherapy began because of our general dissatisfaction with the results of injecting steroids. In addition, we were also concerned about the body of literature that demonstrated that injecting high dose steroids could lead to problems in the joint. This phenomenon, known as apoptosis, means that these medications can shut down all normal repair and maintenance functions in the joint for months, ultimately leading to a less swollen, but more degenerated joint.3 In addition, high dose corticosteroids have also been shown to cause other issues such as systemic side effects and even catastrophic illnesses such as osteonecrosis.

Interventional pain management traditionally has focused on the use of C-arm fluoroscopy to inject the spine. Fluoroscopy is a real time X-ray designed to allow the physician to guide a needle into a specific location.  While Prolotherapy has been performed without the use of imaging guidance, our training in pain management lent itself to using this technology for certain Prolotherapy techniques.

Like many physicians practicing regenerative medicine, our interest in Prolotherapy began because of our general dissatisfaction with the results of injecting steroids. In addition, we were also concerned about the body of literature that demonstrated that injecting high dose steroids (milligram range) could lead to problems in the joint. This phenomenon, known as apoptosis, means that these medications can shut down all normal repair and maintenance functions in the joint for months, ultimately leading to a less swollen, but more degenerated joint. In addition, high dose corticosteroids have also been shown to cause other issues such as systemic side effects and even catastrophic illnesses such as osteonecrosis.

The remainder of this article and more prolotherapy research can be found at  Prolotherapy Under C-Arm Fluoroscopy. For more Prolotherapy information or to find Prolotherapy doctors.

Cervical Radiculopathy

The Journal of Prolotherapy is making more Prolotherapy Research available as free full access

As published in the journal and announced in the Getprolo Prolotherapy information newsletter, a group lead by Ross Hauser, M.D., examined the role of Prolotherapy and other non-operative treatments of Cervical Radiculopathy.

Cervical radiculopathy often produces agonizing neck pain, a burning sensation, along with numbness radiating down the arms, shoulder blades, and back, or up into the head.

The authors discuss cervical radiculopathy from the position of a Physiatrist, chiropractor, and physical therapist. Each author reviews case studies and techniques utilized in order to successfully treat patients presenting with cervical radiculopathy.

Read the the paper at the Journal of Prolotherapy

 

Prolotherapy Treatment Options

What is the best Prolotherapy treatment route for chronic pain and/or injury. Is it Prolotherapy with dextrose, sodium morrhuate, minerals, hormones, PRP, and even stem cell therapy using bone marrow?

PRP Prolotherapy versus dextrose Prolotherapy:
A side-by-side comparison study has yet to be published, Ross Hauser, M.D. utilizes PRP Prolotherapy his office as well as dextrose Prolotherapy, and both certainly work well. Dr. Hauser has published a paper on the use of PRP Prolotherapy in knee patients with meniscus tears told they needed surgery who were able to resolve their injuries with PRP Prolotherapy instead of surgery.

Dr. Hauser says in his opinion that it is not necessary to use PRP Prolotherapy on all patients for all conditions. It has its place, but it is not needed for all patients. That would only add undue cost and time when dextrose Prolotherapy will work great for a wide array of conditions.

Dr. Hauser has a new video out on the subject that you can view below

New free access Prolotherapy research

The Journal of Prolotherapy is offering more free access complete Prolotherapy research and clinical outcome studies.

Below is a case study examining Prolotherapy and lower back pain, pelvic shifting benefit

Background Content: This case study examined the effects of a single Prolotherapy injection series on the left iliolumbar ligament. The ligament measurements were split between medial and lateral portions of the iliolumbar ligament and we hypothesized that growth would occur increasing the cross sectional area and thus provided added stability to the pelvis and lumbar spine.

Purpose: The purpose of our study was to answer two questions: 1) how do you know that the Prolotherapy injectant actually reaches the ligamentous structure you are attempting to heal; and 2) how long does it take for the ligament to recover?

Study Design: Single case study.

Methods: One subject, 32 year-old female with no history of lower back pain (LBP) participated in our study. Her job tasks as a physical therapist required her to twist turn and bend; putting pressure on her pelvis and ligamentous system. The primary author (A.A.) assessed her pelvic ligaments which lead to using a specified Prolotherapy solution for the left iliolumbar ligament. Ultrasound (US) guided imaging was used to take baseline measurements of the left iliolumbar ligament prior to Prolotherapy. Bi-weekly US measurements were up to six weeks to determine cross-sectional area (CSA) changes within the ligament.

Results: The results indicated that after the initial Prolotherapy treatment, there was growth in the left iliolumbar ligament at both the medial and lateral sites. The CSA increased by 27% for the medial measurement and 21% for the lateral measurement compared to baseline. The left iliolumbar ligament also appeared to change its characteristics and looked more uniform as a result of one Prolotherapy treatment.

Read this Prolotherapy and lower back pain outcome
and for general information about
read here Prolotherapy and back pain also read about
Back pain and Prolotherapy

Platelet Rich Plasma Therapy Basic Information

Basic Information on Prolotherapy and Platelet Rich Plasma Therapy. Free access article from the Journal of Prolotherapy by Ross Hauser, M.D.

In this article Dr. Hauser discusses the basic preparation of the blood platelets into growth factor solution before the treatment is admistered to the patient.

Dr. Hauser is recognized as a leading physician in the practice of Platelet Rich Plasma Treatments (PRP) and Prolotherapy.

Prolotherapy research free access article low back pain

Free access to this Prolotherapy research on back pain can be found at the Journal of Prolotherapy

Dextrose Prolotherapy for Unresolved Low Back Pain: A Retrospective Case Series Study

Ross A. Hauser, MD & Marion A. Hauser, MS, RD

abstract
Objective: To investigate the outcomes of patients undergoing Hackett-Hemwall dextrose Prolotherapy treatment for chronic low back pain.

Design: One hundred forty-five patients, who had been in pain an average of four years and ten months, were treated quarterly with Hackett-Hemwall dextrose Prolotherapy. This included a subset of 55 patients who were told by their medical doctor(s) that there were no other treatment options for their pain and a subset of 26 patients who were told by their doctor(s) that surgery was their only option. Patients were contacted an average of 12 months following their last Prolotherapy session and asked questions regarding their levels of pain, physical and psychological symptoms and activities of daily living, before and after their last Prolotherapy treatment.

Results: In these 145 low backs, pain levels decreased from 5.6 to 2.7 after Prolotherapy; 89% experienced more than 50% pain relief with Prolotherapy; more than 80% showed improvements in walking and exercise ability, anxiety, depression and overall disability; 75% percent were able to completely stop taking pain medications. The decrease in pain reached statistical significance at the p<.000001 for the 145 low backs, including the subset of patients who were told there was no other treatment options for their pain and those who were told surgery was their only treatment option.

Conclusion: In this retrospective study on the use of Hackett-Hemwall dextrose Prolotherapy, patients who presented with over four years of unresolved low back pain were shown to improve their pain, stiffness, range of motion, and quality of life measures even 12 months subsequent to their last Prolotherapy session. This pilot study shows that Prolotherapy is a treatment that should be considered and further studied for people suffering with unresolved low back pain.

introduction
Low back pain is one of the leading causes of physical limitation and disability in the United States today. Each year, 65,000 patients are permanently disabled by conditions associated with back pain, and 80% of the U.S. population is estimated to suffer back pain at some point in their lives.1,2 Though acute back pain is believed to be self-limiting, it recurs at a rate of approximately 90%.3 In one study, only 25% of the patients who consulted a general practice about low back pain had fully recovered 12 months later.4 For those who do recover, relapses can be frequent and severe, with two to seven percent developing chronic pain.5

There is some consensus in the medical community on how to treat acute low back pain, but treatment of chronic pain presents many challenges and little agreement on standard of care. Nonsteroidal anti-inflammatory drugs and antidepressants provide some short-term benefit, but no published data warrant their long-term use.6 Manipulative therapy, physiotherapy, and massage therapy studies have also shown only temporary benefit.7,8 Long-term results on more invasive therapies, such as intradiscal electrothermal therapy (IDET) or surgery, have been poor.9,10 Some believe the poor results for the treatment of chronic low back pain stem from the fact that too much emphasis has been placed on pain arising from the intervertebral discs and not enough on chronic low back pain originating from the sacroiliac joint and ligaments.11,12 Because of the limited response to traditional therapies, many people have looked to other approaches for pain control. Prolotherapy (proliferative therapy), also known as regenerative injection therapy, is a nonsurgical injection therapy used to treat unresolved musculoskeletal pain and has shown some promise in relieving lower back pain.13 The procedure involves injecting soft connective tissue with one or more proliferants designed to provoke local inflammation, stimulating the body’s production of collagen at the injection site. The resulting growth of new ligament and tendon tissue is believed to alleviate pain.

Prolotherapy research – Knee Pain

The Journal of Prolotherapy is offering free online access to complete Prolotherapy research articles.

In this article
Researchers investigated the outcomes of patients undergoing Hackett-Hemwall dextrose Prolotherapy treatment for unresolved knee pain at a charity clinic in rural Illinois. Eighty patients were studied, representing a total of 119 knees, that were treated quarterly with Prolotherapy. On average, 15 months following their last Prolotherapy session, patients were contacted and asked numerous questions in regard to their levels of pain and a variety of physical and psychological symptoms, as well as activities of daily living, before and after their last Prolotherapy treatment.

The results of this study showed that patients had a statistically significant decline in their level of pain, stiffness, crunching sensation, and improvement in their range of motion with Prolotherapy.

More than 82% showed improvements in walking ability, medication usage, athletic ability, anxiety, depression, and overall disability with Prolotherapy.

Ninety-six percent of patients felt Prolotherapy improved their life overall. Conclusion: In this study, patients with unresolved knee pain, treated with dextrose Prolotherapy, showed improvements in many clinically relevant parameters and overall quality of life.

Read the entire Prolotherapy and knee pain study