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Prolotherapy Case Histories - Knee Pain CASE 1 From Mark Wheaton, M.D. HISTORY: This is a 50-year-old woman who works with the physically impaired in local school districts. She came in reporting knee pain since July of 1999 following an injury while running with her dog. She twisted to the left when she landed on her knees. Following and MRI and conservative treatment methods she had arthroscopic surgery in April of 2000. However, she continues to experience pain in both knees. She describes her symptoms as occasionally sharp, though constantly experiences a dull ache. She rates her pain a 2-3 out of ten but jumping, running or power walking increase her pain and she has had to avoid these activities. FILMS: An MRI in January of 2000 revealed a bony island medial meniscus tear and medial collateral ligament sprain. An EMG (Electromyography) was also performed but was negative. PREVIOUS TREATMENT: She received physical therapy in January and February of 2000 and was given a home exercise program without significant relief of her pain. She began treating with a chiropractor and was given orthotics. She has had to take pain medication for the pain since her surgery in April. DIAGNOSIS: My diagnosis was chronic ligament sprain in the bilateral knees after a right knee scope/meniscectomy (repair of the meniscus). DISCUSSION: I recommended Prolotherapy to strengthen the supporting structures of the knee following the repair of the meniscus. She is currently in a knee rehab program to strengthen the muscles surrounding the knee. TREATMENT BEGAN: 09/05/00 INITIAL PAIN LEVEL: 2-3 out of 10 (10 being the worst pain) TREATMENT LOCATION: Both knees, including the structures around the knee as well as directly into the joint. TREATMENT SESSIONS: 3 sessions LAST TREATMENT: 11/11/00 FOLLOWING TREATMENT PATIENT RESPONSE: "I can't believe the difference the prolotherapy has made with my knees! I was told by my surgeon and the Mayo Clinic that there was nothing which could be done and that I would "just have to live with it". Then I had twelve different people tell me about either helping them or others they knee, I thought I should come in for an evaluation with Dr. Wheaton. After three prolotherapy treatments I was able to go up and down stairs without pain, actually it was a breeze for the first time in 1 1/2 years and I could do a "frog" or "whip" kick in my deep water job class without any pain. The prolotherapy and recommended physical therapy have made a huge difference. I can even go biking without pain. Thank you and God bless you!" PAIN LEVEL: 1 out of 10, even with activity (10 being the worst pain) FUNCTION: 80-90% improved overall. Moving better, walking farther, able to go up and down stairs and ride a bike.. CASE 2 From Robert Rowen, M.D. KNEE CAP PAIN A 17 year old male with a bipartate patella (knee cap is two pieces) came because of knee pain. His knee surgeon recommended removal of the patella. The patient was a high school football player and the pain prevented him from workout and practice that was to begin several weeks. Since the patella is a bone within a tendon (collagen) I thought strengthening the quadriceps tendon connections to the patella might improve the function of the ailing patella. He had to travel some 50 miles every two weeks for treatment, but we speeded sessions to weekly to try to make fall football season. The pain was reduced from interfering with routine activity to being barely noticeable during full football practice sessions after 8 treatments. Of course, I strongly warned him against further injury from football, but the call of the game was just too great for him. CASE 3 - Misdiagnosed CP Corrected - A Patient's Story Background: Always been active. Team sports, running, etc. Only had some minor problems in the past, nothing that really slowed me down. Onset: October, 2000. Increased my running mileage too quickly. Starting running 8 - 10 miles when I had been running 3 - 4. Pain came on during a run on the inside of my left knee, to the inside of the knee cap. Rested it for a few months. Didn’t get better. 1st Step: January, 2001. Saw my general practitioner. He examined me for about 10 minutes and told me I had chondromalacia patella (CP) and that there wasn’t much I could do about it. Told me I wasn’t built for running. I asked for a referral to an Orthopedic Surgeon (OS). He gave it to me, but told me that the OS would probably come up with the same diagnosis. 2nd Step: Saw an OS at the Hospital for Special Surgery in New York City, apparently one of the most prestigious orthopedic centers in the country. The guy took x-rays (which were completely clean), examined me for 10 minutes and told me I had CP. Said there was nothing I could do. The good news (in his opinion) is that most people don’t get arthritis in their knees. I told him I like to do triathlons. He told me to start taking lots and lots of Aleve or another NSAID a few weeks before a race to keep the inflammation down. The only surgery would be a Lateral Release, and that is only about 25% successful, and that’s not high enough in his opinion to justify surgery. That was the only thing he said that was correct. 3rd Step: Wallowed in self-pity and sat on my couch for three months, hoping it would go away. It didn’t. Every time I tried to run, I’d get the same pain. 4th Step: March, 2001. Hit the Internet. Devoured everything I could find. Found the Chondromalacia Community on Yahoo! (CC). Decided to see a Physical Therapist (PT), because that’s what everybody else was doing. Since I was diagnosed by TWO doctors with CP, he assumed I had the same thing. It wasn’t until I told him that I thought the doctors were wrong that he did a few diagnostic tests himself. He didn’t think I had CP either. Finally, some good news. This PT also discovered that my left leg was longer than my right. He said I could get some orthotics to compensate. I stayed with this guy for a few months, and was getting a tiny bit better. 5th Step: July, 2001. Still wasn’t satisfied. I remembered reading a post from Tom (holyflower) on the CC that mentioned Prolotherapy. It looked interesting but I was VERY skeptical. I checked out Prolotherapy on the web, and found Dr. Ross Hauser’s website (http://www.sportsprolo.com). The information on the site seemed convincing and certainly interesting. I bought Dr. Hauser’s book, “Prolo Your Sports Injuries Away!” for $80. That book convinced me. It is packed with references from medical journals, and other sources that discuss the benefits of Prolotherapy and the hazards of NSAID’s, cortisone and surgery. 6th Step: September, 2001. Found a Prolotherapy doctor an hour from my house and made an appointment (). I loved this guy right away. When I told him my history and what the other two doctors said, he was outraged. He said, “How did he diagnose that? He looked at THESE X-rays and said you have Chondromalacia?!? What a (Blankity-blank) I told you I loved him right away. He examined me for about an hour. Here’s where it gets good…. 1st Discovery: He could find no evidence of CP, and he was specifically looking for it. 2nd Discovery: He found that my hips were out of alignment, and that was causing my left leg to be longer than my right. 3rd Discovery: There was some laxity in my left knee. This was either caused by the abuse the knee was taking from my hips being out of alignment, or, the knee was already weak and that is where the hip problem manifested itself first (the weakest link). Now it gets even better… 1st Repair: A physical therapist that works with my Doctor fixed my hips and now my legs are the same length. It took about five minutes. 2nd Repair: Now that the probable cause of my pain was fixed, the Doctor went to work on fixing the damage that was done. In his words, he was going to “tighten up the joint.” And, over the course of three months and four treatments, he did. He tested me last time I went, and said the joint wouldn’t move. That meant no more treatments for me, and no more money for him, but that’s what he said. Result: January, 2002. Still a little premature to declare myself pain-free, but I’ve been running 5 and 6 miles at a time and haven’t had any pain, where last year at this time, I couldn’t run 5 minutes without my knee starting to hurt. Summary: Despite being told by two doctors that I had CP, I believe my problems had nothing to do with my knee-cap alignment or cartilage. It was a structural problem in my hips that caused the damage and pain in the tendons and ligaments of the knee. Dr. Hauser feels that most joint problems are caused by weakness in tendons and ligaments in the joint. Advice: Find a doctor
who will spend the time figuring out what’s wrong with you. As the PT who
fixed my hips said, “We do things a little differently here. We find out
what’s WRONG with you, and we fix it.” It sounds simple, but most doctors
do neither. The PT, by the way, is a 67 year-old woman who has been practicing
for 44 years. She gets flown all over the world to give lectures. She’s
good. It may take a while, but you have to find someone who understands pain
and injury the way these people do. And don’t even THINK about surgery
unless you absolutely have tried everything else, and cannot function in
day-to-day life. And keep thinking positively. Sitting on my couch feeling bad
for myself did nothing to help my knee. Only when I decided to do something
about it did I get better.
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Getprolo.com cannot guarantee the accuracy of any resources or information from or about the physicians listed on this website. The opinions and statements in this website DO NOT necessarily reflect the opinions of the physician members of the getprolo.com referral network and are those of the article author only. A medical testimonial is intended to represent that everyone will obtain the same favorable results from a given therapy. Getprolo.com disclaims any such intention.
Prolotherapy is a medical
technique. As with any medical technique, results will vary among
individuals.
Prolotherapy may not work for you and as with all medical
procedures there are risks involved. These risks should be discussed with a qualified
health care professional prior to any treatment.
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