27th July 2008 at 13:55 BST by Dr.C.A.Jenner MB BS, FRCA. Permalink.
Article on Prolotherapy
Ligaments make up an important part of the intricate spinal cord system. Found between each vertebral segment and between the spine and pelvis, the ligaments help to provide stability to the joints and prevent the joints from moving outside of their normal or safe range. The ligament system for the spine is very complex, allowing flexibility in some areas and restraint in others. However, these ligaments can become overstretched or torn due to an injury or because of age. This can cause the ligament to not work properly, which in turn can cause the area of the spine it controls to become instable, putting extra pressure on nearby discs or joints.
In this case, the body works to naturally heal itself through inflammation, which in turn stimulates new fibre growth, making the ligament strong again. First, the injured area becomes inflamed, which causes the immune system to increase its presence in the area, removing toxins and damaged tissue. This typically lasts a week and is usually accompanied by swelling and pain. The swelling will start to decrease when new blood vessels start to form, and finally cells that generate connective tissue called fibroblasts produce new collagen, which strengthen the injured ligament. The entire process can take upwards of two months before the ligament has regained its former strength.
Prolotherapy, which is sometimes called Proliferative Injection Therapy, works by encouraging and speeding along the natural healing process. By injecting a solution near the area where a weak ligament is found, inflammation is started and the natural healing process can begin. This in turn stimulates the body to create new fibres to make the weak ligaments stronger, which in turn can render the area more stable and reduce the amount of pain. While prolotherapy is not a new therapy, having been used since the end of the 19th century, it is gaining in acceptance by major medical institutions as a viable alternative to more invasive types of treatment.
Prolotherapy is generally carried out in an out-patient centre and most patients will be able to go home the same day. Because these injections must go deep into the back near the spine in order to be effective, a mild sedation may be offered, either through an IV or a combination of nitrous oxide and oxygen. Then a needle is inserted to the area near the affected ligament and a solution is injected to the site. The solution is made up of a drug that will cause inflammation as well as a local anaesthetic which will reduce the pain associated with the inflammation. Finally, the needle is removed and the injection site covered with a plaster. The whole procedure lasts under twenty minutes.
Patients will need someone to drive them home after the procedure, but they should be able to go on with their normal activities, although the area where the injection was made will be sore for a few days. This procedure usually needs to be repeated a minimum of four times, timed a week apart, and up to six times in order to be effective.
‘Prolotherapy’ was posted by Dr.C.A.Jenner MB BS, FRCA on 27th July 2008 at 13:55 BST and filed under treatment.
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