A Better Method of
Pain Management
review by Richard I. Gracer, MD
Prolo Your Pain Away - Curing Chronic Pain with
Prolotherapy
by Ross A. Hauser, MD with Marion Hauser,
MS, RD, and Kurt Pottinger
Beulah Land Press, 715 Lake Street, Suite 600, Oak Park, Illinois 60304
USA
E-mail: drhauser@caringmedical.com
Prolotherapy is the injection of
substances at the site where ligaments and tendons attach to the bone,
thus stimulating the ligaments and tendons to proliferate or grow at
the injection site. This area is called the fibro-osseous junction.
The most common substance injected is 12.5% dextrose and lidocaine.
Other solutions mix in phenol and a nerve-calming agent called Sarapin
(made from the pitcher plant) with them.
These injections cause a low grade
inflammation, which starts the body's own healing mechanism. What results
is a "proliferation" of stronger, shorter, and less painful
ligaments and/or tendons.
Ligamentous laxity and micro-strains
cause a very large proportion of musculoskeletal pain. The ligaments
hold joints together. The fibro-osseous junction, where they attach,
is the site of maximum strain. This area also is very richly innervated
with both proprioceptive and pain fibers. Over the years wear and tear
can cause a gradual decrease in resilience and increased ligament length,
resulting in joint laxity. These small tears also can become painful
themselves. What develops are loose, arthritic, and often painful joints.
Acute trauma can also cause ligamentous injury, resulting in pain, laxity,
and development of degenerative joint changes.
Repetitive motion and/or injury can
cause an asymmetry of the sacroiliac joints, which can "get stuck"
in the wrong alignment (subluxation) causing ligamentous strain and
pain. Until this misalignment is corrected, the pain may persist, and
until the ligaments are tightened the laxity that results can cause
ongoing pain, and recurrent subluxation, a vicious cycle. This ligament
pain is probably the most common cause of chronic low back pain.
Ligaments, tendons, and joints can
refer pain in a manner similar to a pinched nerve in a pattern termed
"sclerotomal" reference. For example, most sciatica is actually
caused by ligamentous laxity and strain of the sacroiliac ligaments,
and not by a disc protrusion impinging on a spinal nerve; an extremely
common cause of arm pain is shoulder injury.
By systematically evaluating a patient's
pain pattern by careful history and physical examination, a physician
trained in prolotherapy can easily arrive at the correct anatomic diagnosis.
Diagnosis is quickly confirmed by injection of local anesthetic. Injection
of the appropriate proliferative solution results in significant improvement
and often cure in from 75-80% of cases.
There have been two double-blind
controlled studies, and a myriad of case reports and open studies, which
support the use of prolotherapy. I have used this modality since 1979
with excellent results.
Ross A. Hauser, MD is a physiatrist,
which is a physician trained in physical medicine and rehabilitation.
In addition, he along with his nutritionist wife, Marion, has had a
long-term interest in what he terms Natural Medicine. He is experienced
in acupuncture, herbal medicine, and multiple other alternative treatment
modalities. Ross was first introduced to prolotherapy in April 1992
when he contacted Gustav A. Hemwall, MD after Dr. Hemwall successfully
treated one of his patients, who Ross had failed to cure, using everything
he knew.
Dr. Hemwall was 84 years old at the
time, and is perhaps the most experienced prolotherapist in the world.
Patients came from all over the world to have him treat their chronic
musculoskeletal pains. Ross spent many hours with Dr. Hemwall, observing
and then learning his techniques. Within three months Ross was utilizing
prolotherapy in his medical practice. His results, which are similar
to those of us who have used prolotherapy for many years, have been
gratifying and, at times, amazing.
Ross then did something that most
of us have never done. He sat down to write about his experiences and
to share information about this valuable treatment modality in a way
that is understandable to both patients and to physicians who are interested
in learning about prolotherapy. He systematically goes through the human
skeletal system, describing where prolotherapy is most likely to help.
He discusses the mechanisms and theoretical basis of prolotherapy. Easy
to see diagrams show the major sclerotomal pain patterns. Ross stresses
the importance of nutritional medicine and suggests a specific regimen
to enhance ligamentous healing. He outlines a very effective method
of ongoing treatment and an approach to musculoskeletal problems which
debunks many of the traditionally accepted, but misguided ideas that
have actually caused many cases of chronic ligamentous laxity and pain
in our patients. There is also an interesting array of original documents
that Ross reproduced from Dr. Hemwall's library during his research.
There are at least three physician
groups, which practice and teach prolotherapy. The George S. Hackett
Foundation includes Dr. Hemwall and his disciples; the American College
of Osteopathic Pain Management and Sclerotherapy (same as prolotherapy)
is a large and influential group of osteopathic physicians; and the
American Association of Orthopedic Medicine, which is, in my opinion,
the premiere medical organization in North America for the education
of physicians and allied medical professionals in musculoskeletal medicine,
including manipulation, nutritional approaches, and prolotherapy.
Prolo Your Pain Away is not
a book aimed at the practicing, experienced prolotherapist. It is excellent,
however, for physicians who practice prolotherapy to give to their patients,
for promotion of a prolotherapy practice in general, and for health
practitioners who would like to learn more about prolotherapy, but do
not need to know the exact technical procedures. Appropriate advanced
textbooks have been written and are listed in the back of Dr. Hauser's
book.
Ross A. Hauser, MD is a very funny
man. In his book he shares much of his personal life and philosophy,
never sparing his own fallibility and humanity. This does not stop him
from being a serious physician, however. For those of us who practice
prolotherapy, his new book, Prolo Your Pain Away, is a welcome
addition.