From REMARKABLE RECOVERIES
Three Cases of Chronic Pain Relieved with Prolotherapy in Hong Kong Clinic
Stanley King Hei Lam, MBBS, PGDip MSM(Otago), FHKAM(FM), FRACGP, FHKCFP Journal of Prolotherapy. 2009;3:163-165.

A Case History
Ms. A is a 30 year-old financial planner, with a five year history of headache, vertigo, tinnitus, ear pain, jaw pain, pain on wide-opening of mouth, and neck pain. She also describes a pins-and-needles sensation of the hands and forearms during sleep or prolonged use of a computer. She has difficulty concentrating on her work when she has the attacks. She had seen a lot of doctors for help. Her cervical MRIs were unremarkable. Previous treatments included Physical therapy and chiropractic manipulation, each with only temporary, partial relief of the symptoms. She has very poor sleep and was labeled by some doctors to have psychosomatic disorder. So a low dose of antidepressants was given. She was also seeing ear, nose, and throat surgeons for severe allergic rhinitis and sinusitis with facial pain and had been put on intranasal steroid spray for one year with partial relief of the nasal symptoms. She also had gritty and itchy eyes with occasional tearing of eyes with a sense of fullness of the eyeball. She worried that she had glaucoma. She was referred to ophthalmologists for a thorough eye examination, which was normal. She was then labeled to have allergic conjunctivitis and was put on Sodium Cromoglycate eye drops again with partial and temporary relief of the symptoms.

When I first examined her, she had a significantly forward head position with her ear lobe at the level of her sternum. (See Figure 6.)

She had FRSrt C2/3 and C3/41, which means there is non-neutral dysfunction with a restriction for extension and for rotation and side bending to the left between C2 and C3, and between C3 and C4. The left facet joint between C2 and C3 and that between C3 and C4 do not close completely. Overall, she had very lax cervical ligaments. Her TMJ had clicking and the lower jaw deviated to right. Very gentle mobilization of the neck using muscle energy technique was done to realign those neck segments and the TMJ, this brought immediate relief of her vertigo and headache. My diagnosis for her was Barre-Lieou Syndrome.2 Since Prolotherapy is still very new to people in Hong Kong and Asia, she had never heard of this kind of treatment. She was advised to go to the internet and look at certain websites including www.prolonews.com; www.treatingpain.com; and www.drreeves.com to get information on Prolotherapy. She came back one week later as her symptoms returned, but this time she received her first Prolotherapy treatment without fluoroscopic guidance in my clinic. (See Figures 7 & 8.)

A 15% dextrose solution in lignocaine (lidocaine) was used to treat both the superior and inferior nuchal lines, the interspinous ligaments from C2 down to T1, the facet joints of the cervical spines, the origin of the levator scapulae at the medial and superior border of the scapulae, the mastoid processes and the angles mandibles, and the bilateral TMJs. She felt immediate relief of the headache, nausea sensation, and fullness of head after the injections. Her vertigo subsided one day after the procedure. She followed up four weeks later and stated that her headache, vertigo, tinnitus, nausea and vomiting, fullness in head, and numbness over her upper limbs had subsided. Surprisingly, her allergic rhinitis and conjunctivitis improved a lot. Her sleeping quality also improved and she no longer needed her antidepressant. She is now pain and medication-free after her second Prolotherapy treatment. She was taught the correct typing posture and self stretching techniques. I am hopeful she will remain pain free.


bibliography
1. Isaacs ER, et al. Bourdillon’s Spinal Manipulation. Sixth Edition. Woburn, MA. Butterworth-Heinemann Inc. 2002.

2. Hauser R, et al. Prolo Your Pain Away! Third Edition. Oak Park, IL. Beulah Land Press. 2007.