|
Joint Pain Options
●
Ankle
pain
treatments
●
Arthritis
treatment
●
Back Pain treatment
●
Elbow pain
treatment
●
Foot pain treatment
●
Groin pain
treatment
●
Head-Neck Pain
treatment
●
Hip pain treatment
●
Knee pain treatment
●
Rib pain
treatment
●
Shoulder pain
treatment
The Injections
●
Comprehensive Prolotherapy
●
Prolotherapy Treatments
●
Prolotherapy and Diabetes
●
Painless Prolotherapy
injections
●
Whole body Prolotherapy
●
Prolozone
●
P2G phenol
●
Neural Therapy
●
How many injections?
Your Questions
●
Immune system
●
Autoimmune disease
●
Obesity and Prolotherapy
●
Does Prolotherapy Work?
●
Hormones Therapy
●
Prolotherapy not working
●
Prolotherapy Cost
The Research
●
Meniscal Tears and Degeneration
●
Regeneration of Articular Cartilage
●
Long-term NSAIDs
side-effects
●
Prolotherapy research links
Bone Marrow / Stem Cell
●
Bone Marrow for articular cartilage
Prolotherapy and
Medications
●
Motrin
●
Advil
●
Cortisone research
●
Cortisone shots
●
Cortisone injections
●
Synvisc
●
Neurontin and Elavil
●
Pain Management
Medications
●
Prescription narcotics
for pain
●
Use of pain killers
●
Aspirin and Coumadin
●
Painkillers
|
FREE
Prolotherapy e-newsletter
Free weekly privacy
maintained newsletter on Prolotherapy
and other non-surgical options
for the treatment of chronic pain. |
|
From www.getprolo.com
ORTHOPEDIC MEDICINE: A
NON-SURGICAL APPROACH TO CHRONIC PAIN
Lawrence Cohen, M.D.
(Dr. Cohen was a private practice Prolotherapy physician in Connecticut,
one of the first doctors to be listed on
www.getprolo.com - he passed away
in 2003)
When asked what I do, I hate to say "I'm in pain management," because
the focus of my practice is really pain resolution. By the time someone
reaches a pain specialist, they have failed standard interventions such
as physical therapy, medication and even more invasive procedures such
as epidural steroids. They have persisting pain that leaves them less
effective in the home, at work, and in their personal relationships. I
was trained with a physical medicine education to utilize medications,
physical or occupational therapies, psychology, and a few injection
techniques for tendons, bursae or muscle trigger points. This approach
proved inadequate for so many of my patients. I began searching the
alternative medicine world for treatments that worked.
This led me to the field of Orthopedic Medicine, a group of physicians
who are utilizing alternative techniques to deal with complex pain
problems. The direct cost savings can be tremendous; just think of the
cost of one back or neck surgery that might be avoided or the cost of
years of chiropractic, Physical therapy, or physician and emergency room
care. Indirect savings can be greater when adding the return to work
someone who otherwise might be out on disability or worker's
compensation for life.
The focus of this therapy is on the structural component. This might be
the sprained or strained ligament, tendon or muscle- or the "somatic
dysfunction" of the chiropractor or osteopath. One of the most important
lessons regarding structure is that the underlying problem may not be
where the pain is. The injured area is typically tender only to careful
examination, and may be quite distant from the area where pain is
actually felt.
I see many patients involved in car accidents with persistent neck pain
and headaches who have undergone expensive and unnecessary MRIs, EMGs,
physical therapy and chiropractic treatment aimed at the cervical spine,
when careful examination might have focused treatment at the real source
of their pain elsewhere.
In some instances the perpetuating problem results when the head is
whipped to the side, the scalene muscles yank on their insertion into
the first rib and pull it up out of alignment. This results in a super
sensitive spot where the first rib attaches to the T1 spine, and muscles
around it remain severely triggered, referring pain up the neck to the
head, down the medial scapula and down the arm. In this case, osteopath
mobilization followed by Prolotherapy to the ligament that joins rib to
spine and trigger point injections of the remaining triggered muscles,
will resolve the head, neck and shoulder girdle complaints.
For others, the problem occurs following an accident in which they
bounce back into the car seat at their mid thoracic spine. This can
depress one or two segments of the thoracic spine, reversing the normal
kyphotic curve. Here, the posture changes to compensate, straightening
out the cervical curve and shortening the paraspinal muscles.
Restriction and triggering at mid-thorax refer pain up to the skull and
neck. The pain is felt in the neck and head-not in the back! When asked
to flex their neck, patients typically cannot reach their chin to their
chest. Osteopathic mobilization, often facilitated by Neural therapy
block to the paraspinal musculature, will allow resolution.
In another common accident scenario , the person is jamming on the brake
with the right foot while the left foot is hanging loose and the seat is
tethering the pelvis. This may displace the right cuboid (a small bone
in the foot) or, worse, may cause a torsion that shifts the pelvis out
of alignment with respect to the two iliac bones, or to the sacrum that
sits between. The low back may be painful with either one of these
conditions, yet the foot, where the injury really occurred, rarely is.
Either one of these conditions can alter the patient's posture, gait and
stance, resulting in chronic head or neck pain. Osteopathic mobilization
and occasionally Prolotherapy is necessary to obtain correction and
relief.
Finally, there are pain patients where the structural problem is in the
neck. These patients typically are okay as long as they keep seeing the
chiropractor or
Physical Therapist every few days, but they can't
resolve the pain. x-rays may show some arthritis, spondylosis, and
degenerative disc changes, which frequently get the blame for the pain.
Here the structural problem involves the ligament and tendon attachments
to bone. There may be a strain or sprain (micro avulsion or rupture of
fibers as the insert into bone), with local tenderness on palpitation,
causing reactive muscle triggering, which generates much of the pain a
patient feels. In addition, recurring somatic dysfunction in the
cervical spine returns within hours or days after each chiropractic or
PT treatment.
The most effective treatment is prolotherapy, a way of repairing the
ligament and tendon injuries and shutting down the "C" pain fiber
irritation present. In prolotherapy, a hyperosmotic 12 percent dextrose
and lidocaine solution (which may be combines with a chemical irritant
as well) is injected in small amounts at the attachments of tendon and
ligament to bone. This induces the body's healing inflammatory response
to repair strained and frayed ligament, or merely tighten existing
ligaments, made lax by narrowing of disc or joint spaces through
degenerative processes. Through repeated injections, the treated
ligaments can have as much as 140 percent the strength of controls (in
animal studies). Prolotherapy can be used at the neck, low back, knee,
shoulder (see Prolotherapy to the shoulder videos), or any joint to
prevent progression of arthritis and eliminate pain.
© Lawrence Cohen, M.D.
The opinions expressed here does not necessarily reflect the views of
the other member physicians of getprolo.com. |
|
|
|
|
Ross
Hauser M.D.
Caring
Medical and Rehabilitation Services |
|
Ask Dr. Hauser
About Prolotherapy
Dr. Hauser is one of the leading
experts in the treatment of chronic pain and sports injuries with
Prolotherapy.
|
|
