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WHAT DO YOU MEAN THE PROLOTHERAPY WORKED? 
I STILL HAVE PAIN!

Ross Hauser, M.D.

A
patient came in for his sixth Prolotherapy visit. The nurse told me the patient didn't feel much improvement in his knee pain, though he had already received five Prolotherapy treatments. 

I examined his knee and there were no more crunching sounds. His anterior cruciate
ligament had tightened. His anterior drawer sign was negative. He had only slight tenderness in his patellar ligament. Upon further questioning the patient did admit that he felt his knee was more stable but still it felt ‘funny’ when he was running. This is mostly what bothered him, he couldn’t run well on it and that was his main reason for getting it treated. I explained to the patient that his ligaments had been healed by Prolotherapy. It was then that he asked why he still had pain. 

When a joint undergoes ligament damage, the muscles tense up to stabilize the joint. The muscles are then called upon to not only move the joint but also to stabilize the joint. Eventually they get overwhelmed and start to atrophy. When a joint is damaged or degenerated for a long time, one can bet that the muscles surrounding the joint will be significantly weaker than muscles in the other limb, which is what happened to this patient. The pain he was experiencing was due to quadriceps muscle weakness. As a matter of fact, he had lost about 50% of the muscle strength in his right quadriceps. It was one-half inch less thick than his other one. We then went through the exercises he was to do to preferentially strengthen his right leg. One simple maneuver was to wear an ankle weight just on his right side. I encouraged him to do extra sets of exercises just for his right leg. He was to do balance work which involves standing and holding various poses on his right leg. 

So when you do get an injury get it checked out. Don’t wait until the joint degenerates. If it does, often you will need to preferentially strengthen the muscles of that joint along with getting Prolotherapy to obtain complete pain relief.

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