|
CW's story -
Bilateral Knee Pain
From the Journal
of Prolotherapy
Case
One:
CW is a 72 year-old woman who presented in
July 2004, complaining of a five-year history of severe
right
knee pain. She rated her knee pain on the visual
analogue scale (VAS) at a level of 6 on a scale of 0 to
10. She experienced daily pain throughout the whole knee
and noted that the severity of the pain was also
increasing. Her other symptoms were increased pain upon
sitting for long periods of time, difficulty with
stairs, and increased pain with walking. She was not
exercising. She had no previous history of trauma or
knee surgery. Three previous
hyaluronic acid treatments
provided diminishing relief. She used the oral pain
relievers, tramadol hydrochloride and
acetaminophen, as
needed. X-rays done in 2002 showed
osteoarthritis,
marked loss of joint space medially, subchondral
sclerosis and osteophyte formation. CW was told by an
orthopedist that she needed a total
knee replacement surgery.
She read about Prolotherapy in an alternative medicine
newsletter and wanted to try it instead of surgery.
Physical examination showed normal knee alignment.
Lachman, anterior drawer, valgus and varus stress tests
were all negative. She exhibited joint line tenderness
both medially and laterally, but worse medially, as well
as quite a bit of crepitus in the knee throughout the
range of motion. There was no swelling present in the
knee. Her range of motion was 3 to 95 degrees.
Prolotherapy treatments began in July 2004. CW received
nine treatments on her right knee through May 2005. She
reported an incremental decrease in pain and increased
mobility as she was interviewed every four to six weeks
during the course of treatment. Her range of motion had
improved to full extension and flexion to 110 degrees.
Her crepitus was nearly nonexistent. She reported at
this time, “I am 97% better. I have no pain (VAS score
0), just mild stiffness that subsides with walking.” She
was treated one more time and told to return to the
clinic if the pain returned. She no longer needed
medications or a total knee replacement.
CW returned to the clinic in May 2006 because she
twisted her knee and some of her pain returned. Her
physical exam at that time was unchanged from when she
was seen in May 2005, except she showed more medial
joint line tenderness and tenderness at the pes anserine
area. She received four more treatments over the next
four months, making incremental improvements in her
pain. At this time, the patient was doing great, yet
desired to see “how my cartilage was doing.” The X-rays
showed a large increase of medial joint space. (See
Figure 1.) By this time, the patient had received
14 Prolotherapy treatments to her knee.
Seventeen months after her last Prolotherapy treatment,
the patient continues to have full function of the knee
with almost no pain (0 to 1 on VAS). She has returned to
full activities without pain and is on no pain
medications.
Figure 1. Standard
weight bearing knee X-rays of C.W. before and after
Prolotherapy. The widening of the medial joint
space width indicates that cartilage regeneration has
taken place.
|
Prolotherapy
Our
Prolotherapy Books - 
POWER
OVER PAIN