Healing Shoulders with Prolotherapy and PRP
On March 19, 2001 I had a snowboarding accident at Whistler, BC, where an unfortunate encounter with a tree allowed me to experience and appreciate the high professionalism and quality of the Canadian national health care system. Skilled doctors kept me breathing, while orthopedists pieced my bones back together with plates, bolts, screws and compassion. But while it was they who gave me a second chance at life, the tendons and ligaments of my joints were restored by an increasingly respected treatment called prolotherapy.
I’ve practiced Prolotherapy techniques in Portland and Lake Oswego, Oregon since 1999. While I attribute much of my recovery to the benefits of prolotherapy, not many good studies have been published on this practice. Because of this I try to keep my own statistics with the hope of one day having the time to publish my results. I thought I would share the following case review of the first 16 consecutive cases of Rotator Cuff I treated with Prolotherapy.
I have picked Rotator Cuff injuries because they are the most common shoulder injuries encountered. While they happen in all age groups, the risk of rotator cuff injuries and syndromes increases with advancing age. The results of the last 16 cases reveal that 14 cases treated with prolotherapy have had complete or almost complete cures without surgery and all are pain-free without medication. All cases received between 1 and 6 prolotherapy injection sessions. All received concurrent ultrasound and sine wave treatments. Most received at least one myofascial triggerpoint injection into taut shoulder muscles. All were taken off anti-inflammatory drugs prior to beginning treatment. Here are the case presentations. See if you can guess which 2 cases did not respond:
Case #1 – When KJ first consulted me with his rotator cuff injury, he was unable to reach up to comb his hair, or down to his back pocket. He is a fit and active 83 years of age, and he wondered if it would be possible to heal his shoulder. His orthopedist had diagnosed rotator cuff syndrome and frozen shoulder and had treated JK with 2 cortisone injections in his shoulder and months of physical therapy without benefit. Could an old guy like him really expect to return to normal activity? Would surgery be wise, or ins frozen shoulder and Prolotherapy a winning combination? Would prolotherapy restore his mobility?
Case #2 – Dr. D was a lifelong surfer who lived for the waves of his native Kauai. He had taken me to his favorite surf spots the previous winter and I’d gotten the best waves of my life. For several months after that his right shoulder was giving him fits and he’d tried all the natural treatments, including acupuncture and physical therapy. Still his pain would grab him like a snake and take his breath away. When he visited his daughter who attended Lewis and Clark College, we had a chance to give him one Prolotherapy treatment. Would it cure his supraspinatus tendon pain?
Case #3 – DN Had pain and stiffness in both shoulders. A retired nurse, she had declined her doctor’s offer of cortisone injections into her shoulder because she preferred to treat the cause of the problem instead of covering up the pain with cortisone. Plus, she knew that cortisone weakens the connective tissue and causes loss of cartilage. She wanted an alternative to surgery and even though she had never heard of Prolotherapy she was willing to give it a try.
Case #4 – One night MM was on her way home from her nursing job at a local hospital when she lost control of her car on an icy Mt. Tabor road and slammed into a concrete wall She woke up the next day with a frozen shoulder. Prior to the crash she had been fit as a fiddle and her doctor prescribed exercise and physical therapy routine. Months later she still could not lift her arm above the level of her shoulder. Her MRI had revealed fraying of the rotator cuff attachments and surgery was looming over her head like a piano in a Laurel and Hardy episode. Could prolotherapy provide relief?
Case #5 – SJ was a high school competitive gymnast whose partial rotator cuff tear had not responded to months of physical therapy, rest and ibuprofen. His parents had taken him to several physicians and none had offered any options besides more physical therapy, rest, and possibly surgery. Meanwhile, the pain was interrupting his sleep and limiting his workouts. Could prolotherapy injections really help?
Case #6 – AT had overworked her shoulder while staining and polishing the floor in her home studio. Months had passed, and yet her shoulder was still in pain. X-rays revealed calcific tendinosis. Would prolotherapy help?
Case #7 – NC had fallen on ice and caught herself with her right arm extended behind her, tearing her rotator cuff and her posterior labrum capsule. 8 months had passed and she still had limited use of her right arm because of shoulder pain and limited ROM. I recommended PRP prolotherapy. She would have to drive from her home at the coast to get treatment, but she was willing to make the effort if she could avoid arthroscopic surgery. Would PRP prolotherapy heal her torn labrum?
Case #8 – LD had torn her rotator cuff when she was 55, and now at 57 she had become used to not raising her right shoulder past a horizontal level. She could not lift her cast iron skillets, take dishes down from their shelf, or use her right hand to shampoo her hair. Constant nighttime pain had been depriving her of a good night’s sleep. With a chronic rotator guff injury, did Prolotherapy offer any chance of recovery?
Case #9 – MD had 2 cortisone shots in her right shoulder to try to relieve the constant pain she’d had for over 6 months. Physical therapy had not helped her regain her strength or relieve her pain. She had seen 4 physicians and had x-rays, as well as had contrast dye injected into her shoulder for a MRI. She took ibuprofen like it was going out of style, 6 to 12 tablets a day just to be comfortable. Even with this heavy dose, sleep was interrupted by a deep, aching pain.
Case #10 – CS was 40-something and full of energy. But her shoulder had frozen up on her and was keeping her from doing just about any overhead activities, from pruning her fruit trees to painting the kitchen. Her doctor had diagnosed adhesive capsulitis but the therapies were not working. Their home remodel almost complete and she worried it would have to be put on hold because of her shoulder pain. She would need to drive from the coast for treatment in order to avoid surgery.
Case #11 – NT coached a high school La Cross team. We had used prolotherapy to resolve his longstanding knee problems the year before, and so when he injured his shoulder and the pain had persisted for several months he decided to give prolotherapy a try.
Case #12 – DY was a 40-year-old professional athletic trainer. He had the strong and balanced physique of a former competitive gymnast. For over a year his shoulders had tweaked with pain during his weight routine and he was loosing strength and having to back off his exercise routine. He wanted to be stronger in his shoulders, not weaker.
Case #13 – LW’s shoulder gave her such pain at night that sleep was interrupted. She had tried limiting her morning workouts to just her legs but the shoulder pains had persisted. We’d already tried a course of triggerpoint therapy and PT without much benefit. Prolotherapy was her next option. But would it cure her rotator cuff syndrome?
Case #14 – LC had been referred by her chiropractic doctor for her frozen shoulder pain. She had already had cortisone shots years before, as well as months of physical therapy. Surgery had been suggested for her pain, Ibuprofen had caused stomach pain and had to be discontinued. Could prolotherapy free up her shoulder?
Case #15 DP had worked most of his adult 56 years in concrete construction and his right shoulder had finally torn pounding stakes with a cutoff 5 lb sledgehammer. Not having to swing that hammer any more was OK with him, except the pain kept him from his golf game and kept him up nights in pain. He brought his X-rays and an MRI report to his first visit. Was he able to cancel his surgery?
Case #16 – JR was a 42-year-old Pilates convert and had gained a lot of strength and flexibility with the practice. Yet she had somehow injured her shoulder. Her first MRI had found a supraspinatus tear and an injury to her anterior shoulder cartilage. She wanted to avoid surgery if at all possible. Would prolotherapy help?
Could you guess who did not respond? It turns out that #6 and #14 did not respond to prolo. #6 (AT) did eventually respond to ultrasound. #14 (LC) did get arthroscopic surgery and has made great strides since then. All the other cases went on to have complete or almost complete Rotator Cuff repair with Prolotherapy.
With my own shoulders, I know that prolotherapy has made it possible to continue all the sports I enjoy, and with my regular exercise routine, my shoulders stay in pain-free condition. Overall, these prolo sessions cost about 1/10th the combined costs of arthroscopic surgery, and recovery was faster and did not require months of physical therapy rehabilitation.
We treat over 20 different joints a day in our Oregon practice using prolotherapy injections, with and without PRP, from ankles and knees to hips and necks, and the results are equally impressive. So if you have pain in tendons, ligaments and joints, prolotherapy may be the your best option for relief.