Robert G. Schwartz, MD
Treating Torn Ligaments: If ligaments do not heal within several weeks they may remain chronically stretched, torn or strained. Many people do not realize how severe, or prolonged ligament pain can be. They assume that since its soft tissue, it will heal or that it can’t be that bad. While ligament pain may be confined to the injury site it can also refer pain to distant body parts through a portion of the autonomic nervous system called the sympathetic nerves.
The region that a ligament refers pain to is called a sclerotome. It can mimic nerve impingement, cause sensations of numbness and be the source of arthritis pain. Ligament pain can be chronic, persistent, achy, burning and weather sensitive.
The primary function of ligament is to connect bone to bone. If a ligament is stretched, or torn, then too much movement between the bones may occur. This extra movement is perceived as a popping, clicking, catching or feeling of weakness between the bones.
The muscles respond by going into spasm, in an effort to tighten the area down. Many people will try to stretch tight muscles, or strengthen weak ones, in an effort to reduce the pain. They become discouraged, however, when this approach only offers temporary relief.
Treating Torn Ligaments
In order to obtain lasting relief the underlying ligament injury must be treated first. A physical exam by a doctor experienced in ligament injuries, and testing using Musculoskeletal Ultrasound or MRI, can confirm the diagnosis. Treating ligament pain can be ineffective if there is also nerve injury. When the injury is chronic an electrodiagnostic study to rule out nerve injury is often useful as the nerve portion must be treated first.
Fortunately strengthening exercises can take up to 20 per cent of the pressure off a joint from a weakened ligament. Physical therapy to stretch what’s tight and reeducate what’s inhibited is also important. Medications to reduce spasm, pain and Inflammation are often used as well. In most cases a special injection is needed to actually repair, or re-grow the injured ligament.
The medication injected is not steroid (which weakens ligament) but rather a combination of xylocaine with sodium morruhate, dextrose or other special agents that stimulate the body’s own natural wound healing response. Just like a scab on skin, the new ligament grows to replace what is missing. If repeated once every two weeks or so, the ligament will become 40 per cent thicker then it was before treatment. In extreme cases surgery may be needed.
Since the ligaments actually thicken, this technique is often referred to as Prolotherapy (for proliferate). It can very helpful in relieving pain, weakness and sensations of numbness for many conditions, including neck and back pain, sports injuries and arthritis. Moreover, since the body actually repairs the injury site, in the absence of other problems there is no reason to worry about reoccurrence.