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The concept of
Prolotherapy originated in the non-surgical treatment of hernias, varicose
veins, and hemorrhoids, all conditions which are due to
connective tissue
weakness. If the connective tissue in the veins becomes weakened,
hemorrhoids and varicose veins form. Weakness in the
collagen, of course,
causes
Ligament
laxity and tendon degeneration with resultant chronic pain.
Most of the early innovators in injection treatment method were surgeons who
were looking for methods to improve surgical outcomes or replace surgery
with more conservative methods. The injection of hernias, varicose veins,
and hemorrhoids was called Sclerotherapy, because the injection
"sclerosed," or scarred, the area.
Celsus, a Roman
encyclopedist and not a physician, described the earliest application of
Sclerotherapy in the first century B.C. Saltpeter (Potassium nitrate) was
injected to treat hydrocele (accumulation of fluid around the testicle). The
instrument and method of injection was, however, not described. Seventeen
centuries later, Samuel Sharp, a surgeon at Guy's Hospital, the oldest
teaching hospital of the University of London Medical School, began treating
hydrocele by Sclerotherapy and started training others. The Research and Growth of Prolotherapy
In January 1938,
Arthur Steindler and J. V. Luck published a fundamental work related to the
diagnosis of lower
back pain based on procaine injections. They provided
strong evidence that all structures in the lower back, including the
ligaments, fascia, tendons, and muscles, receive sensory nerve impulses.
They pointed out that these structures are all interrelated anatomically and
functionally, and they came up with a list of criteria that had to be met to
prove that an injured structure was causing a pain symptom.
This work was
monumental in the history of Prolotherapy. Now a method to definitely prove
what was causing the pain existed. A person came to the physician with low
back pain radiating to the legs. The doctor, with a needle, then tried to
exactly reproduce the pain and the radiating pain down the leg. When the
exact site was found, an injection of procaine was given. If the correct
structures were injected, all of the pain would be completely removed. The
latter part of this concept is followed to this day. Prolotherapy can
completely remove chronic pain immediately, if the correct structures have
been injected, because of the anesthetic part of the solution. The First Prolotherapy Treatment
In 1937, Dr. Louis
W. Schultz, both a dentist and a medical doctor, published a paper in The
Journal of the American Medical Association on the treatment of subluxation
of the temporomandibular joint (TMJ). In this paper he described how common
TMJ syndrome was, and that the traditional treatments of rest, appliances in
the mouth,
physical
therapy, and surgery were only partially successful. He
described a simple method of shortening and strengthening the TMJ capsule by
injection of Sylnasol, a five percent solution of fatty acid. This was the
first true Prolotherapy treatment. Dr. Schultz collected extensive data from
both animal research and clinical practice , and concluded that the method
he discovered was simple, safe, and essentially 100 percent effective. The Development of Prolotherapy as a Cure for Chronic Pain George S. Hackett, M.D. is considered one of the pioneers, or founders, of modern day Prolotherapy because he brought this technique to mainstream medicine. His research was published in some of the main medical journals of his time and presented at the prestigious American Medical Association meetings. Some of the statistics on his research include:
Dr. Hackett did a
remarkable job in that he followed his patients for 12 years after the
Prolotherapy treatments were completed. Twelve years after treatment, an
impressive 82 percent of the patients considered themselves cured. Dr.
Hackett believed that the cure rate was actually over 90 percent, due to
improvements in the technique over the years. He used Sylnasol, a fatty
acid, as the proliferant, which is no longer available. Later proponents of
the Hackett technique of Prolotherapy found that a simple
dextrose solution
diluted with local anesthetics was as effective as the Sylnasol, and
solutions such as this are still used today. Dr. Hackett also proved in the
laboratory that Prolotherapy induces the growth of ligament and tendon
tissue and is especially effective at strengthening the weld of these
structures to the bone, by proliferating their
fibro-osseous
junction.
In 1955, at an
American Medical Association meeting, Dr. Gustav Hemwall was astonished to
see so many doctors at one particular exhibit. The presenter was talking
about a very successful treatment for
chronic
low back
pain. Nothing was
worse at the time for Dr. Hemwall than having a chronic low back pain
patient come to him, because the treatments he was able to offer were not
very successful. The doctor doing the presentation was George S. Hackett,
M.D., and he was discussing the technique of Prolotherapy.
Once the crowd
diminished, Dr. Hemwall asked Dr. Hackett how he could learn the treatment
described in his book, Ligament and Tendon Relaxation Treated by
Prolotherapy. Dr. Hemwall went to Dr. Hackett's office in Canton, Ohio,
to learn the technique. Dr. Hemwall became so proficient at administering
the technique that Dr. Hackett would later refer patients to him. Prolotherapy owes a great debt to Dr. Hemwall. Between 1955 until his retirement in 1996, he was the main instructor and proponent of Prolotherapy in the United States. He was not a researcher but a clinician, and perhaps the world's greatest Prolotherapist. He treated more than 10,000 patients world wide and collected data on 8,000 of these patients. In 1974, Dr. Hemwall presented his largest survey of 2,007 Prolotherapy patients to the Prolotherapy Association. The survey related the following:
More than 99 percent of the patients who completed treatment with Prolotherapy found relief from their chronic pain. These results are similar to those published by Dr. Hackett, showing that Prolotherapy is completely curative in many cases (75 to 90 percent) and provides some pain relief in nearly all patients treated. At the age of 87, in June of 1996, Gustav A. Hemwall M.D. electively retired from the practice of medicine and turned over the helm of his private practice to Dr. Ross Hauser. He had been on the medical staff of West Suburban Hospital in Oak Park, Illinois for 60 years.
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Prolotherapy is a medical
technique. As with any medical technique, results will vary among
individuals.
Prolotherapy may not work for you and as with all medical
procedures there are risks involved. These risks should be discussed with a qualified
health care professional prior to any treatment.
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THE
HISTORY OF PROLOTHERAPY