LOW BACK PAIN AND PROLOTHERAPY
Ross Hauser, M.D.
The first step in
determining
ligament laxity or instability in the lower back is by physical
examination. The examination involves maneuvering the patient into various
stretched positions. If weak ligaments exist, the stressor maneuver will cause
pain. Do this simple test at home: Lie
flat on your back and lift your legs together as straight and as high as you
can, then lower your legs. If it is more painful to lower your legs than to
raise them, laxity in tile lumbosacral ligaments is likely. During physical
examination by a physician, laxity can be "tested" by palpating
various ligaments with the thumb to elicit tenderness. A positive "jump
sign" indicates ligament laxity.
Low back pain is
one of the easiest conditions to treat with
Prolotherapy.
Ninety-five percent of low back pain is located in a 6-by-4 inch area, the
weakest link in the vertebral-pelvis complex. At the end of the spine, four
structures connect in a very small space which happens to be the 6-by-4 inch
area. The fifth lumbar vertebrae connects with the base of the sacrum This is
held together by the lumbosacral ligaments. The sacrum is connected on its
sides to the ilium and iliac crest. This is held together by the
sacroiliac ligaments. The lumbar vertebrae is held to the iliac crest and ilium by the
iliolumbar ligaments. This is typically the area treated with Prolotherapy for
chronic low back pain.
Sacroiliac Ligaments
The diagnosis of ligament laxity in the
lower back can be made relatively easily. Typical referral pain patterns are
elicited-the sacroiliac ligaments refer pain down the posterior thigh and the
lateral foot, the
sacrotuberous and sacrospinous ligaments refer pain to the
heel. The iliolumbar ligament refers pain into the groin or
vagina. Iliolumbar
ligament
sprain should be considered for any unexplained vaginal, testicular,
or
groin pain.
The most common cause of unresolved
chronic low back pain is injury to the sacroiliac ligaments which typically
occurs from bending over and twisting with the knees in a locked, extended
position. This maneuver stretches the sacroiliac ligaments, placing them in a
vulnerable position.
How effective is
Prolotherapy in relieving chronic low back pain? In one of his
original papers,
George S. Hackett, M.D., noted 82 percent of people treated
for posterior sacroiliac ligament relaxation considered themselves cured and
remained so 12 years later.
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