In this article Marc Darrow, MD discusses Prolotherapy treatments for lumbar spinal stenosis.
Lumbar Spinal Stenosis is a narrowing of the space between vertebrae where the spinal cord and the spinal nerves travel.
It is a diagnostic term to describe lower back pain with or without weakness and loss of sensation in the legs. It is a very common condition brought on mostly by aging and the accompanying degeneration of the spine.
As we age, discs compress, muscles, ligaments, and tendons weaken. With the spine weakened, the boney structures of the vertebrae begin to overgrow (osteoarthritis) as a means to stabilize the structure. The new boney mass begins to encroach on the openings in the spine that the nerves and spinal canal pass through. As the openings begin to narrow, the spinal canal and nerves rub against the bone causing irritation, inflammation and the symptoms of stenosis mentioned above.
A Demonstration of Stem Cell Therapy for back pain
Failed Spinal Stenosis Surgery
Many patients come into our office with a date for surgery or, and more unfortunate, a diagnosis of failed back surgery. For the patients who had put off surgery, they have explored their options and have discovered that surgery is not the answer for them. For the patients who had the surgery, they need more options than before.
In the recommended surgical procedures for spinal stenosis, two choices are the most favored. A decompression procedure where the surgeon will shave and cut away the bone narrowing the spinal canals. The second, a fusion procedure to limit the movement between two vertebrae and hopefully stop the compression of nerves.
Surgery for spinal stenosis should always be considered only after other conservative therapies have been exhausted because it is usually not as successful as hoped and leads to a new diagnosis “failed back surgery syndrome,” where symptoms continue to deterioriate. It is important to note that in instances where stenosis is so severe that the patient has lost circulation to the legs or bladder control – a surgical consult should be made immediately.
Many “conservative” or non-surgical treatment options include the use of anti-inflammatories or epidural cortisone injections. We avoid the use of these treatments as they are temporary “quick-fixes.” The medical literature is now long in studies that have shown that these treatments are contributors to accelerated deterioration of spinal and joint degeneration.
Osteoarthritis occurs because the bone is trying to stabilize a joint. Fusion surgery is recommended as a means to accelerate that type of stabilization – the use of bone for stabilization. Prolotherapy works a completely different way. It stabilizes by strengthening the often forgotten and under appreciated spinal ligaments and tendons.
Prolotherapy for lumbar spinal stenosis
Research over the last 60 years – has shown that Prolotherapy, the introduction of an irritant solution into the spine through injection, strengthens ligaments and tendons and stabilizes the spine by accelerating the body’s natural healing response – regrowth of tissue through control and rapid inflammation.
In one study, one hundred and ninety (190) patients were treated during a seven year study period. The outcomes suggests that prolotherapy using a variety of proliferants can be an effective treatment for low back pain from ligament problems when performed by a skilled practitioner. 1
Dr. Darrow continues this discussion at this article Lumbar Spinal Stenosis
1. Watson JD, Shay BL. Treatment of chronic low-back pain: a 1-year or greater follow-up. J Altern Complement Med. 2010 Sep;16(9):951-8. doi: 10.1089/acm.2009.0719.
Information for patients on Prolotherapy for back pain. These articles are divided into specific treatments and diagnosis:
In this article Ross Hauser, MD explains that the first step in determining if prolotherapy for low back pain can be an effective treatment for the patient is to determine ligament laxity or instability in the lower back by physical examination.
Many times a treatment may not be as successful as hoped because the diagnosis is not always accurate. The examination involves maneuvering the patient into various stretched positions. If weak ligaments exist, the stressor maneuver will cause pain. Read this article Prolotherapy for low back pain
In this article Marc Darrow, MD explains that ligaments can handle a normal amount of stress that will stretch them to their natural limit, and will return to them to their normal length once the stress is removed. If additional (traumatic) stress is applied— stretching the ligament beyond its natural range of extension—the ligament will not return to its normal length, but will instead remain permanently overstretched, diminishing its power. Such a condition is called Ligament laxity. Ligament laxity in the lower back, as elsewhere in the body, may be caused by a major traumatic injury, repeated minor injuries to the same area, or simple normal aging and can cause significant pain. Continue reading this article Prolotherapy for lower back pain caused by ligament injury
In this article Scott Greenberg, MD looks at a big belly as a cause of back pain and that treating back pain is more than surgery and pain-killers. It is whole patient management including Prolotherapy. Read this article Abdominal obesity and back pain. Continue reading this article Abdominal obesity and back pain
In this article, the surgeon’s reliance and emphasis on x-rays procedures and surgery by nature makes him/her think of the spine as a focally or regionally injured organ. Actually, it’s rare for a spine injured by sudden deceleration in an auto accident, lift or fall to receive its injury in one area. The x-ray changes suggesting that simply show the peak of injury, not the breadth. The patient frequently senses this better than the surgeon as he/she notes pain in remote areas where x-rays appear normal. Continue reading this article Prolotherapy and Chronic Pain Treatment