A prolotherapy session

Prolotherapy has not been proven to help ligaments, it is little known, it is little accepted by the medical community. Ask your common physical therapist, and he/she I guarantee has never even heard of it, which is scary. That gets me on to a whole other issue on how little pt’s understand specifics and complex issues of the spine, but i’ll save that for another post. This post is about what a session of prolotherapy is like, from the patient’s perspective.

If you’re reading this, perhaps you are thinking of getting prolo. If so, you’re probably pretty nervous. If you don’t like needles, you’re really nervous. Don’t be. The benefits are worth the 10 minutes of discomfort!

So this is how it will go, or how it went for me:

You arrive at your dr. If you’re extremely nervous, you may be given a muscle relaxer of some sort, I personally have never taken one. You’re in the room, laying on your stomach. If he/she hasn’t already found your trigger points (exact locations on your ligaments that upon pressure, trigger pain), then the dr will proceed to locate these. This is done simply by pressing on a ligament, and if it feels tender (you’ll know it), then it will be marked with a pen.

The dr. will then basically draw on and around your hips and sacrum area for reasons of mapping where your specific spinal layout is. He now identifies all of your sacral ligaments identifying and marking which will receive an injection.

Once this is done, you will be given multiple injections of lidocaine or some numbing agent. These feel like tiny little pin pricks and don’t hurt at all, the needles used for this are extremely small.

After a few minutes of waiting for that to take affect, you’re ready to begin the prolo injections. By this time, your entire sacral area is numb. The dr. will begin inserting the needle at the various prescribed locations. Once the needle is in the skin, multiple injections will be given internally within the one injection site. In other words, the needle breaks the skin once, and then is angled multiple times for various injections. I have had about 6 or so separate prolo sessions and have never felt pain during this. What you will feel is the needle tapping up against the bones of the hip and sacrum. This is normal and doesn’t not hurt, it is just quite odd. Bend your index finger and tap your knuckle against a table very lightly, it’s just like that.

You’ll probably receive multiple injection sites depending on your condition. I usually had about 6 or so different injections at a time, each counting for multiple internal injections as described previously.

That’s it. You’re done. You will lay there for 10min relaxing and probably get some vicoden for the next few days.

You will be able to immediately get up and walk after that. You may even be pain free!! Which is probably just the lidocaine, but is confirmation of the ligamentous nature of your problem.

The next few days the area will feel tight and swolen, and hopefully over the next 2 weeks the prolo will do its thing. You may be given 4-6 treatments 2-4 weeks apart and then reevaluated.

This my friends, is the only thing that helped my. An aggressive stretching routing of the psoas and hamstrings also, but prolo was the key.

Now again, this was my experience with my doctor.  A very well respected doctor, whom i’ve never seen but see his name often, is a Dr.  Hauser.  Here is a video of one of his prolo sessions.  This is nothing what mine was like!! That needle is huge, he moves very quickly with a stabbing motion.. yikes!  My dr. moved very slowly and gently, nothing like this.  However, i’m not a doctor and can not critique professionally so who am I to say… but wow that looks dangerous.

Oh and also, I use this Viniyoga Therapy video in conjunction with prolo and as needed (at least once a week perpetually).

My first Osteopath and finally, a diagnosis

So within a few visits of this new dr., I was diagnosed as a clear cut case of SI-Joint dysfunction.  Exactly the conclusion I had come to on my own, simply out of desparation and frustration and massive research.  Google SI-Joint Dysfunction and read about the symptoms.  They are pretty easy to diagnose, the problem is this is an often little known condition so trying to find a KNOWLEDGABLE doctor is the problem.

The treatment for this is difficult.  I started doing specific PT for it but once a ligament is strained it is hard to heal itself.  If you think about it, the sacrum is held in place by massive ligaments.  If you strain one of these, such as I had did, then your sacrum may be hypermobile (move too much).  The consequence is your pelvis cannot support your spine, body, etc.  This causes all of the muscles in the surrounding hip and thigh to take over the work.  This is what referral pain is.  That in a nutshell was my condition.  Can’t put any weight on one side, walking crooked, pain radiating from lower back and down the thigh.

So PT wasn’t working..what now.  The dr suggested Prolotherapy.  This is little known and highly controversial but is the only treatment that HEALS a strained ligament.  You see, when a ligament is strained it is much like a garbage bag.  Pull a bag and it does not reflex back into shape like a rubberband, it stays stretched.  Add to that, ligaments have very low blood supply, hence very little ability to heal themselves.  Prolotherapy is simply injecting an irritant (usually dextrose and various oils) to irritate the ligament, and kick in the natural healing process.  Read more about this at http://www.prolotherapy.com as i’m not going to repeat everything here.

I had roughly 5 treatments over the period of 2mos and when I tell you I was virtually pain free for the moment, I was virtually PAIN-FREE!   Now, it is not nearly that simple… go get prolo and you’re healed.  Everyone is different.  I had a lot of other factors to take care of and it has been a long road of learning what my specific case has required.

I will continue to discuss so much more… such as various relapses, pain, all of the complex muscles involved and how they seriously impact your pelvic stability.  To this day I am still figuring this all out but I have come so far. 

In a nutshell, I need to keep my psoas & hamstrings very flexible so they don’t pull on my hips.  But there is so much more to talk about..as in how to get through an intense episode of misalignment and back pain, the products that can help you do so, and stretching routines to help survive it. 

This blog has only just begun.   I’ll discuss the mental and physical on how to beat this pain if this is what you’re suffering from.  There is hope!

Stay tuned… my next post will be about a prolo injection session.

Seeking Treatment

So back to where I left off… trying to find treatment now for my chronic pain.  At the time, knowing nothing about the spine and what could’ve been going on back there, all I knew was that I had pain in my right lower back, across the glute and down the thigh.

I couldn’t walk without extreme pain, and it was all that was on my mind.  I was working in Manhattan and all the walking on a daily basis was killing me.  It was affecting my job as all I thought about was the pain.

So not knowing any better, I found what looked to be a large chiropractic facility in midtown.  My first appointment gave me a lot of hope, as the dr seemed to fully understand exactly what I was explaining.  He told me we need to get things back into alignment and then let the body heal itself.  This would be done with 3 visits a week of back manipulations.

Seeing this “doctor”, and I put that in quotes because in my opinion, chiropractors mislead people into thinking they are finding a medical answer to their problems but in reality they all revolve around one thing… cracking your back.  Now some may have PT facilities attached and be very knowledgable about rehabilitation, but understand this – this chiro, not really understanding what was wrong yet, simply laid me on a table and began twisting and contorting me in to all sorts of different positions and cracking my back.  Exactly what is that doing?  Putting the spine in place?  Why are the same 4 or 5 back maneuvers performed on everyone regardless of their issues?  These are the answer to everything?  I don’t buy any of it.

Well, a back crack feels ok, the same way you crack your knuckles, it’s kind of fun.  Now you can do that everyday to the same knuckle, what does that do?  So after roughly 3mos of seeing this chiro, involving a painful midday walk to his office 3 times a week, I was no better off.  In fact, some times leaving his office I was worse off.  I believe he did further damage to my spine with all of this twisting and force just to get a crack or 2. 

So I had MRI’s and X-Rays, they were all negative.  I was getting desparate.  I decided to find another chiro.  This one came highly recommended and this is in Manhattan mind you, where some of the top dr’s in the country are located.  This man took one look at my MRI’s, for about 3 seconds, had nothing to say…laid me on a table and manipulated my back so forcefully I saw stars.  I did not return to him, in fact to this day he still has my MRI’s.

We’re about 4-5mos in now of excruciating back pain.  Mind you i’m roughly 26/27 at the time and the picture of health.  Muscular, no body fat, ripped abs… and I could barely walk.

Next I found a physical therapist, a very nice looking woman in midtown who had me to some exercises in front of her and proclaimed “you’re as strong as a horse”, and gave me some exerices to do.  I did them for a few weeks religiously with no improvement. 

By this time I was scouring the web for answers on a daily basis.  Thank god for the internet at that time..without it, I would never have been able to cover so much information so fast.  I was able to arrive at my own conclusion that I suffered from either piriformis syndrome or SI joint dysfunction.

I sought out a dr who specialized in the latter and found most of them were Osteopaths (skilled in treating the body as a whole) and/or sports medicine doctors.  Turns out, one was a few blocks away from where I worked.  I scheduled an appointment with them. 

In my next post, i’ll describe my first diagnosis of SI-Joint dysfunction, prolotherapy,  and ultimate back saving progress into my condition.

I’d also like to add, I am in no way endorsing or advertising any product or practice over another.  If chiro’s work for you great, if you are a chiro, good luck to you and your practice.  I am again simply describing my experience and I am not a doctor of any sort.

 

Pause for thought… backs are complicated!

Before I proceed, I want anyone reading this to take into account all of the other factors involved in back issues.  I am not a doctor nor am I giving advice on what to do on your situation!!

There are many other factors involved with the spine, and involved in my personal situation.  Such as sit at work 10hrs a day, I have tight hamstrings and/or Psoas muscles, I may have done any other number of things to my spine.

For instance, look at what a tight Psoas (the muscle running from the vertebrae to the top of the femur) would do to your spine…ouch!

In other words, i’m not saying the ligaments of the SI Joint were 100% of my problem… I also believe my Psoas muscle is overly tight from sitting all day, which pulls on the spine and may have attributed to my pelvic tilt and stress on the ligaments.

That’s just one example… so in your quest to solve your pain, take this into consideration.

Some suggested reading:
http://www.floota.com/desk_jockey.html
Anterior Pelvic Tilt

My pain is self chosen…

So the damage was done, and next came the pain.  It was gradual as I can’t remember waking up one day and having a sudden onslaught.  It got worse and worse over a period of time.

The pain started on the right side of my sacrum, radiated across the buttocks and as it got worse, down my right thigh.

It hurt to stand, it hurt to sit.  It hurt to go from sitting to standing.  It hurt to walk.  I also walked crooked, like I had scoliosis of some sort.  This was because the sacrum was not supporting the spine, so just like a sprained ankle, you limp.  Only this was a lean.

As it got worse, the muscles were over compensating around the area because of this structural failure.  They began to tighten up and hurt, aka spasm.  So now my pain spread, over the glute and down the thigh to the dr’s office we go.

By the time I went to see someone (early 1999), I had been in pain for about a month.

By this time, it hurt to:   sit, stand, walk, rollover in bed, put my socks, shoes, and pants on, put any weight whatsoever on my right leg.  My quality of life was detiorating quickly.  People would comment on how slowly I was walking.  I was in visible pain and I was getting concerned.

All I knew at the time was if you had back pain, you went to the chiropractor.  Off I went…

In my next post, i’ll begin to discuss my 6-8mos of visiting multiple chiro’s, misdiagnosis, increased pain and no progress.

My Injury

So what happened to me… well some back pain can be attributed to an isolated incident such as a car accident.  Mine was more of a series of events I believe.

In the 1997-1998 time period, I was in my mid-20’s, good health, very athletic and working out 5 days a week.  Thats where it starts…  I had began doing a lot of heavy squatting in the gym, twice my bodyweight for 20 reps, plus deadlifts, etc.  During some of those workouts, I had felt some very acute, knife like pains in the sacrum area, particularly the sacroiliac and sacrotuberous ligaments.  Of course, I had no idea what those were at the time.

These pains only happened a couple of times and then towards the end of ‘98 I had moved to Manhattan and the intensity of the workouts went way down due to work schedules but was still 5days a week.  I think these workouts were the start of the damage.  I had no persistent pain at this point.

Sometime after the move to Manhattan, I joined a softball team and I was organzing it as well.  One of the thankless tasks involved in doing this was being responsible for the bases.  Yes, in NYC you have to bring your own bases to the field.  Man I don’t miss living there at all.

Anyway, since at that time I was walking to work, days I had a softball game I had to lug the bases along.  These were in a duffel bag and along with some balls and other equipment, I would guess that duffel weighed about 40-55lbs.  Home plate alone was probably 10lbs alone. 

What I suspect was happening, as I walked numerous city blocks, with a heavy duffel bag over ONE shoulder, this added intense pressure to one side of my hip as I walked.  This would compound and jam into the sacrum, further stressing ligaments that I believe I initially injured during squatting.

This hypothesis can not be confirmed and that is somewhat frustrating but it’s my best thought on what happened.

I was now on my way to 2 years of intense back pain, with major flare ups in 2003 and 2009, and numerous minor pains along the way.  I’ll discuss the actual pain, location, and affects on my daily life in the next post.

Introduction – Does your lower back hurt but no one can tell you why?

Hello, i’m starting this blog because i’ve gone through enough pain with my back, searched enough dead-ends, gotten no answers from dr’s, pt’s, chiros, and I wanted to share what i’ve found.

If you have pain, sometimes extreme pain, in your lower back, generally around what is called your sacrum, the pyramid shaped bone at the base of your spine, keep reading. 

Does the pain tend to be more on one side of the sacrum than the other?  Does it hurt to sit, stand, roll-over in bed, put your socks on… do you hear a clicking sound in the area? Do you feel like you can’t walk?  Favor one side?  Does the pain radiate across the glutes?  Down your thigh? 

Been to the chiropractor with no results or actually an increase in pain?  Nothing wrong on your x-rays, mri’s?  Physical therapy does nothing for you?  Do dr’s suggest a cortisone shot, nerve desentization, ibuprofen?  Are you beyond frustrated and considering back surgery  may be in your future?

I answered yes to all of the above back in 1998, and had bouts of off and on since.  That plus what i’ve learned in the past 11+ years is  what this blog is about.

You’ll be happy to know that i’ve spent 99% of the time pain free after my first severe episode of pain back then.  This was not without extensive suffering for 2years in the beginning, a ton of research, and finding the right doctors and procedures that work and more importantly DON’T work!  I’ll be talking about what has worked for me, exercises, products, controversial procedures, and what led me to ultimately understand what was going on with my back.

Since 98/99, i’ve had a couple of bad episodes but they were temporary.  My most recent pain episode was early Oct 2009, thats what prompted this blog.  These episodes, although temporary, are nonetheless worrisome because you don’t know if it’s going to heal up.  This blog is all about what are the right things to do and how to identify if you suffer from SI-Joint dysfunction.

I suggest you read this now:  http://www.backpainstreated.org/175