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TMJ Disorder -TemporoMandibular Joint Message Board

TMJ Disorder -TemporoMandibular Joint Board Index

Hi Sheldon:

I came across this information on prolotheraphy on a healthy talk radio website. I don't know if you've started treatment yet, but you might be interested:

A hundred years ago, it may surprise you to learn that natural therapies such as herbs and homeopathy dominated the American practice of medicine. As the twenty-first century now dawns, the resurgence of interest in alternative therapies is greater than ever before. The most common reasons we seek out complementary or alternative therapies are those conditions poorly served by our conventional medical community. Pain is at the top of the list.

The hallmark of alternative medicine is to provide to the body the nutrients it needs to heal. While we could discuss natural ways to relieve pain symptomatically, let’s focus on prolotherapy. Prolotherapy is a non-surgical, natural way to assist the body to repair injured tendons and ligaments. Pain relief is just one of its well-documented side effects.

Who can benefit from prolotherapy? Anyone who suffers from one of the following:
-Back pain
-Neck pain
-Arthritis pain
-Sports injuries
-RSD (reflex sympathetic dystrophy) pain
-TMJ (temporomandibular joint dysfunction)
-Herniated disks
-Joint pain, i.e. shoulder, elbow, hip, knee

And the benefits are lasting as long as the patient continues an active use of the area involved.

The roots of prolotherapy, as it is presently practiced, date back to the 1920s. It has enjoyed a strong following since a resurgence in the 1950s. Its theory is akin to a technique used by Hippocrates who had a wonderful wisdom about the body’s ability to heal itself. Greek soldiers of ancient times with torn or dislocated shoulders endured a hot poker thrust into the joint by Hippocrates, which resulted in a miraculous healing of the body by itself. It is also closely related to sclerotherapy, the injection technique, for the repair of hernias by injection that developed in the 1830s.

The intriguing history of prolotherapy includes one very satisfied patient who was told in his 40s to expect a life of chronic pain. That patient was a physician destined to make his mark as our surgeon general. C. Everett Koop, M.D. His personal expereince in getting total relief was so impressive that Dr. Koop offered prolotherapy to the parents of his pediatric patients whenever he observed them in pain. The physician, Dr. Gustav Hemwall, who treated Dr. Koop, was one of the greatest teachers of prolotherapy of our time. Many physicians who use both conventional and alternative treatment options find prolotherapy an essential tool to help their patients regain and maintain optimal health.

Prolotherapy is an injection technique using natural substances that cause the proliferation of new cells where the ligament tissue has become weak. Prolotherapy uses the injection of a natural substance (which may be a dextrose solution among other choices), which causes a local inflammation in those areas of weak tissues and pain. The body’s response to inflammation is to draw additional blood there along with the flow of nutrients. All of this stimulates the tissue to heal itself. This healing cascade results in the body’s production of new collagen. The collagen becomes new ligament or tendon tissue. One of the properties of new collagen is to shrink as it matures. This contraction of the collagen makes the ligament tighter and much stronger than it was before. Ligaments that have been injured or have become weak rarely heal back to their original level of strength or endurance. One of the main reasons for this is the poor blood supply of the ligaments, which makes healing slow and often incomplete. Clinical studies have actually demonstrated increased ligament strength after prolotherapy and account for its lasting benefits, estimated to be an increase of 20-40%.

The ligaments do have nerve endings. These nerves produce the pain sensation that marks every condition, which can be treated by prolotherapy, noted above. Once the ligament tissue has been tightened and strengthened, the area is stabilized and the pain often relieved.

Because the substances used for injection are no longer patentable, pharmaceutical companies have no financial incentive to promote their use. Instead, we have a huge market focus on prescription antiinflammatory agents including the newly celebrated Celebrex and Vioxx. Many physicians who appreciate the wisdom and insight of Hippocrates now wonder if we risk limiting our body’s healing response with a “quick-to-write-a-‘script” approach to minimize the body’s inflammatory response. Perhaps, this may account for the fact pointed out by a European Conference in Rheumatology that no prescription drug has ever cured a single case of arthritis.

These treatments may include the use of prolotherapy injections along with the use of injectable glucosamine, yes, that’s the oral nutrient has shown benefit for degenerative joints and disks, along with injections of human growth hormone (HGH) into the deteriorating joint.

This approach addresses the weakened or injured ligaments and tendons, the deterioration of the gel-like cartilage within the joint that precipitates action when it becomes bone-on-bone, and the growth factors that combine for a triple healing team.

The first step is to determine if you are a candidate by sitting down with a trained physician. Some of the signs and symptoms a skilled practitioner will assess include the following:

-People with shoulder pain including those who have trouble sleeping on their shoulders
-Those who suffer from joint dislocation
-A joint that is worse with activity and better with rest
-Someone whose chiropractic adjustments help, but don’t last
-The problem does not respond to muscle relaxants, arthritis medication, cortisone shots, or nerve blocks during a six-week period
-Cases of failed surgery
-A joint that is aided by a brace, a sling, or a splint
-The diagnosis of a ligament or tendon sprain or tear
-The joint has a deep aching or pulling pain
-Cases of shooting pain, tingling, or numbness
-Temporal mandibular pain (TMJ)
-Neck and back pain
-Severe joint deterioration in patients advised to have joint replacement

One of the often asked question is “how many treatments will I need?” Because the healing process is largely individual, one patient may respond to 4-6 prolotherapy injections and another may need twice that or more to achieve full satisfaction. Patients with healthy immune systems seem to respond more quickly.

Each session may involve multiple injections. Some practitioners note that lower back pain may require up to fifty injections per sessions. The pain of the injection is lessened with the use of an anesthetic such as lidocaine. Swelling and stiffness is very common for a few days after the injections.

The injections, in skilled hands, are relatively benign. Dr. Koop states, “The nice thing about prolotherapy, if properly done, is that it cannot do any harm.” As with any medical technique, there can be complications. There were three instances in the early 1950s in the literature that involved an injection too close to the nerve resulting in severe complications. Dr. Hemwall who was the physician of Dr. Koop performed prolotherapy on over 10,000 patients with no serious complications ever noted. Dr. Hemwall states his success rate was 90%. The full healing response may take several months to achieve.

The studies involving prolotherapy have been published in prestigious journals including Lancet and The Journal of the American Medical Association. These studies all cite success rates well over 50% and results lasting from 2-12 years or even longer.

Take care.

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