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PROLOTHERAPY AS AN ALTERNATIVE TO SURGERY
FOR RADICULOPATHY
A patient came to the office discouraged. He had
already had one
back surgery
and now because of lumbar
radiculopathy
the doctor wanted to another one. He heard about
Prolotherapy
and came in to
Caring
Medical
in Oak Park for a visit.
She was told she had a ‘pinched nerve’ and needed
surgery. We disagreed. She received Prolotherapy to her whole neck, upper
back and right shoulder. She felt about 15% better so she was seen in two
weeks because she still had a lot of pain. She needed a total of six visits
over the course of 4 months to get resolution of her symptoms.
How does Prolotherapy help radiculopathy?
Radiculopathy by definition means a nerve is being compromised leading to
symptoms in the extremity. We find that 90% of people coming in with the
diagnosis of radiculopathy don’t have a nerve getting pinched. The majority of
these people have
referred pain down the extremity (leg or arm) from a
ligament
injury in their pelvis, lower back, neck, or upper back. Three to six Prolotherapy sessions and the majority of these pains subside. For the other 10
percent that have a true radiculopathy the following is typically present:
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Crippling pain. The person is in obvious
awful pain
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The person is desperate. The pain is there 24
hours/day. The person is not
sleeping and needs help fast!
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The MRI shows an acute herniated disc.
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The MRI finding is consistent with the persons
symptoms and exams
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The EMG collaborates the MRI
In such an instance what we typically do at CMRS
is get the person some pain control while the Prolotherapy is working. The
person with a true radiculopathy needs to decrease the inflammation of the disc
material pressing on the nerve while the Prolotherapy is helping to stability
the herniated areas.
The best approach, in my opinion, is to give a
steroid injections right around where the
disc herniation is located. We do that in our offices in Oak Park. This is
called a nerve block. Sometimes an
epidural is done, but we like putting the
medication directly where the problem is located. The person is also prescribed
muscle relaxers and rarely oral
steroids. Yes the steroids block some of the Prolotherapy effect, but the person needs immediate pain relief. A medication
to help sleep is also warranted sometimes. Obviously, the person also gets Prolotherapy to the areas. The person is seen in follow-up in one week. At
this time if they still have a lot of pain, then another steroid injection is
given to the painful area. Up to three of these are done. At the two week
point, sometimes another Prolotherapy session is done. Up to four Prolotherapy
sessions are sometimes needed.
The above approach has been used at Caring Medical
for years. It has kept a lot of people out of surgery. In our
experience the above approach even with herniated discs is around 90%
successful. Of course, we have our handful of cases that have needed surgical
consultation and surgery. We are grateful the surgeons are there for back-up. But read that again they are their for back-up. Even for an
acute herniated
disc the surgeon is second line therapy, or the person with a pseudo- or true radiculopathy the treatment of choice is Prolotherapy!
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Prolotherapy
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