By Dr. Ayo K. Bankole

I find prolotherapy the most gratifying therapy I offer my patients for its dramatic and consistent results.  Case in point, a seventy seven year old female who had been experiencing twenty five years worth of dull low back and buttock pain the radiated down her posterior thigh came to see me.  She had extreme pain and limitation with walking and was almost unable to go up and down stairs.  For some relief she needed to stand and walk with her back partially hunched and knees bent.  Pain medications offered her no relief.  After just two prolotherapy sessions she gained remarkable ease in walking and had less pain.  After five sessions she is nearly pain free and continues to walk with more ease and vigor which continues to improve long after her last treatment.  This is just one example of patients chronic musculoskeletal pain succesfully treated with prolotherapy. 

Prolotherapy Gaining Ground

People suffering from chronic low back pain are recognizing prolotherapy as a powerful alternate to prolonged suffering, pain medications or surgery.  With back pain being the most common reason people visit a doctor, wider acceptance of prolotherapy has the potential to revolutionize pain management.  Conservative management of chronic low back pain is limited to muscle relaxants and non-steroid anti-inflammatory drugs like ibuprofen.   When these measures fail, surgery may be recommended, overlooking prolotherapy, a well documented and amazingly effective treatment for low back pain.  

Actions of Prolotherapy

In Prolotherapy, stretched or torn tendons and ligaments are treated with pro-inflammatory agents like dextrose and glucosamine along ligament insertion sites resulting in loss of pain and the return of normal function to the area treated.  The prolotherapy agents act as growth factors providing a stronger, thicker and tighter ligaments and joints.   Also known as regenerative injection therapy (RIT), prolotherapy was first performed in the 1930’s.  From its humble beginnings, prolotherapy is now practiced across the nation and worldwide by hundreds of alternative medicine minded physicians.

Sources of Low Back Pain

The most common cause of chronic low back pain is musculoskeletal.   Pain typically originates from the large ligaments that hold the lumbar vertebra, sacrum and pelvis together.  These ligaments are the lumbosacral, sacroiliac, and iliolumbar ligaments.  These areas represent the weak link in the low back.  With overuse, incorrect body mechanics during lifting, or acute injuries, these ligaments become stretched and even torn.  Loosened ligaments lack the stability needed for a strong healthy back.  They begin sending pain signals to the brain and perpetuate further degeneration of other structures such as the discs.   Ligaments and tendons alike have a limited ability to regenerate on their own.  

Ligaments Are More Likely Cause of Radiculopathy

Radiculopathy is a common symptom experienced as pain radiating down the buttock, thigh, to the groin or even the foot or toe.   Although disc herniation and subsequent nerve root irritation may cause this symptom it by far is not the only cause.   Many physicians falsely attribute all radiculopathy to disc problems.  In fact, ligament and tendon structures of the low back have similar referral pain patterns that mimic a herniated disc. 

In between each vertebra is a gelatinous disc which is stabilized by a surrounding ligament called the annulus fibrosus.  Weakened by degeneration or injury, this ligament allows disc material to herniate.  The preceding cause of a degenerated disc is loose lumbar ligaments that allow excessive movement of the vertebra placing extreme pressure on the disc.  By strengthening the iliolumbar ligaments, prolotherapy treats the cause of herniated disc.   Prolotherapy will tighten and strengthen these ligaments restoring proper alignment, preventing further degeneration.   Loose lumbar ligaments can also allow misalignment of a vertabra which can compress a nerve root resulting in radiculopathy.   Manipulation performed by a chiropractor or osteopath works well to realign the bones relieving the compression and can provide immediate relief.   However, weakened and loosened ligaments have a tendency to misalignment repeatedly.  Prolotherapy is the best way to strengthen the ligaments providing permanent alignment and prevention of further nerve root compression.

Prolotherapie's Beginnings

The earliest contemporary pioneer of the art was George S. Hackett, M.D. who developed much of its methodology in the 1950’s.  Dr. Hackett found in one of his earlier studies that prolotherapy for posterior sacroiliac ligament relaxation resulted in a cure of low back pain in 82 percent of people treated.   K. Dean Reeves, M.D., chief of Physical Medicine and Rehabilitation at BethanyMedicalCenter in Kansas City is a foremost proponent of prolotherapy and author of several contemporary studies on the subject.  He concludes that the inflammatory proliferent injections for chronic low back pain resulted in significant improvement in pain and decreased disability in two randomized, double-blind studies and that “direct exposure of fibroblast to growth factors causes new cell growth and collagen deposition.” 

Consider Prolotherapy for Back Pain

For individuals undergoing prolotherapy, the number of treatments is determined by the extent of degeneration and injury, and your response to therapy partially determined by your age and health at the time of treatment.   Prolotherapy can reverse loose ligaments and resolve back pain in a few as four to six treatments.   In older Individuals, those in poorer health or those who smoke require more treatments than those who are younger or healthier.  Treatments are typically spaced in four to six week intervals.  Back pain doesn’t need to be debilitating or chronic.   Prolotherapy holds the key for many chronic low back pain sufferers.  Before you accept a life long pain or surgery consider the healing and tissue regeneration properties of prolotherapy.

Dr. Ayo Bankole has received advanced training in prolotherapy and is a member of the Naturopathic Academy of Therapeutic Injection www.injectiontx.org, the American Association of Naturopathic Physicians www.naturopathic.org, and the AmericanCollege for the Advancement of Medicine www.acam.org.  He uses prolotherapy to treat pain conditions of the back, hips, knees, feet, shoulders, elbows, and hands.  To learn if prolotherapy is right for you call 951.801.2302 for a free consultation.  Additional reading can be found at www.getprolo.com and www.prolotherapy.org.