Pain free with prolotherapy?

by Charles Downey

Pain free with Prolotherapy Prolotherapy is a less expensive, less traumatic alternative to neck, back, hip, or knee surgery. But it may take some searching to find a practitioner in your neighborhood.

Forty-year-old Janet had been in a terrible car crash and suffered major back and spine injuries. She had several operations on her spine but her condition worsened, even though she was receiving physical therapy and narcotic painkillers. Soon she was confined to a wheelchair and put on disability. Sitting in her wheelchair all day, she gained more than 100 pounds.

Then she heard about prolotherapy, a relatively simple medical procedure in which a physician injects an irritant solution through a syringe that causes bone-ligament connections to regenerate.

"It took three people to get Janet onto the exam table when I first saw her," says Ross A. Hauser, M.D., a physical medicine and rehabilitation specialist in Oak Park Illinois. After three prolotherapy injections into her spine and neck, Janet could leave her wheelchair. After eight treatments, Janet went back to work and is losing weight.

Also known as sclerotherapy, prolotherapy uses an injection of a mildly irritating solution

"Studies have been done on rabbits and other lab animals and some humans comparing tissues before and after prolotherapy," says Dr. Hauser. "In a 1983 study of knee ligaments in rabbits, the researcher found that ligament mass increased by 44 percent over six weeks. In human subjects, researcher Robert Klein gave a series of six weekly injections to the lower back ligaments and then did biopsies three months later. The results showed collagen fiber and ligament diameter improved by an average of 60 percent."

Not incidentally, the prolotherapy group also enjoyed significant improvement in pain relief and back motion. Prolotherapy claims to help back and other related pain because renewed ligaments and tendons can hold vertebrae in proper alignment.

In a study reported in the Journal of Spinal Disorders in 1993, researchers injected knee joint ligaments of human subjects with either a prolotherapy solution or a placebo. The subjects receiving the prolotherapy treatment showed an increase in activity and a reduction in pain. And in yet another study, Gustav A. Hemwall, M.D., surveyed 2000 patients who received prolotherapy and found that 75.5 percent of them reported complete recovery with 24.3 percent reporting general improvement.

People with chronic pain that has lasted for over six months may be good candidates for prolotherapy.

C. Everett Koop, M.D., former U.S. surgeon general, authored the preface to Dr. Hausers book, Prolo Your Pain Away! Curing Chronic Pain with Prolotherapy. Dr. Koop reveals he benefited from prolotherapy so much that he later used the procedure on some of his own patients who suffered from chronic pain.

According to Dr. Koop, "Prolotherapy is not a cure-all for all pain. Therefore, the diagnosis must be made accurately and the therapy must be done by someone who knows what he or she is doing. The nice thing about prolotherapy, if properly done, is that it cannot do any harm."

Dr. Hauser observes that prolotherapy has been presented to, and approved by, a handful of traditional medical societies, including the Chicago Medical Society and the American Association of Orthopedic Medicine. Dr. Koop believes that most physicians are not as open to innovative ideas when they leave their formal training and become established in a practice.

"One possible drawback to prolotherapy is that many people are afraid of needles," says Dr. Hauser who is a former clinical associate professor in the Department of Orthopedics at Loyola Medical Center in Chicago. "So the practitioner must give some patients an anesthetic on the skin

The fees for prolotherapy range from $90-$200 per session; some insurance companies cover the procedure and others dont. "The usual reason for denying coverage is that prolotherapy is not a usual and customary treatment," says Dr. Hauser.

The usual prolotherapy treatment lasts for about six weeks. Some patients get relief with only several injections, while others may require as many as thirty shots. Practitioners say there are no side effects although stiffness and pain occur for several days after the injections. Almost all treatments can be done in the physicians office.

Dr. John Renner is the president of the National Council for Reliable Health Information in Kansas City, Missouri. "I would urge caution with prolotherapy until some definitive, controlled studies are completed at several well known medical institutions. I think one danger [of prolotherapy] is that bodily structures that should not be perforated could be punctured."

According to Dr. Hauser, the risk of a punctured lung during prolotherapy is one in 10,000 cases. Risk of infection is rated at about one in every 1,000 cases.

"I dont see a down side from where I sit," says Dr. Rind. "Prolotherapy is a simple, straightforward procedure as long as the practitioner has good training and experience."

As Dr. Renner says, more study will determine the effectiveness and safety of prolotherapy.