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 LOW
BACK PAIN AND PROLOTHERAPY
The Diagnosis:
Ross
Hauser, M.D.
The first step in determining
ligament
laxity
or instability in the lower back is by physical examination. The
examination involves maneuvering the patient into various
stretched positions.
If weak
ligaments
exist, the stressor maneuver will cause pain. Do this
simple test at home: Lie flat on your back and lift your legs together
as straight and as high as you can, then lower your legs. If it is more painful
to lower your legs than to raise them, laxity in tile lumbosacral ligaments is
likely. During physical examination by a physician, laxity can be "tested" by
palpating various ligaments with the thumb to elicit tenderness. A positive
"jump sign" indicates ligament laxity.
Low back pain is one of the easiest conditions to treat with
Prolotherapy.
Ninety-five percent of
low back pain is located in a 6-by-4 inch area, the
weakest link in the vertebral-pelvis complex. At the end of the spine, four
structures connect in a very small space which happens to be the 6-by-4 inch
area. The fifth lumbar vertebrae connects with the base of the sacrum This is
held together by the lumbosacral ligaments. The sacrum is connected on its sides
to the ilium and iliac crest. This is held together by the
sacroiliac ligaments.
The lumbar vertebrae is held to the iliac crest and ilium by the
iliolumbar
ligaments. This is typically the area treated with
Prolotherapy for
chronic
low back
pain.
Sacroiliac
Ligaments
The diagnosis of ligament laxity in the lower back can be made relatively
easily. Typical
referral pain patterns are elicited-the
sacroiliac ligaments
refer pain down the posterior thigh and the lateral foot, the
sacrotuberous
and sacrospinous ligaments
refer pain to the heel. The
iliolumbar ligament refers
pain into the
groin or vagina. Iliolumbar ligament sprain should be considered
for any unexplained vaginal, testicular, or groin pain.
The most common cause of unresolved chronic low
back pain is injury to the
sacroiliac ligaments which typically occurs from bending over and twisting with
the knees in a locked, extended position. This maneuver stretches the sacroiliac
ligaments, placing them in a vulnerable position.
How effective is Prolotherapy in relieving chronic low back pain?
In one of his original papers, George S. Hackett, M.D., noted 82 percent of
people treated for posterior sacroiliac ligament relaxation considered
themselves cured and remained so 12 years later.
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