The Chapter: Ultrasonography in Prolotherapy
February 4th, 2010
Prolotherapy has been around for decades. Many physicians have assumed that the improvements that patients report after prolotherapy are a placebo effect; meaning the change was in their head not their joint tissue. Of course, an honest assessment would have been that none of us knew what the tissue, like ligaments and tendons, does in response to Prolo, because we had no reliable way to see the tissue. Even MRI is limited in what it can see. Ultrasound imaging, however, can see most ligaments and tendons with much more detail than MRI.
My excitement is increasing as I finish writing a chapter about these issues for the journal Physical Medicine and Rehabilitation (PMR) Clinics. It is an honor to have as my coauthor, Dean Reeves, MD, Clinical Associate Professor of PMR at the University of Kansas and the man who introduced me to prolotherapy in 1995. The chapter focuses on my passion of ultrasound imaging to show healing of tissues in response to “regenerative injection”, better known as prolotherapy. This includes injection of dextrose (i.e. sugar), morrhuate sodium (an extract of cod liver oil) and our newest prolotherapy agent, Platelet-Rich Plasma (PRP). We review the scientific literature that is available on the subject and include examples of tissue repair seen in my practice. I’ve included examples of tennis elbow, golfer’s elbow, osteoarthritis in the knee and finger, osteitis pubis (groin pain), Achilles tendon tear, plantar fasciitis and ankle pain/instability.
The chapter is scheduled for publication in August of 2010. My hope is that this chapter will help to convince physicians who have only been skeptical about prolotherapy to become skeptics with open minds. After all, that is how true scientific advancement begins.