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KNEE PAIN AND PROLOTHERAPY
A blog with Ross Hauser, M.D.

REST, ICE, COMPRESSION, ELEVATION
Q. I have severe knee pain and swelling caused by Osteoarthritis, you don't recommend the RICE treatment?

A. I don't recommend the RICE treatment. The method we recommend is called MEAT. This stands for Movement, Exercise, Analgesics (pain relievers), and specific Treatments that increase blood flow. To speed up recovery from an injury, an athlete or patient should put weight on the area, move the injured limb, take pain relievers that do not decrease Inflammation, and then receive specific treatments that encourage healing. These include Physical therapy, massage, ultrasound, electrical stimulation, magnetic therapy, and Prolotherapy.

OSGOOD-SCHLATTER DISEASE: APOPHYSITIS OF THE KNEE
Chronic knee pain may develop in young athletes, especially teenagers, and is often due to Osgood-Schlatter Disease, a condition whereby the tibial tubercle becomes painful where the patellar tendon attaches to the tibia. Pain occurs because there is tendon weakness at the same area of the tibia that is growing. The pain is exacerbated by physical activity, especially running and jumping, and often limits participation in sports, resulting in the young athlete’s physicians recommending cessation of playing sports. Needless to say, this advice is not popular. In my opinion, better treatment is to strengthen the fibro-osseous junction of the patellar tendon onto the tibial tubercle, eliminating the problem. In a small study published in 1993, Prolotherapy was 83 percent effective in eliminating the pain of Osgood-Schlatter Disease. In this study only one to two treatments were needed to resolve the problem.

Kidd, R. Recent developments in the understanding of Osgood-Schlatter Disease: A literature review. The Journal of Orthopaedic Medicine. 1993; 15:59-63.

Article by Ross Hauser, M.D.

Q. Can Prolotherapy improve a medial inner tear of the meniscus
A. Would I get Prolotherapy if I had a meniscal tear? Most definitely I would. Unfortunately there have not been long term studies to prove or disprove that Prolotherapy helps heal meniscal tears. Anecdotal evidence is there that meniscal tears typically do very well with Prolotherapy. We have many patients, who over the years healed completely and did not need any further care.

Typically it takes 4-6 visits of Prolotherapy to heal a meniscal tear. Meniscal tears typically cause very discrete pain on the medial or lateral knee joint line and it increases with running, squatting, and cutting. Sometimes there is a 'catching' sensation. These symptoms usually decrease with each Prolotherapy session.
 
Answer by Ross Hauser, M.D.
 

Scar Tissue
Q. I have a lot of scar tissue in my knee, (adhesions), I am concerned that Prolotherapy, along with building good tissue will also build scar tissue.

A. Prolotherapy will not interfere with adhesion or scar tissue. The Prolotherapy solutions is injected at the fibro-osseous junction to stimulate production of the collagen matrix which does not create or promote adhesion formation in the body.

Answer by Ross Hauser, M.D.

Completely Torn Ligaments and Prolotherapy
Q. Will Prolotherapy work on a ligament that have become completely detached from the bone?

A. No, if your ligament injury is a complete tear, you would need to have the ligaments surgically reattached before we could treat that part of your body.

Answer by Ross Hauser, M.D.

Tendonitis
I have diagnosed with tendonitis from running. More specifically, I have sharp pain in the back my knees. Is Prolotherapy an option to minimize tendon inflammation and reduce pain?

Dear Knee Tendonitis: I would definitely recommend going to a Prolotherapy doctor, but specifically one that runs or exercises a lot. You need someone who can evaluate your condition as a tendon, ligament, or running mechanical problem. Prolo'ing the tendon or ligament to make it stronger will help but if your running mechanics are off the condition will continue to plague you. At Caring Medical we seek to cure you of the problem so you don't have to get Prolo in the area again!

Answered by Ross Hauser, M.D.

Q. I want to get Prolotherapy for osteoarthritis of the knee what exercises would you recommend during treatment?
A. Typically, we recommend that our patients with knee pain or knee arthritis avoid pounding exercises such as running and opt more for low weight/high rep weight training to strengthen the quad muscles. Swimming is a good activity as well.
 
You need to let pain be your guide to any activity…if it causes pain for more than an hour after the activity, you should probably avoid it.
Answer by Ross Hauser, M.D.