PROLOTHERAPY AFTER BACK SURGERY
Ross Hauser, M.D.

Many people only become aware of Prolotherapy after they have undergone a surgical procedure for back pain. Although the pain may not be as severe as it was before the surgery, most people continue to experience significant back pain after surgery. Why? Because the back surgery involved removing supporting structures, such as a lamina, facet, or disc, thus weakening surrounding segments.

Prolotherapy injections to the weakened segments in the lumbar vertebrae often result in definitive pain relief in post-surgery pain syndromes. Back pain is commonly due to several factors and surgery may have eliminated only one. It is possible, for example, to have back pain from a lumbar herniated disc and a sacroiliac joint problem. Surgery may address the herniated disc problem but not the sacroiliac problem. In this example, Prolotherapy injections to the sacroiliac joint would cure the chronic pain problem.

Unfortunately, it is common for a person to have lumbar spine surgery for a  sciatica complaint diagnosed from an abnormality” on an MRI scan. The  sciatica” complaint was a simple ligament problem in the sacroiliac joint and the MRI scan finding was not clinically relevant—it had nothing to do with the pain problem. For the majority of people who experience pain radiating down the leg, even in cases where numbness is present, the cause of the problem is not a pinched nerve but sacroiliac ligament weakness.

Ligament laxity in the sacroiliac joint is the number one reason for "sciatica,” or pain radiating down the side of the leg, and is one of the most common reasons for chronic low back pain. This can easily be confirmed by stretching these ligaments and producing a positive  "jump sign.” Ligament weakness can cause leg numbness. Most people sense pain when they have ligament weakness, but some people experience a sensation of numbness. Doctors typically believe nerve injury is the only reason for numbness, a reason so many people believe they have a sciatic nerve problem. In reality, it is a sacroiliac ligament problem. The referral patterns of the sciatic nerve and the sacroiliac ligaments are similar. In this scenario, it is unfortunate that thousands of dollars were spent on surgery and post-operative care. Had Prolotherapy treatments been performed on the pain-producing structure, this could have been avoided.