Head/Neck/Jaw
Shoulder
Upper Back
Elbow
Low Back
Wrist/Hand
Groin/Pubis
Knee
Ankle

Click on specific pain syndrome areas

Specific Pain Syndromes

 

These are treated by injection of hypertonic glucose to the tender points at the back of the skull, and tips of the cervical vertebrae at the attachments of the supraspinous and interspinous ligaments. These superficial points are easy to treat and will relieve most neck problems. 

Neck muscle spasm contributes to headaches and mirgaines and there are common trigger points that send pain up into the head. They also increase tone in temporal arteries in migraine-prone people, triggering attacks, especially when foods or hormones are also involved.

Sprains of ankle ligaments respond well, painful sagging arches can be strengthened, the pain of bunions relieved and hammer toes can be straightened. Spurs of the plantar fascia are painful to treat but respond well. [illustration]

It is often assumed that all leg pain is sciatica. In fact lateral leg pain is more common than true sciatica and is usually referred from the sacro-iliac joint. This is very useful diagnostically, and when the patient indicates lateral thigh pain, palpation will reveal tenderness of the sacro-iliac joints confirming the diagnosis. Unless there are sinister points in the history, Xrays or MRIs for disc lesions etc are usually unnecessary as these pain patterns are so distinctive. They were mapped by George Hackett in the 1930s and 40s and have stood the test of time.

True sciatica is, of course, a surgical condition and should be treated surgically, but the patient may also need prolotherapy to the pelvic ligaments, whose instability may have contributed to the disc lesion.

When groin pain is not referred from the ilio-lumbar ligament, it may be due to strain of the adductor muscles at their attachment to the pubis. Prolotherapy is effective. Osteitis pubis responds well to prolotherapy in most cases. I have treated 5 cases with good results: one in the last weeks of pregnancy, two after pregnancy, two sportsmen, and one old lady with a pelvic fracture after a fall. All except one of the post pregnancy patients responded with complete resolution of their pain.

Update 2015 - i have treated many cases since then, most do very well. Occasionally one doesn't.

Knee pain is often due to sprain or strain of the external knee ligaments. This responds well to prolotherapy, and surprisingly even medial cruciate ligament laxity can often be helped. Dr Dean Reeves study of prolotherapy into the knee showed 44% decrease in pain in knee osteoarthritis in the active group compared to placebo, and some regeneration of cartilage was seen on xray. In 16 knees with ACL laxity, 9 were normal at 1 year and 10 were normal at 3 years.

Dr David Rabago's 2013 knee study found that WOMAC scores improved by 15 in the glucose treated group compared with 7-8 in the saline and exercise groups

Somalz (2013) has some amazing pictures of xrays of a 72 year old woman whose grade 4 (severe) knee osteoarthritis improved to grade 1 (as well as the pain) after 6 treatments.

A Lancet 2002 report from Holland showed that steroid injections for lateral epicondylitis (tennis elbow) had a poorer long term outcome than physiotherapy or “wait and see” approach. Prolotherapy has good results and is more logical, as the inflammatory response is utilized for healing rather than being suppressed.

In a 2008 study Scarpone showed that prolotherapy decreased pain score out of 10 from 5.1 to 0.5 over 16 weeks. The saline control patients' pain decreased only from 4.5 to 3.5. The prolotherapy patients also had increased grip strength and the improvements were maintained for at least 12 months.

Osteoarthritis of the thumb and finger joints often respond well to stabilization of the surrounding ligaments, by injection at the tender points, eg pain in thumb joints with lifting heavy plates, or painful Heberden’s nodes. Reeves trial showed 42% improvement in pain in the glucose group compared with 15% in the placebo group. Movement also was significantly improved.

There is strain of the ligaments of the sacro-iliac joints in most low back pain. There is often referred pain in the lateral thigh and even calf and outside of the foot, and under the little toes, unlike sciatica, which goes down the back of the leg and into the big toe and is associated with weakness of the foot.

Prolotherapy injections are used in a wide area, including the posterior sacroiliac ligaments, the ligaments of the lower lumbar facet (or zygapophyseal) joints and the ilio-lumbar ligaments. The pelvis becomes more stable and walking, bending, standing on one leg (eg for dressing) become less painful and more efficient. Dorman (J Orthop Med 1995;17:24-26) showed that patients used less oxygen when walking after their sacro-iliac joints were treated. In most cases pain in these movements can be significantly relieved.

2 randomised double-blind controlled trials in low back pain from California showed significantly greater improvement in the treated group compared to controls. There have been many research studies published since then including one from Yelland in Queensland.

The fibrous acromioclavicular joint is easy to treat with prolotherapy. Tears and tendinopathy of the rotator cuff, eg supraspinatus also can be treated with accurate placement of the prolotherapy solution at the site of the attachment of the tendon to the humerus. Intra- articular injections are used to strengthen the deeper ligaments. Frozen shoulder (adhesive capsulitis) is difficult to treat but many cases can be helped by treatment of the rotator cuff ligaments. Treating the anterior ligaments of the shoulder joint usually helps recurrent shoulder dislocations.

Treating the ligaments around the temporomandibular joint (TMJ) relieves the pain and muscle spasm and prevents locking. 

Typists, hairdressers and other who lean forward constantly in their work often develop upper back pain, due to the tendency of collagen to undergo ‘creep’ when a constant force is applied. Strain of the supraspinous/interspinous ligaments results in pain at the ligaments and paraspinal muscles must work harder than normal to maintain posture. This results in trigger points and secondary strain where these muscles attach to the ribs. This is one of the easiest areas to treat with prolotherapy. 

 

 

Many other painful musculoskeletal conditions can be treated

Clinic Address

Address
SA Sports Medicine Centre
70 South Tce
Adelaide 5000

Phone: +61 08 8211 8002

E:taylorme@internode.on.net