Sacroiliac joint pain - Sciatica

In this article, Ross Hauser, M.D., a leading Prolotherapy doctor, discusses the use of Prolotherapy for SI pain.

Prolotherapy treatments consist of injections that stimulates the repair of connective tissues such as tendons and ligaments by causeing a mild inflammatory response which initiates an immune response. This mimics what the body does naturally to heal soft tissue injuries.Prolotherapy is effective in SI pain because we have found it fairly rare for sacroiliac pain to be caused by a pinched nerve or by a slipped or herniated disc. Much more common is a ligament injury which caused ligament laxity or ‘looseness.” Research published in the medial journal Spine, (A. Schwarzer, 1995) states “ligament laxity in the sacroiliac joint is the number one reason for ‘sciatica’, or pain radiating down the side of the leg, and is one of the most common reasons for chronic low back pain.” Our clinical experience has been that if we treat back pain with Prolotherapy, administering injections into the lumbar and SI ligament attachments that exhibit tenderness, the pain and referred pain diminishes, even when MRI’s showed disc abnormalities. The injections are not given near the discs yet the back pain is completely healed.

LIGAMENTS AND THE SI JOINT
Ligaments connect bones to each other, like the vertebrae to each other and the sacrum to the pelvis. The sacrum is the part of the spine below the fifth and last lumbar vertebrae and above the coccyx. The uppermost portion of our pelvis is called the ilium. The area that connects these structures is called the sacroiliac joint (SI): sacro from the sacrum, iliac from the ilium. There is an expansive mesh of ligaments that make up this sacroiliac joint which is frequently injured. A problem here can affect the groin, pubis, hips and lower lumbar areas as well.

A SUCCESS STORY: From one of the Caring Medical staff – Joe the male nurse.
One of my own injuries that was successfully treated with Prolotherapy perfectly illustrates the point made in the above paragraph. I have been one of Dr. Hauser’s nurses for nearly six years and have had several areas treated. My worst injury began as a left hamstring injury incurred from increasing my pace on a training run. The original point of injury was where the hamstring attaches to the ischial tuberosity (IT), the bottom most part of the pelvis, the bone you sit down on. As with most people, I tried rest, heat, stretching, not stretching, nothing seemed to help. Even me, a person with access to a great Prolotherapy doctor, put off the injection treatment to see if I could heal it on my own. Can you blame me? Nurses don’t like shots either. The problem was my IT hurt on my left so while driving I leaned on my right. After a month of doing this, can you guess what happened? That’s right; the pain was now traveling up into my left SI joint, and was beginning to affect my sleep. The abnormal motion of sitting just on my right buttock caused an imbalance in my SI joint. Because I was educated in the mechanics of the pelvic ligaments, I knew that if left unchecked, my IT and SI problem could eventually cause a problem in my lumbar ligaments. So two months after my original injury, it was time to get up on the Prolotherapy table and take my medicine! After the soreness from the treatment wore off in a few days, I estimated my pain as 40% less. I needed three more treatments spaced about four weeks apart to completely resolve my problem.

To learn more about Prolotherapy research or to Contact Dr. Hauser at 708-848-7789

Prolotherapy for plantar fasciitis treatment

Ross Hauser, MD a leading Prolotherapy doctor, demonstrates a typical heel treatment, medial arch treatment, and plantar fascia treatment with Prolotherapy injections.

Prolotherapy can help give you heel pain relief, foot pain relief, and used for plantar fasciitis treatment and can be successful in treating almost any chronic foot arch pain, including tendon and ligament injury, plantar fasciitis, heel and foot injury.

Prolotherapy research



Ross Hauser, MD, a leading Prolotherapy doctor reviews Prolotherapy research and why there can never be a true double blind study. Prolotherapy is an injection technique that stimulates the body to repair the painful area. It is most often used for chronic pain treatment, including arthritis treatment, sports injury treatment, ACL tear, meniscus tear, labral tear treatment, herniated or bulging disc treatment, back pain treatment, shoulder pain treatment, hip pain treatment, cartilage regeneration and repair.

Prolotherapy Videos

Ross Hauser, M.D., explains Prolotherapy and Prolotherapy treatments for chronic joint pain in a new fvideo library available to view at youtube.

For easy access to these Prolotherapy videos

Stem cell Prolotherapy for injuries to the pitching shoulder

Stem cell Prolotherapy helps NY Yankees pitcher
NY Yankee’s Pitcher Uses Stem Cell Prolotherapy to heal sports injuries

As reported in the NY Times, New York Yankees pitcher, Bartolo Colon’s used stem cell Prolotherapy to treat his injured shoulder and elbow. In this case Colon’s stem cells came from his own body fat.

Ross Hauser, MD a leading Stem cell Prolotherapy doctor says you can obtain your own stem cells by extracting the patients’ bone marrow from either the tibia or the iliac crest.

Dr. Hauser has prepared an extensive website of Stem cell Prolotherapy as well as traditional Prolotherapy.

You can also get more Prolotherapy information and Prolotherapy links at various websites

Chronic pain and brain function

New research on brain function and chronic pain is discussed by Prolotherapy doctor Ross Hauser, M.D. Dr. Hauser is a leading practioneer of Prolotherapy.

Patients with chronic pain often suffer from depression, have trouble concentrating and struggle to remain positive. Current research shows why – chronic pain has an adverse effect on the brain, but it can be reversed with pain relief.

“Treating chronic pain can restore normal brain function in humans.”

In a recent study in the Journal of Neuroscience, researchers at McGill University in Montreal studied 18 people that had been suffering for six or more months from chronic low back pain. When compared to people with no chronic pain, they found that these people had decreased brain gray matter and impaired cognitive ability. Using an MRI, researchers observed thinner tissue and abnormal brain activity while subjects performed a cognitive attention-requiring task. In other words, chronic pain affected areas of the brain that deal with depression and impaired concentration, memory, mood, and social judgment.

Pain Relief and the Brain
Now here’s the interesting part: when the pain was relieved there was a reverse in the deterioration of the brain – the area of the brain (known as the dorsolateral prefrontal cortex) was no longer thinner than the control group. Additionally, there was no abnormal activity observed by MRI when the chronic pain patients performed a cognitive task. In the three people that reported no pain relief from treatment, there was no regeneration of gray matter. This study suggests that chronic pain takes a toll on the brain, but with relief it can regenerate itself.


Effective Chronic Pain Treatment
Each subject in the study chose to have back surgery or facet joint injections for pain relief and were reexamined six months after treatment. Unfortunately we don’t believe that surgery and facet joint injections (involving cortisone) are effective treatments because they don’t always reach the root cause of the problem. For more information on surgery for chronic pain see our previous post.

As for cortisone injections, they can do more harm than good and tend to have an adverse effect on bone and soft tissue healing. They limit the amount of calcium taken in by bone, thereby weakening the fibro-osseous junction that is usually the root cause of the pain. They also inhibit the release of growth hormone that is used to heal injuries; they inhibit the synthesis of proteins and collagen and have an overall weakening effect on joints.

In my opinion, the most effective way to treat chronic pain is through Prolotherapy. Prolotherapy stimulates the body to repair painful injured areas when the body’s natural healing process is not able to do the job on its own. Just as the brain is able to regenerate itself, injured joints can regenerate collagen and soft tissue through an inflammatory process. Prolotherapy is able to induce an inflammatory process to lead to healing, pain relief and ultimately better mental clarity, moods and more.

Learn more about Prolotherapy research
Contact Dr. Hauser at 708-848-7789 or www.caringmedical.com

Bone Marrow Stem Cell Prolotherapy

Is stem cells harvested from your own bone marrow the answer to chronic degenerative joint disease in the knees? Ross Hauser, M.D. is publishing a lot of material on line about using Bone Marrow or Stem Cells in Prolotherapy.

Here is a recent post that will take you to more links talking about Bone Marrow Prolotherapy

Whiplash and Prolotherapy

Here is a great story about Prolotherapy posted on the getprolo.com website 

Staff Sgt. Stacy Pearsall suffered numerous and severe whiplash injuries during her deployments in Iraq, starting with a roadside bomb in 2004.

Her pain was severe and seemingly untreatable - but Dr. Patrick Lovegrove, an Air Force flight surgeon at the time, offered her hope through prolotherapy treatment -- which involves insertion of a 4-inch needle down to the bone -- that lasted for more than two years. Pearsall was able to get off of the pain killers and finally on the road to physical recovery.

Read the article at American Forces Press Services Read about Dr. Lovegrove

Prolotherapy for Turf Toe, Hallux Rigidus

Ross Hauser, M.D, has posted an article about Prolotherapy and turf toe. Dr. Hauser discusses Prolotherapy as a surgery alternative.

Turf toe is painful condition localized to the baser of the big toe. It is most common among athletes who compete a great deal on artifical turf.

The most common treatment options include Rest, Ice, and anti-inflammatory medications, something Dr. Hauser says may not be the best options.

Treatment options for Lower back pain caused by Iliolumbar ligament injury

This is from a free access article at the Journal of Prolotherapy. Clinicians recorded a a case study on one patient's Prolotherapy treatments and the resulting outcome on their lower back pain that was isoloated to the Iliolumbar ligament injury
The clinical outcome concluded:
Patients that experience lower back pain and or pelvic shifting may benefit from the usage of Prolotherapy to strengthen the ligaments surrounding their pelvis. Our study also brings out the positive effects of using US to capture changes that occur within specific tissue.
Read about this Prolotherapy and Iliolumbar ligament injury from the Journal of Prolotherapy.

PRP Prolotherapy

The Journal of Prolotherapy has made more information on PRP and Prolotherapy available as free access articles.

Basic Information on Prolotherapy and Platelet Rich Plasma Therapy. In this article, Ross Hauser, MD a leading PRP and Prolotherapy doctor discusses the basic preparation of the blood platelets into growth factor solution before the treatment is admistered to the patient.

Prolotherapy and back pain research

Dextrose Prolotherapy for Unresolved Low Back Pain: A Retrospective Case Series Study
Ross A. Hauser, MD & Marion A. Hauser, MS, RD
Free access to this Prolotherapy research on back pain can be found at the Journal of Prolotherapy

abstract
Objective: To investigate the outcomes of patients undergoing Hackett-Hemwall dextrose Prolotherapy treatment for chronic low back pain.
Design: One hundred forty-five patients, who had been in pain an average of four years and ten months, were treated quarterly with Hackett-Hemwall dextrose Prolotherapy. This included a subset of 55 patients who were told by their medical doctor(s) that there were no other treatment options for their pain and a subset of 26 patients who were told by their doctor(s) that surgery was their only option. Patients were contacted an average of 12 months following their last Prolotherapy session and asked questions regarding their levels of pain, physical and psychological symptoms and activities of daily living, before and after their last Prolotherapy treatment.
Results: In these 145 low backs, pain levels decreased from 5.6 to 2.7 after Prolotherapy; 89% experienced more than 50% pain relief with Prolotherapy; more than 80% showed improvements in walking and exercise ability, anxiety, depression and overall disability; 75% percent were able to completely stop taking pain medications. The decrease in pain reached statistical significance at the p<.000001 for the 145 low backs, including the subset of patients who were told there was no other treatment options for their pain and those who were told surgery was their only treatment option.
Conclusion: In this retrospective study on the use of Hackett-Hemwall dextrose Prolotherapy, patients who presented with over four years of unresolved low back pain were shown to improve their pain, stiffness, range of motion, and quality of life measures even 12 months subsequent to their last Prolotherapy session. This pilot study shows that Prolotherapy is a treatment that should be considered and further studied for people suffering with unresolved low back pain.
introduction
Low back pain is one of the leading causes of physical limitation and disability in the United States today. Each year, 65,000 patients are permanently disabled by conditions associated with back pain, and 80% of the U.S. population is estimated to suffer back pain at some point in their lives.1,2 Though acute back pain is believed to be self-limiting, it recurs at a rate of approximately 90%.3 In one study, only 25% of the patients who consulted a general practice about low back pain had fully recovered 12 months later.4 For those who do recover, relapses can be frequent and severe, with two to seven percent developing chronic pain.5
There is some consensus in the medical community on how to treat acute low back pain, but treatment of chronic pain presents many challenges and little agreement on standard of care. Nonsteroidal anti-inflammatory drugs and antidepressants provide some short-term benefit, but no published data warrant their long-term use.6 Manipulative therapy, physiotherapy, and massage therapy studies have also shown only temporary benefit.7,8 Long-term results on more invasive therapies, such as intradiscal electrothermal therapy (IDET) or surgery, have been poor.9,10 Some believe the poor results for the treatment of chronic low back pain stem from the fact that too much emphasis has been placed on pain arising from the intervertebral discs and not enough on chronic low back pain originating from the sacroiliac joint and ligaments.11,12 Because of the limited response to traditional therapies, many people have looked to other approaches for pain control. Prolotherapy (proliferative therapy), also known as regenerative injection therapy, is a nonsurgical injection therapy used to treat unresolved musculoskeletal pain and has shown some promise in relieving lower back pain.13 The procedure involves injecting soft connective tissue with one or more proliferants designed to provoke local inflammation, stimulating the body’s production of collagen at the injection site. The resulting growth of new ligament and tendon tissue is believed to alleviate pain.

Prolotherapy and Hip Pain - Full access research article

This is a full access research article on Prolotherapy and Hip pain published at the Journal of Prolotherapy

A Retrospective Study on Hackett-Hemwall Dextrose Prolotherapy for Chronic Hip Pain at an Outpatient Charity Clinic in Rural Illinois

Ross A. Hauser, MD & Marion A. Hauser, MS, RD

Abstract
--------------------------------------------------------------------------------
Objective: To investigate the outcomes of patients undergoing Hackett-Hemwall dextrose Prolotherapy treatment for chronic hip pain.
Design: Sixty-one patients, representing 94 hips who had been in pain an average of 63 months, were treated quarterly with Hackett-Hemwall dextrose Prolotherapy. This included a subset of 20 patients who were told by their medical doctor(s) that there were no other treatment options for their pain and a subset of eight patients who were told by their doctor(s) that surgery was their only option. Patients were contacted an average of 19 months following their last Prolotherapy session and asked questions regarding their levels of pain, physical and psychological symptoms and activities of daily living, before and after their last Prolotherapy treatment.
Results: In these 94 hips, pain levels decreased from 7.0 to 2.4 after Prolotherapy; 89% experienced more than 50% of pain relief with Prolotherapy; more than 84% showed improvements in walking and exercise ability, anxiety, depression and overall disability; 54% were able to completely stop taking pain medications. The decrease in pain reached statistical significance at the p<.0001 for the 94 hips, including the subset of patients who were told there was no other treatment options for their pain and those who were told surgery was their only treatment option.
Conclusion: In this retrospective study on the use of Hackett-Hemwall dextrose Prolotherapy, patients who presented with over five years of unresolved hip pain were shown to improve their pain, stiffness, range of motion, and quality of life measures even 19 months subsequent to their last Prolotherapy session. This pilot study shows that Prolotherapy is a treatment that should be considered and further studied for people suffering with unresolved hip pain.

This article is available at the Journal of Prolotherapy

Synvisc injections

I could be accused of being too opinionated, but as most of our readers know, I try to base my opinions on facts! Sometimes I come across articles or reviews that I really need everyone interested in pain medicine to read. Here is one of those articles that I came across that definitively needs reading!

In a comprehensive review published in the Canadian Medical Association Journal the authors noted that intra-articular injections of hyaluronic acid (and its derivatives, like Synvisc) did not improve knee function at any time point and that the reduction of pain on a scale of 0 to 100 was only -7.1.1 This means that on a scale of 0 to 10 the reduction of pain was only 0.7.  In other words, if you started with a knee pain level of 6, after 3 Synvisc visits (after you and/or the government spent $1500+) you can expect your pain level to be 5.3 after 22-30 weeks and thereafter the pain to return to its previous level.

What a complete waste of money!
In summary this article, noted “The currently available evidence suggests that intra-articular hyaluronic acid is not clinically effective and may be associated with increased risk of adverse events. There, this type of therapy should not be used for the treatment of painful osteoarthritis (except in clinical trials) until a large long-term trial with clinically relevant and uniform end points has been clarified the benefit-risk ratio.”1

How do these results compare to Prolotherapy?
In a comprehensive review of our published data involving over 700 patients treated with Hackett-Hemwall dextrose Prolotherapy with an average of 18 months post-treatment follow-up, the mean pain level decreased by a total of 4.2 points on a scale of 0 to 10.  Compared to Hyaluronan/Synvisc, dextrose Prolotherapy improves pain six times more effectively, or in other words is at least 600% more effective.  Dextrose Prolotherapy also provides long-term pain relief where Hyaluronan/Synvisc provides minimal relief at best and is only short term (then pain returns.)

Compilation of Dextrose Prolotherapy Results for Various Joints at a Charity Medical Clinic.
Dextrose Prolotherapy caused a statistically significant improvement in pain in various joints in patients who on average suffered with pain for 55 months.  Ninety-eight percent of the patients treated said dextrose Prolotherapy improved their quality of life and thus, have recommended it to other people.

In my opinion
It is my opinion that dextrose Prolotherapy is the most effective alternative treatment to Hyaluronan/Synvisc intra-articular injections available. Dextrose Prolotherapy provides short-term and long term pain relief at a much greater level than Hylruonan/Synvisc. The Canadian Medical Association Journal recommends that patients with painful arthritis not get this treatment until long-term studies show its efficacy. Long-term studies have already determined that it doesn’t work. I concur with their findings. One point is missing, however. Patients with painful osteoarthritis of the knee should receive dextrose Prolotherapy, because as our results show, it definitely works!

Ross A. Hauser, M.D
Dr. Hauser the Medical Director of the comprehensive Prolotherapy, PRP, and Bone Marrow Prolotherapy clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois. Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy.

The Regeneration of Articular Cartilage with Prolotherapy

Can research and clinical observation be documented to show that articular cartilage can be regrown with Prolotherapy? Ross Hauser’s, M.D. article from the Journal of Prolotherapy is now available online

The Regeneration of Articular Cartilage with Prolotherapy
What most people may not realize is that chondrocytes, the cells that make articular cartilage, are metabolically active. Chondrocytes proliferate and actively make articular cartilage. Osteoarthritis is an example of this, in that both the degradation and synthesis of articular cartilage are enhanced. It is well known that in osteoarthritis, chondrocytes retain their proliferative activity. Osteophytes or bone spurs are an example of this activity.

Another example of adult articular cartilage cells’ replication is acromegaly. In this condition the body produces an excessive amount of human growth hormone and with it, articular cartilage. Acromegalics often suffer from joint abnormalities caused by proliferation of chondroytes in articular cartilage. In other words, they produce too much cartilage.

When a healthy articular cartilage cell is injured, it demonstrates an enhanced reparative response and can replicate its DNA to form new cells. The rate of formation of articular cartilage can be enhanced by such stimuli as altered hydrostatic pressure, varied oxygen tension, growth factors, as well as nutrient and substrate manipulation.

If by traditional orthopedic surgery or medical standards, articular cartilage injury or degeneration causes such symptoms as knee pain, stiffness, clicking, crunching, and inability to walk, then the reversal of such symptoms with Prolotherapy must mean that articular cartilage regeneration has taken place. In this scientific editorial, the author makes the case for using Prolotherapy as the treatment of choice for degenerated joints.

The remainder of this article on Prolotherapy research is available at  Knee pain treatment research articles at www.journalofprolotherapy.com

Ross A. Hauser, M.D
Dr. Hauser the Medical Director of the comprehensive Prolotherapy, PRP, and Bone Marrow Prolotherapy clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois. Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy.

Spinal Fusion alternative question

We recently received an email from a patient who had received fusion surgery in her back due to scoliosis as a child-she is now suffering with pain that she feels is coming from her SI joint and wonders if Prolotherapy would help her.

As you know I am not a big fan of fusions unless absolutely necessary. The problem with a surgical fusion is that once the two, three or in your case 8 vertebrae are fused, the forces get transmitted above and below the fusion. Eventually these vertebral segments or in your case sacroiliac joints break down and start causing pain. Let me preface this all by saying there are times, like in scoliosis (especially childhood), where fusion is necessary (to stop the scoliosis from restricting breathing for instance). So what can Prolotherapy do in your case, Pam?

You feel the pain is coming from your sacroiliac joint and I suspect you are right. Prolotherapy works great for sacroiliac pain, dysfunction or ligament laxity. Degenerative low backs from degenerative arthritis, spondylisthesis, spinal stenosis, spondylosis, spondylolysis all typically respond great to Prolotherapy. I would add that Prolotherapy I believe is the best alternative treatment for low back pain. As a Prolotherapy Doctor, chronic low back pain is one of the conditions that responds the best to Prolotherapy.

Prolotherapy for post-fusion pain has a high success rate.  Anyone who has had a fusion and then subsequently had either low back, thoracic or neck pain, most likely has had the weight transfer or force transfer to the areas below or above the level of the fusion.  These are the typical areas treated with Prolotherapy. 

We have more detailed information in our article data bases at spinal fusion alternatives and Prolotherapy

Ross A. Hauser, M.D
Dr. Hauser the Medical Director of the comprehensive Prolotherapy, PRP, and Bone Marrow Prolotherapy clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois

Bone Marrow Prolotherapy an Alternative to Hip Surgery

Severe Hip Osteoarthritis Treated with Bone Marrow Prolotherapy

One of our first patients to receive Bone Marrow Prolotherapy to his hip has reported great results thus far (it's only been 1.5 weeks) but he says he can feel a difference. MG is a 46 year old contractor who does alot of physical work. He received regular Hackett-Hemwall Prolotherapy with HGH to his severely arthritic hip from late 2007 to early 2009. He was much improved from this Prolotherapy but had not been able to return to full athletics because the increased activity would aggravate his hip. He was interested in trying out Bone Marrow Prolotherapy.

Here is what he had to say...

Comments: I just wanted to give you guy's an update, I had the Bone Marrow prolotherapy on 12-24-10 from the posterior Iliac Crest and I have to say definitely that for people who have severely degenerated joints like I used to have, this is the way to go. I have more comfort and relaxation in the hip joint and it has not even been two weeks. How long does this healing continue because this is great. If it goes like this for another month it will be completely healed. Thank You. MG

Needless to say, MG is so happy that Prolotherapy gave him a fantastic alternative to hip replacement surgery so that he can now live a healthy active life!

Bone Marrow Prolotherapy is not something that we would choose for every case of a sports injury or pain condition. But it is a good choice for those severely degenerated conditions or conditions where getting back to a sport quickly is of utmost importance. As with any Prolotherapy technique done at Caring Medical, a consultation with Dr. Hauser to discuss your medical condition and goals is needed to determine what type of Prolotherapy is best for you. There are two types of Bone Marrow Prolotherapy offered at Caring Medical:

Direct Bone Marrow Prolotherapy:
Bone marrow is aspirated typically from your tibia, and then directly injected into the injured joint. The cost of this treatment is $1100 in addition to the cost of the Prolotherapy. As an example, $350 for Prolotherapy to the knee plus $1100 for the Bone Marrow procedure, total $1450. As you can see, this is a more expensive option, but for those cases where surgery may be the only other option, it is "relatively" affordable comparatived to surgery and its related rehabilitation costs, lost time from work etc.

Concentrated Bone Marrow Prolotherapy: Bone marrow is aspirated, then processed and spun to "concentrate" it, giving you more cells per volume. The cost of this procedure is $2400 in addition to the Prolotherapy charge.

Ross A. Hauser, M.D
Dr. Hauser the Medical Director of the comprehensive Prolotherapy, PRP, and Bone Marrow Prolotherapy clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois. Specializing in joint pain treatments including Prolotherapy for hip pain. Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy.