In this article Scott Greenberg, MD explains Prolotherapy for Spinal Stenosis.
We see many patients who come in with a diagnosis of spinal stenosis. Their doctors have told them that they have a narrowing of the spinal column and that is causing pressure on the spinal cord, and/or a narrowing of the openings where spinal nerves leave the spinal column. In recent research, doctors found that while stenosis was common on MRI, its cause as the pain source was described as “relatively uncommon.” 1
Spinal stenosis usually occurs as a person ages and the disks become drier and start to shrink. At the same time, the bones and ligaments of the spine swell or grow larger due to arthritis or long-term swelling (inflammation).
Often, symptoms will get worse slowly over time. Most often, symptoms will be on one side of the body or the other. These symptoms include:
- Cramping, or pain in the back, buttocks, thighs, or calves
- Tightness and pain in the neck , shoulders, or arms
- Weakness of part of a leg or arm
Symptoms are more likely to be present or get worse when a person stands or walks. They will often lessen or disappear when a person sits down or leans forward. Most people with spinal stenosis cannot walk for a long period of time.
But is it the Stenosis that is causing the problem? The patient is convinced it is because they have an MRI that says so. BUT, a considerable proportion of patients may be classified incorrectly by MRI for HNP (herniated disc) and spinal stenosis. 2
Please see our article for more information about failed treatments for lumbar disc herniation.
When there is back pain, there is spinal instability. Spinal instability can be caused by weakened, loose ligaments and tendons that allow for excessive movement in the vertebrae.
Prolotherapy for Spinal Stenosis
At our practice we utilize Prolotherapy for Spinal Stenosis, Platelet Rich Plasma Therapy (PRP), and stem cell therapy. These techniques help stabilize the spine, which is imperative as unstable joints can lead to – or further exacerbate – the arthritis that causes spinal stenosis. Additionally, by stabilizing the spine with these natural procedures, we reduce the symptoms and treat the underlying disease. In fact, we have successfully treated patients who were previously told that they would never be pain free without spinal fusion – and they’ve been pain free for a decade or more!
In fact, we developed one of the most innovative uses for prolotherapy – the correction of a pelvic tilt or functional leg length discrepancy. This disorder produces uneven forces across the joint, thus contributing to its damage. Using prolotherapy, we immediately correct this tilt and help promote the overall healing process.
We also work with our patients to help them identify appropriate physical activity – especially stretching exercises – to help them improve their joint function, while helping them manage the stress often associated with the pain associated with spinal stenosis.
1. Ishimoto Y, et al. Associations between radiographic lumbar spinal stenosis and clinical symptoms in the general population: The Wakayama Spine Study. Osteoarthritis Cartilage. 2013 Mar 5. pii: S1063-4584(13)00706-1. doi: 10.1016/j.joca.2013.02.656. [Epub ahead of print]
2. Wassenaar M, van Rijn RM, van Tulder MW, Verhagen AP, van der Windt DA, Koes BW, de Boer MR, Ginai AZ, Ostelo RW. Magnetic resonance imaging for diagnosing lumbar spinal pathology in adult patients with low back pain or sciatica: a diagnostic systematic review. European Spine Journal 2012; 21(2): 220-227.
3. Further resources on spinal stenosis treatments and information
4. Prolotherapy information for patients, an introduction to Prolotherapy for patients interested in the treatment.