Prolotherapy and Spine Pain

Prolotherapy and Spine Pain

Prolotherapy and Spine Pain

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As a Spine Specialist,  there are times when our traditional treatments just have not been beneficial.  In my opinion,  as a surgeon,  the patients with the very large disk herniations, and with the corresponding physical complaints and findings are the easiest to treat.  Epidural steriod injections are often beneficial.  For these patients,  surgical management is a reasonable option for those who do not improve with medications,  time,  therapy,  or injections.

The reality is most patients do not have those large disk herniations that are so predictable in their effects,  as well as recoveries.

Most people have back and neck pain from wear and tear of the disks,  ligaments,  tendons and muscles.   In the spine,  there are many areas where these various parts can be an issue.  That is why it is so difficult to treat some of these chronic,  or intermittent neck and back complaints.

Assuming there is no dangerous cause of pain  (such as a tumor,  infection,  fracture, etc),  and the traditional treatments such as anti-inflammatory medications, physical therapy,  cortisone shots  and stretching do not work,  patients often turn to so called alternative,  or complementary medical treatments.

One of these treatments is Prolotherapy.

Prolotherapy has been practiced since the 1930’s,  and the concept is contrary to most treatments that are designed to decrease inflammation.  The treatment is based on the concept of proliferation of tissues.  The theory is an inflammation effect will cause thickening,  and strengthening of weakened tissues,  thereby stabilizing the structure.  Conceptually,  the effect appears to make sense.  Many scientists attribute excessive stretching of ligaments,  tendons,  and muscles as the source of some of the pains in the spine.  While it may be a challenge to identify all the ligaments, and structures that are stretched,  if we can treat those structures,  theoretically,  we should be able to help reduce the instability caused by the stretched tissues.  We can stabilize the spine,  and reduce the pain.

Unfortunately,  the scientific data on Prolotherapy is controversial.  Yet,  there are plenty of patients who feel great benefit from the procedure.  If you are interested in the procedure,  understand that it usually takes multiple  needle injections over several months to see if there is a benefit.  Most insurance plans consider the procedure experiment, and will not authorize the procedure (you must self fund the procedure).  You must avoid the use of anti-inflammation drugs after the procedure, as it will negate the intended effect.  There is a chance the procedure may not work.  If you understand all this,  and would still like to pursue the treatment,  please discuss the option with your physician.  While we cannot say definitively that it will help you,  we are willing to try the procedure if we can identify a ligament,  tendon,  or tissue that may benefit from the procedure.

Citations

  • Slattengren AH, Christensen T, Prasad S, Jones K. PURLs: Prolotherapy: a nontraditional approach to knee osteoarthritis. J Fam Pract. 2014 Apr;63(4):206-8. PubMed PMID: 24905123

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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