Prolotherapy and Pseudogout
Robert Filice, M.D. Former staff physician

Generally Prolotherapy is performed on patients suffering pain from chronic degenerative arthritis or injury to tendons or ligaments. Since Prolo works by restarting inflammatory and reparative processes in the treated areas, one might rightly ask how Prolo could be helpful for conditions that are basically inflammatory in nature such as Rheumatoid Arthritis, gout, and pseudogout.

One answer  is that the inflammatory process damages joint structures, and when applied in the non-inflammatory stage of these diseases can be quite helpful. The other answer is based directly on our experience in the clinic. Although it is supposedly an inflammatory joint condition, pseudogout rarely present with inflamed joints that are red, hot, and swollen. Instead, what we see is presentation with knee, wrist, or ankle pain in a joint that is NOT red and hot. Orthodox physicians treat pseudogout with typical anti-inflammatory regimens: drugs, sometimes steroids, and removal of fluid from inside swollen affected joints. The cause has been determined to be accumulation of crystals of calcium pyrophosphate in the joint and joint structures. It is the separate and distinct uric acid derivative sodium urate that crystallizes in the joints of patients with true gout and causes the extremely painful and inflamed joints (especially the big toe) characteristic of that disease. Gout and pseudogout can be diagnosed and differentiated from each other by microscopic examination of the crystals present within aspirated joint fluid specimens. Pseudogout when left untreated will eventually cause degenerative changes in the affected joint similar to those we see in most patients for whom Prolotherapy is the best indicated treatment.

Clinical practice and experience is a crucial foundation for the excellent practice of medicine, and provides a necessary counterbalance check on the researchers. If you only read books, and only believed the ivory tower academic “authorities” you’d come away with the idea that pseudogout is inflammatory, and that the last thing you want to do is to re-inflame it by taking Prolotherapy. On the contrary, we have seen consistently outstanding results in pseudogout patients whether they were being treated between or during the characteristic relapses. Usually we see patients present with knee pain, and that pain resolves completely with 3 or 4 Prolotherapy sessions. Here is a recent case history.
 

J came into Caring Medical with the diagnosis of Pseudogout.  He was on Indocin for it.  On physical exam he had crepitation (crunching sounds) in his knees with movement but the knee was not red or inflamed.  He had significant medial joint line tenderness.  He was told he was a good Prolotherapy candidate but he needed to stop the Indocin and take Tylenol instead.  He received Prolotherapy on the first visit, and on his second visit he said: "I was amazed how much better my knee felt right away."   He was 30% improved after one Prolotherapy treatment. He went on to have 3 more visits and total resolution of his pain.  On the last visit I noticed that  his knee crepitation was less."

You owe it to yourself to receive an evaluation for treatment by a Prolotherapy doctor if you have known pseudogout, or experience undiagnosed intermittent attacks of severe pain in the knee, ankles, or wrists. Since this disease may have some important metabolic correlations, most cases of pseudogout will also do well to have a comprehensive natural medicine evaluation for disorders that may disturb calcium metabolism.