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.