Prolotherapy and Muscle Wasting?
Q. When I went for my first prolotherapy treatment for my sacroiliac joint I had to sign a paper releasing the doctor for the responsibility if I had any muscle wasting as a result of the therapy.

He said in his experiences he has seen one that had muscle wasting.  Is it possible that Prolotherapy can cause muscle wasting?  I am wondering because I have had 3 prolo treatments and my buttock muscles are smaller and my chiropractor said one of them is shrinking. 

A. In the forty years Dr. Hemwall (my mentor) had done Prolotherapy and the 15 years I have done it, we have had no muscle wasting.  If a muscle is tense because it is trying to stabilize a joint like the sacroiliac joint and the person gets Prolotherapy which stabilizes it, the muscle spasms stop.  In this case the pain would go away and I suppose the muscle could look less 'tense'. That is the only explanation I can think of.  We have never had a case where the needle was stuck into the nerve and then injured the nerve causing muscle wasting.

Answered By Ross Hauser, M.D.
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COMMENT - BY ANONYMOUS
I would like to comment about muscle wasting (buttock area) and sacroiliac joint/ligament injuries.

I have personal experience w/a SI joint injury and I have treated many clients w/these injuries as well (I am a massage therapist and therapeutic exercise specialist).

Research has documented that when ligaments and joint structures are injured one of the consequences is neurological inhibition (atrophy) of the muscle that act on the particular joint. With a SI joint/ligament injury the gluteal (buttock) muscles will atrophy due to neurological inhibition, not to mention people will compensate for pain by limiting movement/stress on the side of the body that hurts - in other words they will shift their weight over onto the non injured hip which will also contribute to muscle atrophy in the symptomatic side.

In my experience an injury to the SI joint/ligaments will cause whole body dysfunction leading to progressive breakdown in the ligaments/joints in the spine, hip, knee and ankle/foot primarily on the side of the body of the injured SI joint. Prolotherapy is a unique and essential treatment for these injuries. Ideally the patient needs to engage in a consistent exercise program to strengthen the atrophied muscles as well as overall "core" conditioning aimed at stabilizing all joint structures. Movement reeducation is also essential - walking and lifting are 2 movements that need to be performed w/ideal body mechanics. Orthotics are also helpful for those who have significant foot dysfunction which is common w/SI joint injuries.

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