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| Yikes! |
There are many tools and techniques to choose from in the world of
medicine. Recently I’ve been asked about what I thought about prolotherapy…is
it good, bad, evil?
Well, let’s go over it…
The first thing you have to realize is that you need to love needles…or
at least tolerate them. Prolotherapy involves injecting dextrose, lidocaine
(a common local anesthetic), phenol, glycerine, or cod liver oil extract into a
really flimsy, overstretched tendons or ligaments for the purpose of
strengthening the suspect tissue to try and relieve musculoskeletal pain.
Prolotherapy
sessions are done every three to six weeks, gradually tapering off over time
until they are, hopefully, no longer needed.
Like any
technique, there is a bit of an “art” to it. So the more experienced the doctor
is the better. You don’t want someone to “practice” this on you.
The concept
is simple. A joint is forced to move more than it’s designed and its tendons or
ligaments become flimsy. However, unlike a muscle, you can’t make tendons and
ligaments stronger with resistance training. Instead, the trick is to somehow
get them to shrivel up, get shorter and thicker...the body's natural response to direct trauma with a sharp instrument. Kind of like a face lift.
Or you
could remove the perpetual cause…but we’ll get to that later.
Basically,
prolotherapy injections irritate the heck out of the involved tissue to get it
to thicken-up and get stiffer. That’s the goal. Essentially it’s a skillfully
applied scar.
Another
technique, referred to as “needling”, has a similar objective. Picture a Roman
doctor stabbing a hot needle into a gladiators “unstable” shoulder. Today’s
less barbaric version of needling is becoming very common to use on horses. And now that I’m thinking about it Platelet
Rich Plasma (PRP) Therapy probably works via the same mechanism, and may have
nothing to do with the red blood cells or the growth factor they try to inject.
There’s a
good history with this approach. But other than direct injury, why would
someone, other than a gladiator, need to give their ligaments and/or tendons a
face lift?
Well, like
any chain, if there is a rusty link, the adjacent link will move more than it’s
designed to, and wear out faster than normal. In this case, the ligaments that
are suppose to limit the joints motion, and the tendons that the muscles use to
move and stabilize the joint, can get trashed over time, if the joint is forced
to compensate for an adjacent “rusted” joint.
If you have
any structural abnormality, you will have a bunch of “rusty” joints, all
over your body, which will force their neighbors (above, below, other side)
to become “flimsy” to one degree or another.
“Flimsy”, hypermobile
joints are usually the ones that end up hurting. Naturally, these are the ones
that can be candidates for prolotherapy.
But, you
have to ask yourself…What’s the sense in doing prolotherapy on a joint that is
just going to get loose again anyway? It’s like lubing the loose links and
ignoring the rusty ones.
This is how
I think.
The PRIMARY
conditions, that can lead to a joint-hypermobility, that I focus on correcting,
include: Short Leg Syndrome, Compensatory Lumbar Scoliosis and Anterior Head
Syndrome… which result in the loss of the normal loading of the vertebrae,
resulting in abnormal joint movement, abnormal mechanoreception (joint
dysafferentation in general) which is never limited to the spine, because the
extremities almost always end up getting caught up in the mix. Especially the
lower ones
It’s
valuable to understand how things are connected. How a SYSTEM works. How the
hip bone is connected to the…
So, for
some patients, prolotherapy is a possibility. It takes advantage of the body's natural reaction to direct trauma, skillfully applied with a needle, hopefully. It's not good, bad or evil...it just doesn't make sense if you aren't going to provide the
hypermobile joints a better environment, by giving the “flimsy”
joints some slack, to reduce or eliminate the primary condition (rusty
link).
Of course
there is the occasional exception…Some links just can't get unstuck.
