Scott_1984
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Re:Prolotherapy - 2008/07/18 23:04
Hiya Mick 
I have no first hand exprince of this treatment or therapy,
But I have read up on it in the past.
Here are some websites on the subject:
http://en.wikipedia.org/wiki/Prolotherapy
Prolotherapy ("Proliferative Injection Therapy") involves injecting an otherwise non-pharmacological and non-active irritant solution into the body, generally in the region of tendons or ligaments for the purpose of strengthening weakened connective tissue and alleviating musculoskeletal pain.
There is conflicting evidence about its effectiveness and it is an experimental treatment.
Prolotherapy can be distinguished from sclerotherapy. Sclerotherapy is the use of injections of caustics into the veins, in vascular surgery and dermatology, to remove varicose veins and other vascular irregularities.
Prolotherapy is the use of injections in the treatment of connective tissue weakness and musculoskeletal pain.
Prolotherapy is also called "proliferation therapy" and "regenerative injection therapy."
Prolotherapy is often used as an alternative to invasive arthroscopic surgery.
A double-blind placebo-controlled study on arthroscopic surgery for osteoarthritis of the knee was published in the New England Journal of Medicine in July 2002 and concluded that the group that received actual arthroscopic surgery did not report better function or pain than the placebo group."
Arthroscopic surgery of the knee is, however, rarely performed for the indication of osteoarthritis, but rather for mechanical tears or disruptions of cartilaginous tissue.
Prolotherapy is not intended to address this type of problem.
Doctors and surgeons have given anecdotal accounts of successful treatment for knee injuries, shoulder separation, and typical injuries to golfers (epicondylitis, shoulder strain, lower back strain and injury, hip and knee injury)
However, the vast majority of established musculoskeletal health care professionals do not support prolotherapy as mainstream treatment pending further investigation.[citation needed]
As of April 2005, doctors at the Mayo Clinic began supporting prolotherapy. Robert D. Sheeler, MD (Medical Editor, Mayo Clinic Health letter) first learned of prolotherapy through C. Everett Koop’s interest in the treatment.
Mayo Clinic doctors list the areas that are most likely to benefit from prolotherapy treatment: ankles, knees, elbows, and sacroiliac joint in the low back.
They report that "unlike corticosteroid injections — which may provide temporary relief — prolotherapy involves improving the injected tissue by stimulating tissue growth."
An evidence-based medicine review of prolotherapy for low back pain concluded: "There is conflicting evidence regarding the efficacy of prolotherapy injections for patients with chronic low-back pain.
If used alone, prolotherapy injections do not have a role in the treatment of chronic low-back pain.
When combined with other treatments, they may give prolonged partial relief of pain and disability."
More studies are currently underway (see Ongoing study section below).
http://www.prolotherapy.com
Prolotherapy is helpful for what conditions?: http://www.prolotherapy.com
The treatment is useful for many different types of musculoskeletal pain, including arthritis, back pain, neck pain, fibromyalgia, sports injuries, unresolved whiplash injuries, carpal tunnel syndrome, chronic tendonitis, partially torn tendons, ligaments and cartilage, degenerated or herniated discs, TMJ and sciatica.
http://www.bimm.org.uk/Prolotherapy.shtml
PROLOTHERAPY-Sclerosant Injections to Ligaments
Ligaments help to provide stability in the joints. They prevent the joint from moving more than the 'normal' range (though what is 'normal' varies from one individual to another).
Some people have lax ligaments that allow more than 'normal' movement - often spoken of as 'double jointed'.
In the spine there is a complex arrangement of ligaments, both between each vertebral segment and between the spine and pelvis, which allows flexibility in some directions and produces restraint in others.
Sometimes ligaments can be overstretched, or even torn (as in a sprained ankle).
The ligament may then not control the joint adequately – thus leading to 'instability' which may put abnormal stresses on the joints and discs in the spine.
In women, the pelvic joints need to be supple for child bearing, and so the ligaments soften and stretch more readily.
Sometimes they do not tighten up after childbirth and therefore allow too much movement - hence 'sacroiliac instability'.
Prolotherapy works by stimulating the body to make new fibres, which are laid down within the substance of the ligaments, thickening and strengthening them.
The solution: phenol 2%, dextrose 30%, glycerol 30% is mixed with local anaesthetic, and a small amount (half a cc) is injected into each end of the ligament, close to its attachment to the bone.
This initially provokes inflammation, attracting the cells that make collagen fibre to the area.
Over the ensuing weeks, the fibre is incorporated into the existing ligament.
Each ligament has to be stimulated 3 or 4 times (sometimes up to 6), at intervals of a week, in order to produce sound fibrous development.
Hence the injections are given as a course of treatment.
The solution used for the injection is used in other treatment, such as varicose veins, so it is known to be safe.
However, because prolotherapy for ligaments is not widely practised, it has not as yet been licensed for this particular type of treatment.
Because the organic compounds in the solution are rapidly disposed of by the body, it is safe to
have a repeat course of treatment - should it be necessary.
Prolotherapy does NOT create scar tissue but healthy collagen fibres in the lax ligaments.
Injections are commonly given in the lumbar region, sacroiliac region, thoracic and cervical spine. They are also useful in the ankle and shoulder region.
When receiving these injections, ENTONOX analgesia maybe offered (Nitrous oxide and oxygen, as used in labour) to relieve the discomfort of the injection.
Intra-venous sedation is also available for those who prefer it.
This produces a relaxed and sleepy state. With sedation, arrangement for transport home will be necessary.
POINTS TO NOTE:
These injections do cause some aching and stiffness for two to three days.
Rest is not necessary; normal activities should be continued.
Paracetamol, rather than aspirin or Nurofen, can be taken for pain relief.
Complications are very rare since the injection is not placed into the spinal canal or near spinal nerves. (Infection occurs in 1 in 17,000 cases, this being the main
complication).
The benefit is not immediate but gradual. It becomes noticeable after 6-8 weeks, increasing up to twelve weeks.
If there are any further questions or uncertainties please ask the doctor.
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