Am I A Candidate For Prolotherapy?

I’m 26 years old. I grew up showing horses and I have and injury where I injured my L4 and L5 vertebrae in my lower back. Would I be a good candidate for prolotherapy?

Possibly. The key to prolotherapy is if you have point tenderness in your lower back. Some people think prolotherapy is helpful for herniated disc. I disagree with that. I think it’s too invasive a procedure. But if you have areas on your back where you can say, “I know exactly where this hurts,” prolotherapy is very appropriate. Because when we give you the injections, we give them at the point of pain, because that’s telling us where the ligament or tendon is damaged.

For an older relative of mine, he often experiences shoulder pain, possibly arthritis. Could prolotherapy help him?

Yes. I had a woman come to me who could not raise her shoulder. She had severe arthritis. She also had what’s called adhesive capsulitis.

She came to me and asked if I’d do prolotherapy. At the time I was a little skeptical. I gave her the injections and also an intensive physical therapy program to get her shoulder moving again.

She is my favorite patient now. She is so happy. She has 90% motion in her shoulder and her pain has gone away. I didn’t believe it so much, so I took another x-ray, and actually some of the arthritis was decreased. Really.

I had another woman with a torn rotator cuff who refused to have surgery. I said, OK, I’ll treat you. She had an MRI which showed the rotator cuff. She came back three months later like this [raises his arm]. Is said, “Do you mind if I do another MRI? I’ll pay for it myself.” The MRI report showed no rotator cuff tear – it was completely healed.

How Prolotherapy Works?

I’m 26 years old. I grew up showing horses and I have and injury where I injured my L4 and L5 vertebrae in my lower back. Would I be a good candidate for prolotherapy?

Possibly. The key to prolotherapy is if you have point tenderness in your lower back. Some people think prolotherapy is helpful for herniated disc. I disagree with that. I think it’s too invasive a procedure. But if you have areas on your back where you can say, “I know exactly where this hurts,” prolotherapy is very appropriate. Because when we give you the injections, we give them at the point of pain, because that’s telling us where the ligament or tendon is damaged.

For an older relative of mine, he often experiences shoulder pain, possibly arthritis. Could prolotherapy help him?

Yes. I had a woman come to me who could not raise her shoulder. She had severe arthritis. She also had what’s called adhesive capsulitis.

She came to me and asked if I’d do prolotherapy. At the time I was a little skeptical. I gave her the injections and also an intensive physical therapy program to get her shoulder moving again.

She is my favorite patient now. She is so happy. She has 90% motion in her shoulder and her pain has gone away. I didn’t believe it so much, so I took another x-ray, and actually some of the arthritis was decreased. Really.

I had another woman with a torn rotator cuff who refused to have surgery. I said, OK, I’ll treat you. She had an MRI which showed the rotator cuff. She came back three months later like this [raises his arm]. Is said, “Do you mind if I do another MRI? I’ll pay for it myself.” The MRI report showed no rotator cuff tear – it was completely healed.

Prolotherapy For Arthritis

There are many people in their 30’s, 40’s and 50’s that are starting to develop early arthritis. These patients come in with mild pain. This is due to the fact that their cartilage is starting to deteriorate and has small defects and microfractures of the cartilage. Prolotherapy helps to produce fibroblasts that fill in these areas to smoothen out the cartilage – in the same way you would put asphalt in the road to make your ride smoother. This helps to relieve the pain of arthritis significantly. Even patients with severe arthritis can get relief as well.

Knee Pain

Prolotherapy treatment for knees is the number one condition we treat. It is a very effective treatment for cases of arthritis and knee instability that are the result of tendon and ligament damage. Prolotherapy for these type of knee conditions is effective 85% of the time. However, it is not effective for a torn meniscus, unless it is a peripheral tear.

What is Prolotherapy?

Prolotherapy, also called regenerative injection therapy, is a way of injecting an irritant solution into a tendon or ligament in order to cause a reparative inflammatory reaction to help repair the tendon and relieve pain.

How long has prolotherapy been available in the United States?

Prolotherapy was first used by Dr. George S. Hackett, and it was introduced to the AMA (American Medical Association) in 1955. It has been used mostly on the west coast of United States and now it’s moving very steadily towards the East Coast. It’s been progressing over the last 60 or 70 years.

What are some of the most common uses for Prolotherapy?

Some of the common uses for prolotherapy are tennis elbow, groin strains, sacroiliac instability – which is a common cause of lower back pain – tendonitis of any kind, wrist, ankle, knees.

Can prolotherapy help plantar fasciitis?

Yes. I had a professional weightlifter who couldn’t do the strongman competitions anymore because he couldn’t pull a train or a truck because he had to use his feet. He came to me and got 3-4 prolotherapy injections and now he’s back in competition again.

What is the story about tendonitis?

There are a lot of misconceptions about tendonitis. Everyone thinks that tendonitis is an inflammatory process, but in reality over 90% of the diagnoses of tendonitis are actually a damaged tendon and there’s no inflammatory reaction going on. As a matter of fact, what prolotherapy does is try to create an inflammatory reaction to reignite it so that the healing process starts all over again. Classically, we treated these conditions with cortisone injections, non-steroidal anti-inflammatories and such, usually what happens is you get better for a week or two and then the pain comes back again. That’s because the anti-inflammatories have only masked the injury and what’s really needed is to stop anti-inflammatories, treat it with prolotherapy and incite a new healing process, i.e. the inflammatory reaction, which will start the tendons to heal.

Shoulder Issues

Our practice treats patients who typically have the following shoulder related issues; arthritis, most rotator cuff tears as well as biceps ligament tears. Prolotherapy is not effective for adhesive capsulitis. When treated over a period of five weeks, 80% of our patients have found we have alleviated their pain.

Prolotherapy For Rotator Cuff

If your x-ray shows that you do not have an impingement of the tendon or rotator cuff by a spur of the acromioclavicular joint, then prolotherapy is effective. I have been able to heal a number of pure rotator cuff tears and help people avoid surgery. However, if you do have a spur that’s impinging, or even a down-sloping acromion, that is digging into the rotator cuff, I would suggest that you have decompression surgery and a surgical repair of the rotator cuff, since prolotherapy will not help that condition.

Osteoarthritis

Osteoarthritis is caused by a combination of genetics, weight and activity - as well as trauma.

It is unusual for people under the age of 50 to have persistent joint pain unless there is some underlying arthritis. This would be defined as wear tear of the cartilage of the joint surface

It has been shown that Osteoarthritis has been treated successfully by prolotherapy 85% of the time. Almost any joint in your body can be treated with the exception of the spinal column itself. Most commonly hips, knees, shoulders, ankles, elbows, wrists, hands and feet.

Most people get at least 50% - if not complete - relief of their pain for a minimum of a year and sometimes much longer. Prolotherapy is not just a pain reliever. The treatment works by stimulating the growth of fibrous tissue which makes a cushion between the bones and fills in the cracks in the cartilage. For this reason, prolotherapy lasts longer depending on the activity of the individual.

Back Pain

Back Pain Boston

Back pain is very uncomfortable for people of all ages, and can many times lead to depression. As we get older it is one of the primary reasons for people not being able to go to work. As we age many of us commonly complain of back pain because of degenerative disk disease. This affects parts of the lower back, including the vertebrae, ligaments, muscles, and nerves.

In many cases, back pain can be alleviated by a variety of treatments including correct body mechanics. Surgery is rarely used to treat pain in the lower back. If you are interested in easing back pain, you may be a candidate for Prolotherapy. This treatment by Dr. Franchi of Boston Prolotherapy & Orthopedics focuses on a series of injections to start the recovery process and promote healing. Dr. Franchi has helped hundreds of patient return to work.

Causes of Back Pain

The back is a series of discs, bones, tendons, ligaments, and muscles. If you have back pain, your medical provider will use imaging tests to determine the cause and the affected area. Common causes of the back pain include:

1. Structural Issues

The human spine features interlocking bones that are stacked on top of each other called vertebrae. The space between each vertebrae is occupied by protective tissue named discs. If the discs rupture, herniate, or bulge, you will experience back pain. People with degenerative disc disease will quite often develop sacroiliac instability which is a very common cause of lower back pain. Although Prolotherapy does not treat disc problems, it is very effective for sacroiliac instability.

2. Strain

Sleeping at an awkward angle, using the wrong form during workouts, and lifting heavy objects can result in a pulled muscle or ligament in your back. You can also strain back muscles from over-activity, such as prolonged sports sessions without intermittent rest.

3. Poor Posture

Many people spend hours every day hunched over their computers and develop back and neck pain. Maintaining proper posture and taking regular breaks from your computer, even for just a few minutes can help immensely.

Your work could also be placing you at a higher risk of developing back pain. Occupations such as construction, warehousing, landscaping, gardening, and working with patients in a nursing home are among the riskiest activities.

When to See a Physician

Many episodes of back pain can resolve after a few days or weeks. It is best to consult a physician if the pain is severe or ongoing. Back pain can be accompanied by other symptoms that warrant medical care, including:

1. Sudden Weight Loss

If you lose a lot of weight unexpectedly without trying, you should have your back checked by a physician.

2. Fever

Back pain that is accompanied by fever can indicate a severe infection. Sweats, chills, and other flu-like symptoms can also indicate an infection.

3. Trauma and Injury

If your back pain results from a car accident, sports injury, serious fall, or another severe trauma, you should immediately consult a doctor.

4. Numbness or Tingling Sensation

Shooting pain down your legs or arms is an indication of nerve compression in your spine, and you should call your physician as soon as possible.

5. Loss of Bladder Control

Loss of bladder control is an emergency and may indicate cauda equina syndrome. It requires immediate attention and you should go as soon as possible to an emergency room.

Back Pain Treatment

Some common treatments include:

1. Medication

There are many over-the-counter remedies available to relieve back pain. After working with your pharmacist and the pain persists, it could be time for a medical evaluation. Your physician may recommend analgesics, muscle relaxants, and NSAIDs to reduce inflammation. Some practitioners may use cortisone injections to relieve sciatica, but this is only a short term solution and treatment for pain relief.

2. Therapies

Physiotherapy is effective at improving strength and flexibility. A physical therapist will stretch your back muscles and ease your back pain. This type of treatment will be more effective when paired with low-impact exercises such as cycling and swimming. If your back pain is interfering with everyday activities such as tying your own shoes, getting dressed and working at your desk, it’s possible that your physician or massage therapist may recommend supportive devices.

At Boston Prolotherapy & Orthopedics, we have found an 80-90% success rate in using Prolotherapy for back pain arising from sacroiliac, cervical facet, and interspinous ligament instability. Prolotherapy treatment will promote the rejuvenation of the torn ligament and ease your back pain.

Prolotherapy Treatment Process

Walk me through the process.

When you come in, I examine you to make sure that prolotherapy is indicated. I may take an x-ray to make sure there’s not some other source of your pain that I can’t solve. Then, we use sterile technique, and I use a 50% dextrose solution with lidocaine so it doesn’t hurt as much. I give the injections in the appropriate areas.

The first office visit takes 15-30 minutes. But after that, once we know your problem, you could be in and out of the office in five minutes. I start my office hours at 7:00 a.m.

How do you know where to inject?

A lot of that comes with experience. I’ve had the advantage of being a classically trained orthopedic surgeon. So, I’ve seen the anatomy of 1000’s of people from the inside. So I tend to know where things are. I have very good eye-hand coordination and skills, to know where the tendons are supposed to be. So I can coordinate that with my judgment.

You have to apply the needle to the ligament/bone interface – where the ligament inserts into to the bone. You have to know where that is, and you have to know how deep to go with the needle. Obviously, experience counts.