Pain Got You Down? Ask Your Doctor About Prolotherapy For Pain Management
Around 2008 I learned about a new treatment for Chronic Pain labeled Prolotherapy.
A physician who had relocated to Colorado started a duel practice between Lakewood and Vail CO. Working with clients for pain management, some who had terrible years of long term pain from injuries, especially back and neck pain that was slowly improving or stuck in a cycle of daily pain, I felt their frustration. These patients are trapped in the use of pain modulators, Narcotics, which bring other complications, including symptoms of digestive distress, constipation, altered focus, sleeplessness, and worst of all depression, The need for something more effective in the medical arena that can restore people and relieve pain is Prolotherapy.
What is Prolotherapy?
Prolotherapy is mostly concentrated sugar in a combination of a few other medical approved growth factors or liquid pumice that creates a mock injury to the pain region of a Ligament that is lax or has not recovered from an injury. It is injected into ligament areas the correlate to chronic pain and restricted movement as assessed by the Physician. These Ligaments play the strongest role in holding the body up and allowing functional movement. The area is numbed first by a local anesthesia such as Lidocaine, then a larger syringe with the sugar water combination is injected throughout the ligament of the designated area. The injection process is under 5 minutes, but the relief can last for years, and in some cases is permanent. In severe cases, a patient may have to come every two months for about three treatments to resolve the pain problems.
The new Physician I met was passionate about this treatment and took time to explain the value of Prolotherapy and it’s incredible benefits. One practical benefit is the patient undertaking this treatment can return to their normal routine within a day or two, and even return to work with very few limitations. No anesthesia but a local Lidocaine at the injection site is used for the comfort of the patient prior to the Prolotherapy injections.
What was most impressive, was the first referral I sent for this new technique, had her spine crushed between two vehicles, followed by many surgeries to repair the spine, implantation of rivets and metal plates, she lived with constant pain and greatly needed the narcotic Morphine to manage pain and sleep. On observation, the Morphine dulled the pain, but did not eliminate it, and created many further debilitating symptoms like dietary distress, constipation, brain fog, thyroid imbalance, and depression. From my own alternative medical training, I was able to address some of these symptoms, but not the spine pain that lingered. She needed a miracle to gain her life back.
After three treatments my first referral was back to her yoga class, eating, sleeping, and was able to reduce the need for morphine to only a couple times a week. She was a new person who could embrace a normal life again. Best of all, her pain and depression were relieved. The treatment of Prolotherapy succeeded in pain management and body function.
Who created Prolotherapy?
Prolotherapy has been used in medicine since 1937. The treatment protocol began as treatment for subluxation of the temporomandibular joint by Dr. George Hackett, a practicing Physician. Today Prolotherapy is a regenerative injection to treat tissue that binds muscles and joints and tissue together. Prolotherapy is considered a viable alternative to surgery, and as an option to pain medications, cortisone or steroidal injections. An alternative that has better outcomes, far outlasts the other choices, and has no post treatment side effects.
Experts in Prolotherapy
With permission from Dr. Thomas Ravin, who practices in Denver, Co, he has collaborated on understanding the human body in pain and benefits of Prolotherapy in the book “Principles of Prolotherapy”, Ravin, Cantieri, and Pasquarello.
The Ravin Technique–The injured ligament treatment
Prolotherapy is a treatment for lax ligaments that is done by a physician. The goal is to stimulate the growth of new collagen the building blocks of ligament tissue.
It works by Creating an acute inflammation by causing tissue to repair using concentrated sugar water.
- Injecting an irritating material such as pumice into the ligament to stimulate the resident fibroblasts to produce collagen.
- Injecting growth factors into the ligament tissue stimulate the resident fibroblasts to produce collagen.
- Injecting platelets into the ligament stimulate the resident fibroblasts to produce collagen.
- Injecting stem cells into the ligaments.
What to expect from Prolotherapy
After spending time at Dr. Ravin’s practice and observing the treatment on many patients, there are some key advantages that one should consider in finding a physician who practices Prolotherapy. The Prolotherapy is in office, takes about an hour, and you can return to work. There is discomfort from the treated area that might require a mild over the counter analgesic for one or two days. The treatment takes hold over a period of 2 to 8 weeks and gives chronic pain relief and muscle function that keeps improving. One or more areas can be treated at a time. There is no down time nor does a person need to change their lifestyle in the recovery process.
Expense of Prolotherapy
With Health Insurance premiums so high today, people often avoid alternative treatment. Prolotherapy is not covered by insurance can be a drawback. However, as the treatment is so effective, patients come about one to three times a year in the initial treatment for pain, this cost is far less than most insurance deductibles, and many people do not need to return as the pain has been resolved. There is so much “Bang for the Buck“ using Prolotherapy as a treatment and a life changer.
Am I a Candidate for Prolotherapy?
The best candidates for Prolotherapy are persons who have chronic pain from accidents and injuries related to movement and daily function. This is a great alternative to surgery and covers a broad spectrum of pain injuries. It is a perfect alternative for sports oriented people. People who have endured pain for even a decade can be a wonderful candidate for Prolotherapy. Prolotherapy is viable for people who have had the surgery for torn connective tissue, muscles, tendons and ligaments, yet have not resolved the pain making it a post-surgical treatment.
It is not a treatment for joint pain or arthritic conditions, or diagnosed auto immune patients. Heart conditions would have to be assessed by the physician. It is limited to functional movement that correlate to ligaments that express pain.
Endorsement of Prolotherapy
When one of our past United States Surgeon General makes a statement regarding Prolotherapy, you can feel confident in its treatment endorsement.
In Prolo Your Pain Away by Dr. Ross Hauser, C. Everett Koop, M.D., ScD, Former United States Surgeon General offers his opinion, “The nice thing about prolotherapy, if properly done, is that it cannot do any harm. How could placing a little sugar-water at the junction of a ligament with a bone be harmful to a patient?”
The best healing is when the body itself can partake in it’s own recovery. Surgeries and pharmaceuticals impede this process in so many long term chronic injuries. Knowledge of alternative treatments can make your life better. Prolotherapy has its place in recovering from pain, it’s a treatment by trained Medical Doctors, who value the inclusion of the body’s wisdom.
About Thomas Ravin, MD
Thomas Ravin, M.D., has been practicing musculoskeletal medicine and prolotherapy for over 30 years in Denver, Colorado, and has taught these subjects both nationally and internationally since 1990. He is the lead author of Principles of Prolotherapy, the first major textbook on prolotherapy, published in 2008.