Back Pain Following Trauma and Disease—

Hackett, George S.; Huang, T. C.; Raftery, Alan; Dodd, Theodore J.

doi:10.1093/milmed/126.7.517

Cited by 14 publications

(14 citation statements)

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“…Case series have documented the efficacy of prolotherapy for many ligament injuries: the sacroiliac joint [187][188][189], lower back [190,191], neck [192,193], shoulder [194], elbow [195], knee [196,197], temporomandibular joint [198,199], and other articulations [200,201]. …”

Section: Prolotherapymentioning

confidence: 99%

Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics

Hauser¹

2013

TOREHJ

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Ligament injuries are among the most common causes of musculoskeletal joint pain and disability encountered in primary practice today. Ligament injures create disruptions in the balance between joint mobility and joint stability, causing abnormal force transmission through the joint, which results in damage to other structures in and around the joint. The long-term consequence of nonhealed ligament injury is osteoarthritis, the most common joint disorder in the world today.Ligaments heal through a distinct sequence of cellular events that take place in three consecutive stages: an acute inflammatory phase, a proliferative or regenerative phase, and a tissue remodeling phase. The process can take months to resolve itself, and despite advances in therapeutics, many ligaments do not regain their normal tensile strength.Various diagnostic procedures have been used to determine and assess ligament injury. Traditionally, MRI and X-rays have been the most utilized techniques; however, because ligaments do not show up clearly with these devices, there have been many false positives and negatives reported due to inconclusive or inaccurate readings. Newer technologies, such as ultrasound and digital motion X-ray, are able to provide a more detailed image of a ligament's structure and function.Numerous strategies have been employed over the years attempting to improve ligament healing after injury or surgery. One of the most important of these is based on the understanding that monitoring early resumption of activity can stimulate repair and restoration of function and that prolonging rest may actually delay recovery and adversely affect the tissue's response to repair. Likewise, there is a shift away from the use of steroid injections and nonsteroidal antiinflammatory medications. Although these compounds have been shown effective in decreasing the inflammation and pain of ligament injuries for up to six to eight weeks, their use has been shown to inhibit the histological, biochemical, and biomechanical properties of ligament healing. For this reason their use is cautioned against in athletes who have ligament injuries. Such products are no longer recommended for chronic soft tissue injuries or for acute ligament injuries, except for the shortest possible time, if at all.Regenerative medicine techniques, such as prolotherapy, have been shown, in both case series and clinical studies, to resolve ligament injuries of the spine and peripheral joints. More research and additional studies are needed to better assess ligament injuries and healing properties.

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Section: Prolotherapymentioning

confidence: 99%

Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics

Hauser¹

2013

TOREHJ

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“…These therapies decrease the complaints at short-term. But no evidence could be found that they improve arthritis level at long-term (1-3, 6, 7). Clinical and radiological improvements were demonstrated with our therapy method.…”

Section: Discussionmentioning

confidence: 97%

“…Injected solution causes inflammation at connective tissue. The immune response to inflammation regenerates ligamentous compounds and resolves ligamentous laxity occurring at joint during arthritis (6, 7). …”

Section: Discussionmentioning

confidence: 99%

Treatment of Advanced Stage Gonarthrosis With Prolotherapy: Case Report

Solmaz¹,

Deniz

Cifci³

2013

Anesth Pain Med

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IntroductionThis case report aims to discuss the clinical and radiological outcomes of prolotherapy at a patient whom to total knee prosthesis had been planned but surgery couldn’t be performed due to co-morbidities.Case PresentationA 72 year old woman presented with severe pain at her knees for over 5 years. Treatment methods include weight loss, decreasing the weight bearing on the joint, stretching exercises, nonsteroid anti-inflammatory and steroid drugs, and physiotherapy. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale was applied to measure the osteoarthritis level of the patient: Pain level; 25 points, stiffness level; 10 points, Physical function loss; 80 points, and total WOMAC 115 points. At radiological evaluation, the patient was diagnosed as grade IV osteoarthritis due to significant osteophyte presence and complete joint space narrowing. Six sessions of knee prolotherapy protocol was applied to the patient, one session monthly.ConclusionsSignificant improvement was noted at WOMAC scale (Pain level; 5 points, stiffness level; 2 points, Physical function loss; 15 points, and total WOMAC 22 points). Osteoarthritis level of the patient was improved to grade I at radiological evaluation after a year. Our case is the report that presents radiological evidence in addition to clinical findings of improvement of osteoarthritis level. As a result of this case report, further studies aiming to offer a different minimally invasive treatment option to the patients before surgery may be performed. We are in the opinion that prolotherapy may be preferred more commonly as an efficient method once the importance of ligamentous structures at pathogenesis of osteoarthritis is established.

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“…Thus, treatment of the ligament injury-induced myofascial pain should be targeted to restore the ligament and tendon structure. Complete stabilization of the joint and ligament and tendon tissue can then naturally resolve the ligament injuryinduced muscle spasms and the trigger points [14][15][16][17][18][19].…”

Section: Prolotherapymentioning

confidence: 99%

Structural Basis of Joint Instability as Cause for Chronic Musculoskeletal Pain and Its Successful Treatment with Regenerative Injection Therapy (Prolotherapy)

Hauser¹,

Blakemore²,

Wang³

et al. 2014

TOPAINJ

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Joint dysfunctions and associated musculoskeletal pain are among the most common medical complaints presented to clinicians. Ligaments are collagenous fibrous structures that are primarily responsible for maintaining smooth joint motion, restraining excessive joint displacement, and providing stability across the joint. Ligaments also act as sensory organs for the joints and have significant input to pain sensation. When ligaments are subjected to forces beyond their normal range of motion, injury and failure occur, resulting in joint laxity (looseness or instability), and subsequent disruptions in the balance between joint mobility and joint stability. These dysfunctions can result in joint pain and the development of osteoarthritis. Several strategies have been employed over the years in attempts to improve joint instability from ligament injury; however, some of the standard therapeutic approaches (drugs, corticosteroid injections, and surgery) employed to address these problems have not been very effective because they often do not address the underlying cause of the problems, and in fact can inhibit ligament healing and restoration. For these reasons, there is current and growing interest among patients and clinicians in prolotherapy, an alternative therapeutic modality that can reduce or eliminate pain by stimulating the natural regenerative processes in and around the joint to facilitate the restoration of degenerated ligaments and tendons to a healthy state, improving joint support, function and reducing pain. This review presents current evidence from clinical studies demonstrating that prolotherapy is a significant and effective alternative treatment modality for people with ligament-related injuries and resultant joint instability.

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Back Pain Following Trauma and Disease—

Cited by 14 publications

References 0 publications

Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics

Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics

Treatment of Advanced Stage Gonarthrosis With Prolotherapy: Case Report

Structural Basis of Joint Instability as Cause for Chronic Musculoskeletal Pain and Its Successful Treatment with Regenerative Injection Therapy (Prolotherapy)

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