A Novel Concept in the Treatment of Chronic Pain
By Jon Becker, M.D.
Athletes at all competitive levels endure pain and injury at some point in their lives. Chronic tendon and ligament injuries are common. For those who don''t respond to more traditional remedies, there is a relatively new treatment called prolotherapy . Prolotherapy is generally used for chronic pain associated with ligament and tendon injuries. Webster''s New Collegiate Dictionary defines prolotherapy as "the rehabilitation of an incompetent structure such as a ligament or tendon by the induced proliferation of new cells." Treatments generally involve repeated injections into the affected structure with the goal of promoting a healing response. Slowly, this treatment has been gaining popularity with patients as well as acceptance within the sports medicine community. collamask price
Common overuse injuries to tendons and ligaments include tennis or golfer''s elbow, Achilles and patellar tendonitis, plantar fasciitis, as well as a host of other problems. Fortunately, these are generally self-limited conditions that can resolve with a little time, relative rest and maybe a bag of ice. With persistent symptoms, the usual treatments may include, but are not limited to anti-inflammatory medications, braces, physical therapy and steroid injections (cortisone shots). As these regimens become exhausted, these common problems can quickly become frustrating and painful. They develop into debilitating conditions that greatly affect the athlete''s performance and quality of life. Furthermore, the athlete and physician are quickly faced with a lack of options. macho man цена
Injections of some sort have been a long-standing mainstay of non-operative treatment for musculoskeletal problems. Generally, most of these chronic issues are referred as some type of "- itis ." This implies that the pathology behind a tendonitis or fasciitis is inflammation. Therefore, treatment has focused on methods to decrease inflammation such as anti-inflammatory medication and steroid injections (steroids, like cortisone, have a potent anti-inflammatory effect). Recent work has challenged this notion. Biopsy studies have revealed that as these "- itis " problems become more chronic, short-term inflammation is replaced by degenerative changes. These changes are noted even within two to three weeks after an injury is recognized. Therefore, words such as " tendinosis " and " tendinopathy " have become commonplace among sports medicine physicians. This reflects the notion that many of these afflictions are the result of chronic tendon damage rather than acute inflammation. hi white cream
PROMOTING HEALING varicobooster
In light of these findings, many have questioned the long-standing practice of treating inflammation when the problem is one of a more degenerative nature. Therefore, many have proposed that the focus of treatment should be to promote healing rather than stymie non-existent inflammation. This is why prolotherapy is gaining increased acceptance. Typically, the treatment involves a series of injections into the affected tendon or ligament with a mixture that is predominantly composed of a high-concentration dextrose solution. This is often combined with sterile water or saline solution as well as a short acting anesthetic. If this sounds like plain old sugar-water with a little novacaine, you are not terribly mistaken. The goal of the injection is to create trauma and yes, inflammation, at the site that has undergone degenerative changes. Theoretically, the local trauma will cause an inflammatory response that promotes the influx of growth factors. Subsequently, this leads to healing and a reduction of symptoms. psorifix
As far as the prolotherapy injection itself, there are no specific guidelines or standards regarding the process or the solution that is injected. It is generally accepted that some form of dextrose solution is used, but some practitioners of prolotherapy are using more caustic substances in order to promote a more vigorous response. However, there are many who feel that the solution itself is meaningless; rather, it is the act of the needle-induced trauma that yields the majority of the benefit. Injections are generally recommended weekly or bi-weekly for approximately four to six weeks. The injections can be a bit painful, but the local anesthetic can certainly alleviate a significant amount of the discomfort. The procedure itself may last a number of minutes depending on the patient''s tolerance since, again, the goal is to actually promote inflammation. epic mass xxl efekt
BENEFITS TO PROLOTHERAPY miralash nebenwirkungen
One of the major advantages with prolotherapy is the lack of side effects when compared to steroid injections. Unlike steroid injections, prolotherapy does not cause wear-and-tear damage. Thus it can be repeated at any desired interval as long there appears to be a benefit and the patient tolerates the procedure. Furthermore, when dealing with specific problems such as patellar and Achilles tendonitis, steroid injections may increase the damage to the tendon, theoretically increasing the risk of completely rupturing the tendon. Therefore, many practitioners hesitate to directly inject a tendon. This risk does not seem to apply to prolotherapy. titan gel bewertungen
Prolotherapy also seems to offer benefits when compared to additional treatment options beyond injections. When compared to anti-inflammatory medications, prolotherapy is only a local treatment to the affected tendon or ligament, so there are no associated systemic side effects. This allows the patient to avoid the cardiovascular and gastrointestinal side effects that are recognized with this class of medication. Additionally, when treatment discussions for advanced problems turn toward options such as cast immobilization or surgery, a less invasive option is enticing. Also, comparing costs, prolotherapy can serve as a more cost-efficient option than of medications, surgery and physical therapy. ibright whitening
Much of the skepticism with regards to prolotherapy is centered on the lack of evidence behind its benefits. This argument is difficult to dispute. Only a few controlled studies have examined its risks and benefits. Studies looking at prolotherapy treatment for osteoarthritis, back pain and ligament disorders have been few and yielded mixed results. This is not surprising considering the type of patient most likely to entertain the notion of prolotherapy - those suffering from more chronic symptoms who have likely already exhausted a number of different treatments. phantom 4 pro test
I have performed prolotherapy on about 20-25 patients. The results have been mixed. For the patients who have benefited, they have found significant relief for their chronic pain. In my practice, I have reserved prolotherapy for those who have exhausted a number of traditional treatments and have become frustrated with their ongoing symptoms. Any patient considering prolotherapy needs to understand the nature of the injections as well as the lack of current scientific evidence. Currently, large, controlled studies are underway that may yield answers in the future. At this point, prolotherapy cannot be considered a first line regimen for common overuse injuries and is only slowly gaining acceptance in mainstream medicine. However, for anyone with chronic pain from a ligament or tendon injury who has exhausted numerous medical options, prolotherpy offers a safe and non-invasive choice that is worth exploring. xtrasize استعراض
Jonathan Becker, M.D. is a sports medicine specialist with Orthopaedic Specialists in Louisville . He is board certified in family medicine and fellowship trained in primary care sports medicine. He attended the Chicago Medical School and subsequently trained at the Hennepin County Medical Center in Minneapolis . His team physician affiliations include the Louisville Fire, Ohio Valley Wrestling, IU Southeast, Spalding University , and local high schools. His office is located at 4003 Kresge Way #300 , andhe can be reached at 502-212-BONE.