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The Big File All issues not easily categorized in the above forums are here. Comments on general health, diet, "getting comfortable," and more are here.


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  #1  
Old 05-17-2005, 02:31 AM
t t is offline
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Anyone heard of it or had any success/experiences with this procedure?

An aquaintance's father suggested checking into this. Apparently it is some sort of injection that produces inflammation that promotes rebuilding of tissues.

Any information is appreciated.

regards,

t~
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  #2  
Old 05-17-2005, 05:24 AM
Alastair Alastair is offline
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There is a complete article about this in the FAQs (use the "hop to" function bottom lefthand side)
Best,
Alastair
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  #3  
Old 05-17-2005, 08:28 AM
t t is offline
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Alastair,

My apologies for not doing a more thorough search. The FAQ should have been my first stop.

Anyone had this done for a disk?

regards,

t~
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  #4  
Old 05-17-2005, 08:56 AM
annapurna annapurna is offline
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I've started a prolotherapy regimen for SI joint and surrounding ligaments. No miracles so far, but, I may have other issues (nerve scarring) that the prolo would not address. In addition to the article in the FAQ's there are many studies that you can find on the web. Unfortunately, the clinical studies don't show much definitive success. On the other hand, the clinical studies are somewhat limited and do not always involve strict patient selection.

As far as prolo for disc repair, I think the only possible potential would be bolstering of some of the annular fibers. All prolo can do is stimulate growth of fibrous tissue - not the proteoglycans of the disc nucleus. Since the disc annulus is fibrous tissue, there is some logic to the idea that prolo could help - maybe. At the same time, remember that, in order to access the disc, your prolotherapist would need to introduce the scleorescerant solution fairly near your nerve roots. If some of the solution leaked onto the nerve roots, that could result in nerve root scarring - something surgeons go to great lengths to avoid.

Personally, I'd employ prolo to strengthen surrounding ligaments that have easily accessible attatchements to the bone. This would be safer and possibly give you increased stability. Then go after your disc problems with SED, ADR, nucleoplasty, abrasion, etc. Then you've got the best of both worlds so to speak. Of course, this is just my opinion, so...

Good luck and please keep us posted on how you do if you try prolo or any other course of treatment.

Laura
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  #5  
Old 05-17-2005, 09:31 AM
Alastair Alastair is offline
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Hiya,
There was an article in Medscape

Yelland MJ; Del Mar C; Pirozzo S; Schoene ML
Discipline of General Practice, University of Queensland, Brisbane, Queensland, Australia. myelland@bigpond.com.
STUDY DESIGN: A systematic review of randomized and quasi-randomized controlled trials. OBJECTIVES: To determine the efficacy of prolotherapy injections in adults with chronic low back pain. SUMMARY OF BACKGROUND DATA: Prolotherapy is an injection-based treatment for chronic low back pain. Proponents of prolotherapy suggest that some back pain stems from weakened or damaged ligaments. Repeatedly injecting them with irritant solutions is thought to strengthen the ligaments and reduce pain and disability. Prolotherapy protocols usually include co-interventions to enhance the effectiveness of the injections. METHODS: The authors searched MEDLINE, EMBASE, CINAHL, and Science Citation Index up to January 2004, and the Cochrane Controlled Trials Register 2004, issue 1, and consulted content experts. Both randomized and quasi-randomized controlled trials comparing prolotherapy injections to control injections, either alone or in combination with other treatments, were included. Studies had to include measures of pain and disability before and after the intervention. Two reviewers independently selected the trials and assessed them for methodologic quality. Treatment and control group protocols varied from study to study, making meta-analysis impossible. RESULTS: Four studies, all of high quality and with a total of 344 participants, were included. All trials measured pain and disability levels at 6 months, three measured the proportion of participants reporting a greater than 50% reduction in pain or disability scores from baseline to 6 months. Two studies showed significant differences between the treatment and control groups for those reporting more than 50% reduction in pain or disability. Their results could not be pooled. In one, co-interventions confounded interpretation of results; in the other, there was no significant difference in mean pain and disability scores between the groups. In the third study, there was little or no difference between groups in the number of individuals who reported more than 50% improvement in pain and disability. The fourth study reporting only mean pain and disability scores showed no differences between groups. CONCLUSIONS: There is conflicting evidence regarding the efficacy of prolotherapy injections in reducing pain and disability in patients with chronic low back pain. Conclusions are confounded by clinical heterogeneity among studies and by the presence of co-interventions. There was no evidence that prolotherapy injections alone were more effective than control injections alone. However, in the presence of co-interventions, prolotherapy injections were more effective than control injections, more so when both injections and co-interventions were controlled concurrently.
Language: English
MEDLINE Indexing Date: 200409
Publication Type: Owner: NLM
Publication Type: Journal Article
PreMedline Identifier: 0015454703
Journal Code: IM
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  #6  
Old 05-17-2005, 09:36 AM
Alastair Alastair is offline
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Also

Jan. 9, 2004 � Ligament injections of saline are as effective as prolotherapy for chronic low-back pain, according to the results of a randomized trial published in the January issue of Spine. The editorialist praises the study.

"In chronic nonspecific low-back pain, significant and sustained reductions in pain and disability occur with ligament injections, irrespective of the solution injected or the concurrent use of exercises," write author Michael J. Yelland, FRACGP, FAFMM, from the University of Queensland in Brisbane, Australia, and colleagues.

This controlled trial with two-by-two factorial design was triple-blinded for injection status and single-blinded for exercise status. During the six-month study period, 110 subjects with nonspecific low-back pain (average duration, 14 years) were randomized to have repeated prolotherapy with 20% glucose/0.2% lidocaine (lignocaine) or normal saline injections into tender lumbo-pelvic ligaments. Subjects were also randomized to a program of flexion/extension exercises or to normal activity. Follow-up was maintained through 12 months in 96% of subjects and through two years in 80% of subjects.

Throughout the trial, ligament injections resulted in significant and sustained reductions in pain on the visual analog scale and in Roland-Morris disability scores. However, prolotherapy injections were no more effective than saline injections, and the exercise program did not confer any additional benefit over normal activity. Transient, minor adverse effects of injections occurred more often than documented in earlier trials.

At 12 months, more than 50% reduction in pain from baseline occurred in 46% of the prolotherapy group vs. 36% of the saline group, and in 41% of the exercise group vs. 39% of the normal activity group. More than 50% reduction in disability occurred in 42% of the prolotherapy group vs. 36% of the saline group, and in 36% of the exercise group vs. 38% of the normal activity group. None of these differences were statistically significant.

"This trial's success rates in reducing pain and improving disability are at least as good as those reported for spinal cord stimulation, surgery, or multidisciplinary treatment," the authors write. "The effect may lie in the needle rather than the specific injection solution, by a counterirritation effect."

National, foundation, and professional organization funds helped to support this study. The authors report no financial conflicts of interest.

In an accompanying editorial, John D. Loeser, MD, from the University of Washington in Seattle, calls this a "beautifully conceived and executed study in all respects." He discusses the many questions raised by these findings, including the role of physician-patient interaction.

"Every needle has a sharp end that goes into the patient and a blunt end that is attached to a health care provider," he writes. "Anyone who thinks that all of the action occurs at the sharp end does not understand human behavior."

Spine. 2004;29(1):9-16
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Your best asset is your health
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Thank goodness for Dr Zeegers I am painfree
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I now run the UK spine site and can be contacted at

www.adrsupportuk.com/
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  #7  
Old 05-17-2005, 09:38 AM
Alastair Alastair is offline
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I think this is important too


"Every needle has a sharp end that goes into the patient and a blunt end that is attached to a health care provider," he writes. "Anyone who thinks that all of the action occurs at the sharp end does not understand human behavior."
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ADR Munich 26th July 2002 L5/S1. Aged 82 now
Your best asset is your health
My story is here
http://www.adrsupport.org/alastair.html
Thank goodness for Dr Zeegers I am painfree
I am here to help,I live in the UK


I now run the UK spine site and can be contacted at

www.adrsupportuk.com/
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  #8  
Old 05-17-2005, 11:38 AM
letteski letteski is offline
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Alastair,

That's more like it! You have so much to share and give to others.

t- ask away that�s what this board is all about! Sorry can't help you out.


P
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  #9  
Old 05-23-2005, 07:07 PM
paulam310 paulam310 is offline
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When I worked in a physical therapy clinic, half the people who had prolotherapy told me it made a huge difference, the other half said it didn't help. Most were getting injected for low back pain some for the shoulder area. The theory is that loose ligaments are a major cause of pain so they inject it to irritate it and cause scarring that will tighten it up. Ligaments, once stretched do not have the ability to contract back like a muscle.
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