When you become a physician, you take the Hippocratic Oath. The first rule of the Hippocratic Oath is “First of all, do no harm.” This is why Prolotherapy appealed to me as a physician. I was a doctor at a famous HMO. After learning Prolotherapy, however, I went into private practice. Patient after patient came to the office with foot pain, knee pain, shoulder pain, back pain, sports injuries, you name it. I probably knew more than the average doctor in regards to musculoskeletal injuries, but I was still at a loss as to how to cure the pain. I helped the pain in many cases, but cures were seldom. You see, I had studied to be an osteopathic family physician because I wanted to be able to help not only medical problems, but musculoskeletal complaints as well. Though I had learned manipulation and state-of-the-art rehabilitation techniques, there were many chronic pain patients whom I just was not able to get better.
Osteopathic physicians (D.O.s) receive the same medical education as M.D.s, and hold equivalent licenses to practice medicine. However D.O.s receive extra training in the musculoskeletal system. Osteopathic physicians can prescribe medications, but are also skilled in musculoskeletal adjustments which enhance skeletal alignment and optimize circulation. For many people this combination is very appealing.
When a person with chronic pain came into my office, I would make sure they were in proper alignment using such treatments as manipulation. Physical therapy was usually prescribed to improve the chances of healing the injuries and improving their strength. If a patient failed to respond to the usual modalities, I felt helpless. Because of my belief that a physician should “Do no harm,” I was reluctant to prescribe pain killers or send someone for a surgical consult unless it was a clear-cut case of a surgical need (this is extremely rare). The statistics on musculoskeletal surgical procedures helping people never impressed me. I have seen too many drug addicts accidentally created by physicians. Because of this I cannot encourage someone in that direction. I have also seen people go into kidney failure from Anti-inflammatory medication, so I cannot advocate that method of treatment. I was getting discouraged because I would continually hear, “Doctor, it’s better but the pain is still there…” or, “Doctor, why does my joint click?” or, “Doctor, am I ever going to get better?” I began to dread picking up a chart and seeing the diagnosis of knee pain or back pain. That is, until I learned about Prolotherapy. Now I look forward to these cases, because I can help them with Prolotherapy.
Curing Chronic Pain versus Covering Up Chronic Pain
Prolotherapy is a minimally invasive, tremendously safe therapy that stimulates the body’s healing mechanisms. In that sense I believe it is a natural treatment. (Pain comes from) tears in the ligaments commonly referred to as sprains, where tears in the tendons are called strains. Ligaments connect the bones together, providing stability to the joints. Tendons connect the muscles to the bones and move the joints. When ligaments and tendons are injured they hurt. Typical treatments available to the patient including cortisone shots, ice, and anti-inflammatories just cover up the pain, so the patient feels better temporarily. (Feeling better) the patient then cannot sense further (damage to their ligaments) because the cortisone shot is covering up the pain. This just makes the injury worse.
Prolotherapy can remove the source of the pain, rather than covering it up, because it helps the ligaments heal. Ligaments were always an enigma to me and I could never figure out why, on the cadavers and anatomical drawings, they always appeared white. When I started studying Prolotherapy, it all made sense. Ligaments have a deficit in their ability to heal because they have a poor blood supply. Because they have a poor blood supply, and because they are rich in nerve endings, they are white in color. Muscles, on the other hand, appear red in color because of their plentiful blood supply. This is why muscle injuries heal quickly and are almost never the source of chronic pain or athletic injuries.
For those with a chronic pain injury, Prolotherapy essentially turns the chronic injury into an acute one by activating the immune system at the site of the injury. After the Prolotherapy treatment is given, an increase in the blood supply to the area occurs which brings nutrients and immune cells to heal the area. Prolotherapy not only strengthens weak joints, some studies have shown it can continue to increase the strength in a joint above normal. (Liu, Y. et al. An in situ study of the influence of a sclerosing solution in rabbit medial collateral ligament and its junction strength.)
At a Prolotherapy conference, Dr. Gustav Hemwall, the world’s most experienced Prolotherapy doctor at that time, was asked the question, “Why don’t more people do Prolotherapy if it is so effective?” Dr. Hemwall calmly and accurately answered, “Because it’s too simple.”
There you have it. What is simpler than finding an area that is painful, where the ligament attaches to the bone, and injecting it with a solution that will cause the ligaments to regenerate and strengthen? I hear all the time from patients that the orthopedist required x-rays in order to properly diagnose their problems. What ever happened to examining the patient? The fundamental basis for all healing is listening and examining. Rarely are x-rays and MRIs ordered in the Prolotherapy doctor’s office because they are just not needed.
The exact location of the pain is often found by simple palpation. By palpating the point where the ligaments attach to the bones (the fibro-osseous junction) and eliciting a positive jump sign,” the patient and doctor feel confident that the exact site has been found. Prolotherapy to that exact painful area is then done. If the correct area is injected with enough proliferant-containing anesthetic, the patient will have immediate pain relief.
(Article is excerpt and edited from Prolo Your Sports Pain Away, Donna Alderman contributor)