Hi, I was wondering if anyone here has tried Prolotherapy for their cervical area or any other place. Prolotherapy involves injecting a dextrose solution and basically inflaming the ligament/tendons, causing more collagen to be laid down and hence stabilizing the ligament or making it tighter.

My concern is if its done close to the neck, the safety aspect.

I believe prolo is the solution (if its safe) to my cervical instability. Based on my reading, I believe I have cervical instability. I fell on my face several years back at speed and injured my neck badly. It was rotated which means that the chances of damaging the ligaments are much higher than normal.
There are ligaments which hold the neck to the spine and ones which hold the neck together. I believe I injured the ones at both levels.

I have my neck sway from one side to the other when i raise it up and down (flexion and extension), indicating segment to segment damaged muscles or ligaments, especially at the top of my neck and down at the bottom.

This damage especially to my left side, I believe, caused a wry neck. The SCM on my left side got super tight & the brain recruited my scalenes and other muscles on the front and back on the right side to ensure it all evened out. This was because it quickly figured out post the accident there was a severe loss of stability. Of course, a Drs attempt to "help me" with 20lb traction probably didn't help my ligamental stability much.

In turn those hypertonic muscles caught up my blood vessels (subclavian vein) and other nice nerves to cause TOS and shoulder instability and pain on both sides, with Right greater than Left.

So at the end of the day, to fix this, I need to fix my cervical instability. Depending on which side is weaker or stronger etc the doctors usually do fusion. I want to avoid surgery.

So the only option that seems to be left in town is prolotherapy.

So has anyone tried it, any stories of good practitioners and success?

Akash, you might find the info in this link (and links therein) helpful in deciding whether or not prolotherapy could help you; https://www.sciencebasedmedicine.org/prolotherapy/ .

I've had dextrose prolotherapy on my injured right shoulder and got 3 yrs good relief...but dragging my feet mostly due to money.

I KNOW prolo can work as it worked for me.

Then there is PRP which is platlet rich plasma injections...platlets from your own blood. Here in So. Cal one MD does this PRP and Stem Cell injections all day.

I don't know where you are but here is a link for prolo workers in the U.S.

getprolo.com

The MD I'm talking about here is Marc Darrow and you can check him out and all the info on PRP and Stem Cells. He still does dextrose prolo but it's not used as much now..but I'd bet still effective for certain areas and length of condition.

Just like all medicine, there is always NEW drugs coming out to replace long standing meds that work. Dextrose Prolo can work.

At least check out a consult for the neck area. C

Akash, these are just my thoughts on what Caroline has contributed.

Dextrose is just another word for glucose. Injecting glucose into a site of tissue damage will, through well-understood physiology, means that on a time-scale of minutes, it will leave that site and enter the general pool of glucose which is about 5 mmol/L in the blood. I doubt that a brief exposure to a lot of glucose at a site of tissue damage would be of benefit.

"Stem Cells" can refer to many different kinds of cells. Before you embark on putative stem cell therapy (this has become a bit of a buzz-word in the comp/alt med community) I would be inclined to ask a doctor who might suggest that approach hard questions: (1) Which stem cells - there are lots of different kinds?, (2) How will they be isolated? (3) What is the clinical evidence that those (whatever they may be) stem cells might help me?

Kiwis, thanks a ton for joining the thread and you too Caroline. Helps to get a complete understanding (well as much as i can understand anyhow).

Kiwi you note:
Dextrose is just another word for glucose. Injecting glucose into a site of tissue damage will, through well-understood physiology, means that on a time-scale of minutes, it will leave that site and enter the general pool of glucose which is about 5 mmol/L in the blood. I doubt that a brief exposure to a lot of glucose at a site of tissue damage would be of benefit.

I think the logic is repeated irritation (I am leaving out the statements of "regeneration" etc since its basically scar tissue/extra collagen creation) to help strengthen the muscle/ligament (to whatever extent). Since its not one injection they are speaking of, but many over a period of time, from what I understand.

My question is if the sugar solution gets in contact with nerves, is that a toxic interaction? One link I read had a doctor mention dextrose is not good for the nerves.

I can tolerate ineffectiveness, but safety is my BIGGEST concern. I'd hate to end up worse off than what I am currently.

Caroline, thanks - so where did you get it done, and how many times?

I also found this link of interest.

https://thesportsphysio.wordpress.co...-as-it-sounds/

My understanding after polling a lot of people - randomly on forums with general muscle and hypermobility issues - is that there are several anecdotal claims of success (which I don't discount at all), this forum is a perfect example of how many anecdotes actually helped me (as versus conventional medical literature which is completely silent on many aspects of TOS and ignores it).

To my mind one good reason for less interest in prolotherapy could be the predominance of surgical ortho surgery - which works and has a clear mechanical explanation.

Prolotherapy seems to me, to be somewhat like trigger points. Works for many people, but the "hows and whys" are not really clear - the initial logic of Ms Travers referred pain has come under a lot of scrutiny - now it could be peripheral nerve networks (nerve network for the nerves), merely temp inhibiting muscles that cause strain on other muscles and so forth.. all put under a catch all rubric of trigger points. Many folks are giving up on it, its not the complete solution but something I guess..

My biggest concern is safety, what happens if the dextrose/lidocaine solution touches a bunch of nerves...?!

The most active folks on the net seem to be the Caring Medical guys - they do have a paper out there

http://www.ncbi.nlm.nih.gov/pubmed/25328557
and this:http://www.caringmedical.com/proloth...k-instability/

A lot of this seems to apply to me. I can't turn my head to the left. And I did fall the way he describes, and everything seems to add up.
https://www.youtube.com/watch?v=TDv6K-5PpHM

The other methods seem to be "hit everything and hope it works" method aka the Hackett Hemwall method.

This gent is doing that:https://www.youtube.com/watch?v=I5pQOhgt_B0
http://backcare.in/

I am concerned about Solution/needle, nerve interactions.
There seem to be no ways to actually do an ultrasound guided safe session..?!

One interesting study:

Present data suggest that prolotherapy is likely an effective therapy for painful overuse tendinopathy. Specifically, Scarpone et al.8 provides level A evidence for prolotherapy as an effective therapy for lateral epicondylosis. Subjects with refractory lateral epicondylosis and treated with prolotherapy reported significant reduction in pain and improved isometric strength compared to those who received control injections. These findings are supported by the Maxwell,7 Topol57 and Ryan61 studies that report strong case series results for Achilles, hip adductor and plantar fasciitis, respectively and provide level B evidence for these conditions. Given that the underlying mechanism of injury and pathophysiologic effects are similar for tendinopathies, prolotherapy is a reasonable option for these conditions as well. Randomized controlled trials for all three tendinopathies and for other tendinopathies are indicated.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831229/

I can clearly understand why prolo alone can't help low back pain, because if your issues are due to (say) muscular imbalance, without removing that, merely strengthening 1-2 ligaments wont really work, would it? But there seems to be some evidence of efficacy as seen above.

There is no guarantee to anything we try. I'm so disappointed from hip replacement surgery..I'm left with numerous complications....never dreamed I'd end up like I have. Often wish I hadn't done it, but where would I be then. Worse off or not...Limping regardless as I do now with hip parts changed.

I have a friend who can't move her neck in either direction....totally frozen and she's working now at chiro with ultrasound and laser therapy. She would never do neck surgery....she got this issue when in rehab from hip replacement...says the pillow she slept with was so inferior so neck got all messed up. So the neck mess has caused arm and hand numbness......what a vicious cycle.

My shoulder dextrose prolo was with Dr. John Chang, sports medicine MD here in my city. He injected dextrose in 8 sites on my shoulder, 1 visit, and I did get 3 years of relief.

I believe certain areas work better than other areas, like smaller areas.

I've talked to people who got help with PRP in their knees....it can take 2-3 visits. One doesn't know until they go thru it. It's the cost of PRP that holds me back. But surgery on knee is out of the question for me.

Whatever you decide I wish you the best results. I'd like to hear how you are.

Akash, your link above is indeed "One interesting study" - it seems to me that the authors have summarised the current state of play well.

You also mentioned Lidocaine above - this link discusses its uses and possible side-effects; http://www.drugs.com/pro/lidocaine.html .

Hi,Caroline, thanks, a tangent, from your hip replacement surgery are you having issues at the hip itself and the SIJ joint?

One thing I have learn in my research is when we start off walking a long way back, we imitate those around us, and subconsciously stand with one knee locked and other one flexed. So this basically rotates the pelvis and becomes a habit putting stress on the joint.
So one side you may have tight hip flexors and weak glutes (it will be rotated forward) and the other side ends up compensating. If you are seeing a PT please explore this. Stretching should be ok but should be done with some PT advise and also unless you have hypermobility/EDS where it is contraindicated.

Very interesting sir! This is used as a nerve block too? Curiouser and curiouser.
Have you any data on dextrose and nerve interaction by any chance?

This is really surprising.
http://www.ncbi.nlm.nih.gov/pubmed/15920223

Dextrose in water 5% moved nerve response up, whereas lidocaine stopped it!

Perhaps the hypothesis that motivates these guys (but they offer no evidence and only offer a hypothesis):
http://www.jointandspine.com/proloth...-prolotherapy/

I found this one from 1938!!
http://jama.jamanetwork.com/article....ticleid=280518
Six cases of median nerve injuries caused by dextrose. But was it due to the needle and/or the amounts injected?

These guys claim dextrose is all nice and safe
5% dextrose
(D5W) is painless on
injection and does not
cause any long-term sequel in animals or
humans when injected around neurological
tissue (2). - Looks like (2) refers back to the first link by Tsui et al.

http://www.researchgate.net/publicat..._VS_5_dextrose


Facet joint blocks seem to operate on the basis of mix of lidocaine and dextrose
http://drwilderman.com/treatments/in...ck-injections/

Another link - tested dextrose in rabbits to introduce fibrosis to see if that had an effect on the median nerve (is carpal tunnel syndrome actually due to fibrosis); they conclude that dextrose did increase connective tissue (in rabbits) and it did impact median nerve conduction velocity (which makes me wonder how illogical it is to inject folks hands with dextrose to help CTS or are any positive effects due to anti-inflammatory effects postulated?)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706150/