A Pain in the Buttock (and
back)
treated with Prolotherapy and PRP
Scott Greenberg, MD
Many of us who have had back
pain will also feel the pain radiating down the leg, into
the hip, and into the buttock. It takes a great degree of
skill, experience, and knowledge to determine what the
appropriate treatment is for a patient with these symptoms.
We cannot just rely on the MRI, no matter how abnormal the
disc or joint may seem. The following case will illustrate
this:
Mr. AP is a diabetic 64 year
old male who presented to me, Scott Greenberg, MD, with a
horrible, stinging pain in his buttocks. This pain
prevented him from driving any distance in his car, and he
could not sit for any period of time. Furthermore, the
nighttime was especially difficult and he had to try to
sleep on his couch or recliner, because sleeping in bed was
uncomfortable. He also felt pain in in the back, and his
foot was numb.
Mr. AP had already seen the
spine surgeon (who wanted to operate, but could not
guarantee a good outcome), had taken pain medication, and
also saw a pain management doctor who gave him 2 epidurals,
which only helped slightly, but told him that the numbness
in his foot would take at least a year or two to resolve.
Mr. AP decided to try
something else, and had heard about prolotherapy and PRP,
but he wasn't sure if it would help him, as he was told he
had "nerve damage".
On examination, I found no
evidence of nerve damage, as his strength was good in his
musculature, but because of pain, he could hardly lift
himself on the examining table. His reflexes were fine, and
other tests for disc irritation were not found. However,
palpation and manual testing revealed pain in the sacrotuberous ligament, the pyriformis, the posterior hip
capsule, the gluteal muscles, and in the sacroiliac
joint. He also had a complete pelvic tilt.
I reviewed the MRI, and also
saw evidence of disc degeneration, arthritis, and spinal
stenosis. I had a discussion with the patient of where I
thought his symptoms were originating from, and also how
they connected to the degeneration seen on the MRI. He did
not want surgery, so I discussed the treatment options with
him.
We used a combination of
prolotherapy and PRP (platlet rich plasma) therapy on his
low back. His pelvic tilt was immediately corrected and he
started to feel some relief of the low back stiffness. Even
after the first treatment, some of the numbness in the foot
had resolved. He was treated every three weeks, and after 4
treatments was very comfortable sitting, as the stinging
buttock pain was resolved. After 5 treatments, he was able
to sleep comfortably in bed, something that he was not able
to do for months and months. He was happy! He progressed
until his back pain was resolved, and the numbness in the
foot was completely resolved. Furthermore, he could hop up
and down on the examining table, not crawl and struggle to
get up as before.
Dr. Greenberg is located at the Magaziner Center
Prolotherapy New Jersey
