Can Prolotherapy Injections Heal Lumbar Disc Slippage? A Rehab Perspective

Prolotherapy injections and rehabilitation?

Hello Doctor, I had a car accident in May and suffered an ankle fracture.
By the end of June, the bone had healed, but in July, I noticed tightness and pain in my right thigh and calf, which progressed to numbness.
After an MRI in July, I was diagnosed with a grade 2 lumbar spondylolisthesis and was advised to undergo surgery.
Concerned about potential sequelae, I sought treatment at a rehabilitation clinic and received prolotherapy injections.
In August, I had my first injection with three needles administered on both sides of the spine and at the coccyx.
This provided temporary relief for the tightness in my thigh, but after a week, the symptoms returned.
On September 16, I received my second injection, which was only at the coccyx.
After this injection, the tightness in my thigh worsened, and I experienced a pulling sensation in the nerves of my leg, making it difficult to walk.
I rested at the clinic for 40 minutes, but the symptoms persisted.
Upon returning home, there was slight improvement, but I still have tightness and pain in my thigh.
Currently, I am undergoing lumbar traction and foot circulation therapy, and I have been in rehabilitation for two months, but the tightness in my thigh has not resolved.
I would like to ask the doctor if prolotherapy can truly cure lumbar spondylolisthesis.
It seems that rehabilitation only provides temporary relief for the discomfort.
Thank you, Doctor.

Yan Zi, 50~59 year old female. Ask Date: 2021/09/22

Dr. Li Yanheng reply Rehabilitation

The details of the treatment cannot be commented on as it is not my diagnosis; it is necessary to consult the treating physician directly to understand the treatment's effectiveness and indications.

Reply Date: 2021/09/22

More Info

Prolotherapy, also known as proliferative therapy, is a treatment that involves injecting a solution (often a dextrose solution) into an injured area to promote healing. This therapy is primarily used for musculoskeletal pain, including conditions like ligament laxity, tendon injuries, and joint instability. In the context of lumbar disc slippage, or spondylolisthesis, the effectiveness of prolotherapy is still a subject of debate among medical professionals.

From a rehabilitation perspective, it is essential to understand that lumbar disc slippage can lead to various symptoms, including pain, muscle tightness, and neurological symptoms due to nerve root compression. The primary goal of treatment is to alleviate pain, restore function, and prevent further injury. Prolotherapy aims to stimulate the body's healing response, potentially strengthening the ligaments and surrounding structures of the spine.

However, the evidence supporting prolotherapy for lumbar disc slippage is limited. While some patients report improvement in pain and function following prolotherapy, the results can be variable. Factors such as the severity of the slippage, the presence of nerve compression, and individual patient characteristics can all influence outcomes. In your case, it seems that the injections provided only temporary relief, and the symptoms returned after a short period.

It's also important to consider that prolotherapy is often used as an adjunct to other treatments, including physical therapy and rehabilitation exercises. Rehabilitation plays a crucial role in managing lumbar disc slippage. A comprehensive rehabilitation program typically includes:
1. Physical Therapy: Targeted exercises can help strengthen the muscles supporting the spine, improve flexibility, and enhance overall function. A physical therapist can design a program tailored to your specific needs and limitations.

2. Pain Management: This may involve medications, modalities like heat or ice therapy, and techniques such as manual therapy to alleviate pain and discomfort.

3. Education: Understanding proper body mechanics and ergonomics can help prevent further injury and manage symptoms effectively.

4. Activity Modification: Learning how to modify daily activities to reduce strain on the lumbar spine is essential for long-term management.

5. Gradual Return to Activity: As symptoms improve, a gradual return to normal activities, including sports or exercise, is crucial to regain strength and function.

Regarding your experience with increased tightness and pain after the second prolotherapy injection, it is not uncommon for patients to experience temporary exacerbation of symptoms. This can occur as the body responds to the injection and begins the healing process. However, if symptoms persist or worsen significantly, it is essential to communicate this with your healthcare provider. They may need to reassess your treatment plan, consider alternative therapies, or investigate other underlying issues contributing to your symptoms.

In conclusion, while prolotherapy may offer some benefits for certain musculoskeletal conditions, its effectiveness for lumbar disc slippage remains uncertain. A multidisciplinary approach that combines prolotherapy with a structured rehabilitation program may provide the best chance for recovery. It is crucial to work closely with your healthcare team to monitor your progress and make necessary adjustments to your treatment plan. If you have concerns about the long-term implications of your condition or treatment, don't hesitate to seek a second opinion or further evaluation from a specialist in spinal disorders.

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