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 Diseases
treated by Prolotherapy -
Peripheral Joints
Jay
W. Nielsen, M.D.
TMJ
Tempero-Mandibular
Joint Syndrome is more often diagnosed by the dentist than the doctor.
Symptoms include clicking of the jaw joint in front of the ear, fatigue with
chewing, jaw locking and spasms in the throat. Symptoms at a distance include
all the symptoms of
Barre-Lieou syndrome,
headache and vague dizziness.
The dentist
can grind down a high tooth with occasional relief. A denture designed to put
a space between the back molars can also help. It these fail, major medical
centers will cut the jaw and re-align it though not with very good success. A
single injection into the joint once every two weeks for five visits can
relieve most if not all the symptoms in a majority of cases. If the ligament
is completely torn, it cannot be repaired because Prolotherapy only
strengthens existing ligament; it will not bridge a gap.
Shoulder
Pain and the Rotator Cuff Tear
The
shoulder
starts at the sternum and thoracic spine.
ligament injury to the
shoulder is
usually broad and weakens all structures. Therefore, Prolotherapy works best
on the
shoulder when it is all inclusive of these areas.
Ligaments of
importance attach the collarbone to the breastbone, the collarbone to the
scapula (shoulder blade), and the scapula to the humerus (the upper arm bone).
There are a dozen small ligaments holding the
acromion process, coracoid
process, clavicle and humerus in position. It these are weakened, the space is
narrowed with subsequent Thoracic Outlet Syndrome. The humeral head drops in
the socket causing
arthritis and clicking and grinding begin. Many injured
shoulders are associated with a ruptured
cervical disc in the neck. Shoulders
pain evaluation should always include a neck
x-ray. A large
Rotator Cuff Tear
on
MRI in the middle of the ligament cannot be repaired with Prolotherapy. The
healing effect will not reach that far across the long ligament. Surprisingly,
many patients with mid-belly tears improve anyway because the Prolotherapy
lifts the humerus back into the fossa relieving pressure on the cuff.
Tennis
Elbow or Lateral Epicondylitis is one of the simplest things to repair with
Prolotherapy. Because we have recently (five million years!) become bipedal or
upright, we have restructured our elbow to allow better use of tools rather
than knuckle walking.
This
resulted in the forearm muscles attaching at the elbow over a very small
surface area. Wrenching at heavy objects such as knobs, pliers or repeatedly
hammering with the fingers on a keyboard rips the attachment off the bone
partially leaving a chronic
tendonitis. It the tendonitis that makes this easy
to fix. Since the ligament is already inflamed, the Prolotherapy shots don't
need as many injections to start the fibroblast formation. The injections
permanently make the attachment wider and stronger.
● Carpal
Tunnel Syndrome
Carpal
Tunnel Syndrome is the number two cause of missed work after
back pain in the
American worker. The cause of CTS is that repetitive use of the forearm and
wrist as with Tennis Elbow tears the ligaments over the back of the wrist. The
wrist is an arch of bones in two rows that create a tunnel through which pass
the tendons, arteries, nerves and veins to the hand in order of
compressibility.
Hip Pain
Hip pain is a very complicated work-up. The obviously worn hip on x-ray
frequently is not the cause of
hip pain. Before performing Prolotherapy on the
hip or surgical joint replacement, thorough attention needs to be paid to the
lumbar discs,
sacroiliac joint and knee. Every one of these diseased joints
can refer to the hip. Sometimes, remarkable relief comes just from inserts for
a fallen arch or a shoe lift for a short leg. Hip pain also can arise from
inflamed structures in the
pelvis such as ovarian cysts, diverticulitis or
bowel cancer.
Knee Pain
The knee is
the most common joint to undergo joint replacement after the hip. A
disappointing number of patients are dissatisfied with the results. The
rehabilitation is long, the surgery is expensive and the socket comes loose
and needs redone with injury as minor as a fall. Once the knee is replaced,
there is no going back, the joint has been disposed of and if the implant
infects, the knee is useless and months of
antibiotics will be required.
The role of
knee ligaments is to keep the flat plane of the tibia in perfect alignment
with the moving curved surface of the femur. If the medial or collateral
ligaments in the knee are
stretched by injury or repetitive use, the joint
starts to wear on one edge rapidly eroding the
cartilage and then bone.
As the joint narrows,
the process is compounded by instability, as the ligaments that spanned the
joint are now too long to keep the joint tight.
Prolotherapy directly
addresses the problem by restabilizing the joint ligaments. The kneecap or
patella also becomes loose and rides erratically down the groove wearing out
the back of the kneecap. All these ligaments are rebuilt together with
surprising success. Continuous use of
glucosamine keeps the little remaining
cartilage continually healing to allow the patient to avoid surgery. No knee
joint is too damaged to try Prolotherapy in our experience. While Prolotherapy
cannot repair a torn cruciate ligament, the knee ligaments are rarely injured
one at a time. If the cruciate is no more than torn half through, stabilizing
the other ligaments can postpone or completely cancel surgery. Prolotherapy is
commonly used by veterinarians to keep thoroughbred horses racing after
significant injuries. James Matthews MD of New York is an Orthopedic Surgeon
who has principally been performing Prolotherapy for decades in his practice
prior to surgical management. He published a fascinating study in the Journal
of Orthopedic Medicine.
ABSTRACT: "This
is a preliminary report on a new approach to the treatment of
Osteoarthritis
(OA) of the knee. Patients with OA of the knee, having no history of
significant injury or inflammatory
arthritis, were examined for evidence of
sacroiliac joint (SIJ) ligament laxity and SIJ mal-alignment. Sixteen patients
meeting these criteria were treated with ligament Prolotherapy of the SIJ
ligaments. Improvement in
knee pain was noted in 15 of 16 patients. In the 8
cases with significant loss of range of motion and effusion (fluid in the
joint), objective improvement occurred in 7.
This is the reason
why hip and knee pain evaluation must include x-rays all the way up to the
back. Every one of these patients had pain directly as a result of back
pathology.
Knee replacement would most likely have failed in every case.
Ankle Pain: The most
common cause of adult
chronic ankle pain is failure to follow instructions at
the time of relatively simple ankle sprains in youth. The ligament ceases to
be painful in 10-14 days but the ligament is not healed for weeks after. If
the patient doesn't rest and wear and Aircast for eight weeks, the ligament
heals in a lengthened position and now the ankle is even more prone to
re-injury.
Chronic weight
bearing on the joint out of alignment causes premature arthritis. The second
cause of adult chronic ankle pain is ligament injury at the time of fracture.
While the bones knit nicely, the associated ligaments are disrupted by the
swelling and callous formation of the fracture. Ankles show excellent response
to Prolotherapy regardless of age.
Foot
pain and deformity is most often better
handled by the Podiatrist with inserts in the shoes but when conservative
measures fail, the foot should be evaluated for permanent ligament laxity.
Heel spur, bunions and mid- foot pain can all be partially relieved by
Prolotherapy.
knee pain (see Prolotherapy research
paper)
© Jay
Nielsen, M.D.
The opinions expressed
here does not necessarily reflect the views of the other member physicians of
getprolo.com.
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