SI/low back with prolotherapy

I had a very similar diagnosis to you for SI/lumbar instability and the L4/L5 area was also an issue - pain through hips as well from the back injury. I had been able to keep running good distances but with constant pain and almost all exercises were painful.
My eventual successful treatment involved going right back to basics on the exercise front (swimming and LOTS of core stability focussed on transverse abdominus- the exercises were basic rehab stuff, no weights, nothing that aggravated it - dull but necessary it seems...).
Medical treatment had initially been cortisone shots but then a much more experienced doc took over who is a pioneer of prolotherapy in the UK. The treatment was EXCRUCIATING, particularly on the 2nd and 3rd rounds - i would highly suggest some sedation, and obviously you need to take no anti-inflammatory pain relief for months... the results for me were dramatic - good stabilisation after 2 months, and added to the core exercises resolved most of the pain. Some residual pain was left in my hip (ITB and periformus v tight still) and so accupuncture (western style - trigger point needling) took out the tension and killed the pain... i get accupuncture (either chinese or trigger point) around every 3 months now - keeps the pain away totally and keeps my "tight" muscles from tightening up again - doesnt work for everyone but certainly did for me.

Hello- this is long answer but I hope you will find it worth reading and helpful !

In response to anyone asking about experience with prolotherapy.

yes I have ! I am a ski instructor. I am now 44 but had the first treatment almost 2 years ago

The treatments were not painful - just a sensation of the needle going in - this depends entirely on the therapist and even then..there is a risk of hitting a nerve but that is ot too much to worry about - a qucik stab then you feel ok..the local anaesthetic and gas works a treat.

The treatment has been utterly successful and I would like to share my story - because there are some CAVEATs....read on.

I had a chronic lower back problem(which was basically slack SI ligaments and lumbar ligaments on lower right side...very common indeed) which I had been having treatment from 2 osteopaths for which would not heal - osteopaths who had cured me of all other aches and pains very quickly over the preceding 5 years - I was very confident in these guys so when they couldn't fix me I looked further.

I had xrays and MRIS done so I could see if there were any other reasons for my pain other than lax ligaments - the xrays and mris looked perfect - the traumatologists, osteopaths etc all looked at them and said the same - you look perfect...PERFECT...it's just a bit of hypermobility..it will go away...well after 28 months of NOT going away I was not going to just accept their answers...not just because they had letters after their names and nice white coats...oh no...not me....

I found prolotherapy on the internet and spent 1 year reseearching it every day - I asekd many osteopaths, orthopaedic surgeons - ones who were personal friends AND by going to see specialists at clinics in the UK and Spain and France....nobody that I spoke to had even heard of it !

Well...I can tell you that I wish I had not spent 1 year researching it because I wasted a year of my life by having to tolerate the pain - the prolotherapy was effective very quickly - I wish I had just gone to the doctor I found the first day I read about it !!! BUT...I was lucky....the doctor I saw does nothing but prolotherapy and had had the treatment himself 40 years earlier and as a result studied it and has been a leading practicioner for 35 years - I was lucky to find someone with this experience first time.

I have since learned - through more research and discussions with my doctor - that it is very clear that the success of prolotherapy depends on 3 IMPORTANT THINGS..

1) The skill and experience of the therapist - the therapist needs to be VERY skilled, sensitive and accurate

2) The actual solution the therapist uses - they are NOT all the same - each therapist has his preference - therfore one with more experience can judge what wrosk better.....for example...the solutions used in the US are often NOT as effective as the solution my doctor uses because many doctors are unwilling to use enough of the one of the irritant substances - which also happens to be an antisceptic - because it has in a very small numbers of cases caused temporary but painful side effects - this is apparently very very rare and often due to the inaccuracy of the therapist - as I am informed. The effectiveness of the treatment is clearly
governevd by how much irritant solution is used in each treatment - the more used the quicker and more pronounced the healing BUT there is a limit to how much the body will tolerate - do not forget the healing process is an immune response - prolotherapy provokes an immune response..or it should do if given correctly !

3) ACCURATE diagnosis....I knew what my problem was because I had felt it grow over the years and remember the final injury that provoked this particular injury - I had had lots of treatment with osteos, physios, etc during 15 years of sport - I could feel what the problem was - after a few little injuries you can recognise what type of problem you have.
BUT...to confirm I had the luxury of private health and so i just kept going to see different people - inclusing the main professional winter sports clinic in Barcelona - until I was satisfied I had the info. I went to see the prolotherapist in London with all my mris etc...he just laugheed and said.."I have seen your problem every day of the week for the last 35 years - almost everyone has this problem - I dont need these mris but thanks I will look at them for you...oh yes..as i suspected...you cannot see any problem...well you won't ! The SI ligaments will not show any damage on an MRI..the slightest stretching or damage to these can be very painful but you can't see it. Do you want me to treat you now or do want to mess around for another year ?"

He examined me and clearly demonstrated to me that one side of my pelvis was far more mobile than the other...my previous osteopaths had both diagnosed the same thing - and explained which ligamenst would be treated.... I started there and then...I had far fewer treatments than recommended - I was in the gym within 48 hours...skiing within 2 weeks...I am a ski instructor....I have to travel from Spain to the UK for treatment.

I had 3 treatments between nov 2005 and feb 2006....the problem was 95% resolved by the 3rd treatment...but i should have had a treatment every 3 weeks for about 6 months I reckon..it would have solved it totally and much quicker..i have since had 5 more sessions between may and oct 2006...the function of the joint was stabilised within 4 weeks of first session..my osteopath in Spain was astonished at the change and increase in stability of the right side....bearing in mind he had treated me for 5 years before and regularly had to realign my pelvis...since prolo he has never had to do that. The mobility/movement in the joints is now almost equal on both sides. That has been confirmed by the 2 osteopaths who are not connected to my prolotherapist - both of whom had seen me with the problem.

The pain had gone almost completely by the 3rd treatment..it had reduced to about 20% of original pain after the first treatment.

If I had to sum it up...I would say I am now 100% functional and pain free for 90% of the time..before I was in pain 90% of the time.

the other 10% I feel a slight sensation of stiffness - not PAIN - and this continues to reduce and occur less often..even without treatment...however..i stress...I would prefer to have had more treatments close together to be sure of eliminating the problem and strengthening the ligaments as much as possible..I will have another 3 or 4 treatments very close together when i can afford it just so I don;'t have to think about it for another 30 years !!

Is that enough of a postitve vote for prolotherapy when administered correctly and appropriately ????

Good luck...back pain is horrible..and in most cases TOTALLY curable...DO NOT accept back pain advice from doctors who have NOT suffered it themselves !!!! And do not accept it as part of growing old and something you have to live with. Ask your proltherapist lots of questions..how long have they been doing it, what solution they use etc....they are not all the same - but when you find the right one - you will be very happy !

Hi krunchie,

I've been suffering low back pain associated with sciatica like symptoms for three years.

I have tried every thing including prolotherapy.

I need an extraordinary prolotherpist in London or in Europe because I still beleive that prolotherapy can help me .... please recommend someone to me ?

Thanks

In the part of London described I can see only one prolotherapy practitioner listed on the BIMM website- Dr B.Pattinson. I do not know if he is the practitioner in question but I see no reason why a recommendation cannot be given openly.

hi there, i too have suffered chronic back pain (from the top of my neck to the si/hip/pelvis area) for 3.5 years. A year ago my osteopath recommended prolotherapy. I had read about it on the internet about 6 months prior to seeing the osteopath, but the chiropractor and massage therapist i had been seeing talked me out of it. I wish I had started it right away. At the time, I was having pain only in the mid-thoracic/shoulder blade area with both ribs and vertabrae. After the 3rd session, that area stabilized, but then the instability in the lumbar/SI area became apparent. Between that area,a minor scoliosis, and a tonsillectomy that left me with tmj dysfunction, I am still undergoing treatment. I have experienced about 10 treatments now (spaced out in 6 week incremements) and I am far from cured, but the difference is definitely noticeable. In fact, my jaw joint responded after the first treatment (probably because it was only a few months after the injury). I should note that I'm in the US and my insurance company will not pay for the preferred prolo solutions. The solution my doctor has been using is a saline/serapin mix, which may explain why the process with my back has taken a bit longer. Anyway, I would recommend this treatment to anyone! It is safe, noninvasive and you can go on with your life immediately following the injections. No time off of work, no bed rest, etc. I just wish my insurance company would see the benefit of the injections and pony up for the stronger solution!

Never heard about it. Guess I'll try it after I come back from my trip with the European Cruises.

I think I have heard about this some weeks ago when I was on a trip with the Cunard Cruise Lines. I don't really understood what was it about, but now I think things are pretty clear. Anyway, can you give us some more details on this subject? I would love to hear more. Thank you very much in advance.