Do the injections hurt?
Is there such a thing as a painless injection? Sure, it hurts. However, with prolotherapy the pain is moderate, but can last a few days. Some unfortunate individuals have longer duration of pain.
What are complications of prolotherapy?
Besides pain, one can have bleeding, infection, nerve injury and tissue damage. Rare but these complications do occur
Is pain relief with prolotherapy permanent?
Well depends on whom you listen to. The doctors say yes to everything, but the real patients who have had injections say no way. Fact – if it works, the pain relief is transient.
Where are the injections done?
In an office or a clinic
Can one combine prolotherapy with other procedure used to treat back pain?
Sure, if you have any money left over, you can combine it with acupuncture, chiropractic, physical therapy, and massage therapy. Now ask your self this question, if prolotherapy was that great, why would there still be a need to combine other treatments? - answer- makes more money for the health care workers.
Is Prolotherapy safe?
Well the human being is a sturdy individual. You can probably inject small amounts of glucose almost anywhere in the body and not screw up. Therefore, in that sense prolotherapy is safe. However, the occasional health care worker goofs up and complications can occur like infections, bleeding, nerve injury and more pain than what you started out with
How long are the sessions spread over?
Well, these Prolotherapy maniacs recommend 2-3 sessions/week over 2-3 months. Ample time to collect down payment on a new Lexus.
Is Prolotherapy better than steroid injections or physical therapy?
The people who market this therapy say yes to everything. Remember you are paying for it and like plastic surgery, there are no refunds.
Thursday, March 26, 2009
Prolotherapy for Back Pain Part 1
What is Prolotherapy?
Prolotherapy is also known as Regenerative injection therapy. The procedure essentially involves injection of high concentration of glucose (yes simply sugar water) into the attachment of bone- such as tendon and ligaments. The solution is injected at precise points and the theory is that glucose water magically increases blood supply, repairs the tissues and relieves pain (and all this time I thought sugar was bad!)
Is there scientific proof that prolotherapy works?
There have been a few experimental studies performed in rats. But because the experimental rats cannot communicate so it is hard to know. However, the rats did run and eat as normal. The few human guinea pigs who have been studied did not see any improvement.
What type of pain disorders are treated with prolotherapy?
Well, physicians and alternative practitioners recommend prolotherapy for almost all musculoskeletal disorders associated with pain including back pain, shoulder pain, groin pain, elbow pain, and arm pain and so on.
What other disorders are treated by prolotherapy?
Prolotherapy has been used to treat a wide range of musculoskeletal disorders like whiplash and neck pain, low back pain, cervical disc, lumbar disc herniations, rotator cuff injuries, tennis/golfer’s elbow, wrist problems, knee arthritis and pain, hip pain, ankle sprains, achilles tendonitis and plantar fasciitis - but this does not mean it works in all of them
Does Prolotherapy Work in humans?
Depends on whom you ask. The doctors and alternative care health practitioners who sell this therapy are adamant that it works. They are sure about it and always quote some study. However, if you talk to individuals who have had this therapy, the word BULL SHIT is the first thing that they say. Hopeless and fake are a few other choice words for this treatment.
IS there any scientific data to support prolotherapy use in humans?
Well, there are very few reports published but an overview analysis of prolotherapy by Cochrane, revealed that it did nothing. Cochrane does say the glucose injections are not bad for the body, but as far as pain was concerned, it did diddly squat. Most studies are difficult to understand and have conflicting data. Overall, prolotherapy does nothing.
How many sessions are required?
When there is money to be made, rest assured nothing will be cured in one session. Same goes for prolotherapy. One needs at least 6-14 sessions. Sometimes two parts of the body can be treated in each session. The treatment as the experts say should last several months.
Prolotherapy is also known as Regenerative injection therapy. The procedure essentially involves injection of high concentration of glucose (yes simply sugar water) into the attachment of bone- such as tendon and ligaments. The solution is injected at precise points and the theory is that glucose water magically increases blood supply, repairs the tissues and relieves pain (and all this time I thought sugar was bad!)
Is there scientific proof that prolotherapy works?
There have been a few experimental studies performed in rats. But because the experimental rats cannot communicate so it is hard to know. However, the rats did run and eat as normal. The few human guinea pigs who have been studied did not see any improvement.
What type of pain disorders are treated with prolotherapy?
Well, physicians and alternative practitioners recommend prolotherapy for almost all musculoskeletal disorders associated with pain including back pain, shoulder pain, groin pain, elbow pain, and arm pain and so on.
What other disorders are treated by prolotherapy?
Prolotherapy has been used to treat a wide range of musculoskeletal disorders like whiplash and neck pain, low back pain, cervical disc, lumbar disc herniations, rotator cuff injuries, tennis/golfer’s elbow, wrist problems, knee arthritis and pain, hip pain, ankle sprains, achilles tendonitis and plantar fasciitis - but this does not mean it works in all of them
Does Prolotherapy Work in humans?
Depends on whom you ask. The doctors and alternative care health practitioners who sell this therapy are adamant that it works. They are sure about it and always quote some study. However, if you talk to individuals who have had this therapy, the word BULL SHIT is the first thing that they say. Hopeless and fake are a few other choice words for this treatment.
IS there any scientific data to support prolotherapy use in humans?
Well, there are very few reports published but an overview analysis of prolotherapy by Cochrane, revealed that it did nothing. Cochrane does say the glucose injections are not bad for the body, but as far as pain was concerned, it did diddly squat. Most studies are difficult to understand and have conflicting data. Overall, prolotherapy does nothing.
How many sessions are required?
When there is money to be made, rest assured nothing will be cured in one session. Same goes for prolotherapy. One needs at least 6-14 sessions. Sometimes two parts of the body can be treated in each session. The treatment as the experts say should last several months.
Epidural Steroid Injections Part 3
Final Word
Most of the current evidence on epidural steroids is anecdotal. A few studies indicate that this therapy is essentially not effective. The majority of patients find no long-term benefit from steroid injection and it does not prolong the time to surgery. The problem is that the health care professionals have become charlatans and offering dubious therapies with no proven benefit. For all those with back pain, remember medicine and money never make a good mix.
Cost
Epidural steroid injections can cost anywhere from $1200- $2000. There are many health care specialists who are now into the business of pain management and perform the injections. The majority of them do it because they make money.
By the way, most insurance companies and Medicare do not fully reimburse these steroidal injections.
If you have back pain, read the literature on this topic and choose your health care provider well. To date, the only thing epidural steroidal injections have been known to cure is your wallet.
Most of the current evidence on epidural steroids is anecdotal. A few studies indicate that this therapy is essentially not effective. The majority of patients find no long-term benefit from steroid injection and it does not prolong the time to surgery. The problem is that the health care professionals have become charlatans and offering dubious therapies with no proven benefit. For all those with back pain, remember medicine and money never make a good mix.
Cost
Epidural steroid injections can cost anywhere from $1200- $2000. There are many health care specialists who are now into the business of pain management and perform the injections. The majority of them do it because they make money.
By the way, most insurance companies and Medicare do not fully reimburse these steroidal injections.
If you have back pain, read the literature on this topic and choose your health care provider well. To date, the only thing epidural steroidal injections have been known to cure is your wallet.
Epidural Steroid Injections Part 2
After the injection at home?
At home, it is highly recommended that one rest for 24 hours. If the procedure was done without any hassles, most individuals can return to their life style or even go to work. The injection site in the back is not painful, but some individuals may feel an odd ache for a few days. These individuals can take an over the counter pain pill or apply an ice pack. The corticosteroid does not work immediately and takes at least 2-4 days to work. The maximum pain relief occurs after 7-10 days.
What are Risks of epidural injections?
While the procedure is generally safe, complications are not unheard off. Some patients develop more pain, bleeding, severe headaches, infection, and even allergic problems to the drug.
In some cases, the headache can be persistent and can last several weeks and may require another injection (blood patch) to cure the headache.
Finally, the injection may not work at all for the back pain. If there is no pain relief within 2 weeks, it is unlikely to work at all. At this point, it is better not to attempt a second injection because it simply won’t work. If the physician insists, ask him/her to pay for the injection (see costs below).
How often can the injections be given?
Epidural injections are only given 2-3 times a year. The reason is that the corticosteroids can have profound complications that include:
- Thinning of skin
- Weakening of bone
- Weakness of muscles
- Stop the body from producing its own steroids
Does everyone get relief from pain after the injections?
Epidural injections with corticosteroids do not work in all individuals. Even the same individual responded to the first injection, there is no guarantee that future injections may help.
The pain relief is temporary and not a cure for the problem
Do Epidural Steroid Injections help?
In general the answer is NO. the rare patient who has pain radiating to the back of his legs may feel a little better. The other group of individuals who may respond are those with recent acute back pain. Other than this two groups, epidural steroidal injections are all about throwing away your hard earned money to unscrupulous physicians.
At home, it is highly recommended that one rest for 24 hours. If the procedure was done without any hassles, most individuals can return to their life style or even go to work. The injection site in the back is not painful, but some individuals may feel an odd ache for a few days. These individuals can take an over the counter pain pill or apply an ice pack. The corticosteroid does not work immediately and takes at least 2-4 days to work. The maximum pain relief occurs after 7-10 days.
What are Risks of epidural injections?
While the procedure is generally safe, complications are not unheard off. Some patients develop more pain, bleeding, severe headaches, infection, and even allergic problems to the drug.
In some cases, the headache can be persistent and can last several weeks and may require another injection (blood patch) to cure the headache.
Finally, the injection may not work at all for the back pain. If there is no pain relief within 2 weeks, it is unlikely to work at all. At this point, it is better not to attempt a second injection because it simply won’t work. If the physician insists, ask him/her to pay for the injection (see costs below).
How often can the injections be given?
Epidural injections are only given 2-3 times a year. The reason is that the corticosteroids can have profound complications that include:
- Thinning of skin
- Weakening of bone
- Weakness of muscles
- Stop the body from producing its own steroids
Does everyone get relief from pain after the injections?
Epidural injections with corticosteroids do not work in all individuals. Even the same individual responded to the first injection, there is no guarantee that future injections may help.
The pain relief is temporary and not a cure for the problem
Do Epidural Steroid Injections help?
In general the answer is NO. the rare patient who has pain radiating to the back of his legs may feel a little better. The other group of individuals who may respond are those with recent acute back pain. Other than this two groups, epidural steroidal injections are all about throwing away your hard earned money to unscrupulous physicians.
Epidural Steroid Injections 101
What is an epidural steroid injection?
One of the treatments for back pain is to inject corticosteroids in the spine- in an area called the epidural space. Most of the nerves which transmit pain signals to the brain run in the spinal cord-so it makes sense to block the nerves here. The epidural space is the inner canal in the spinal cord and can only be accessed with a long thin needle.
Can anyone receive an epidural injection for back pain?
Definitely not. In some patients, the nerve may be pinched and irritated by pressure. When the nerve is pinched, it may cause pain, numbness or, tingling in the neck, arms, legs or buttocks. Sometimes the pain may also radiate down to the back of the foot. In most cases, individuals who have recent onset of back pain generally respond to epidural injections. Other individuals who have back pain which radiates to the back of the legs may be helped. For those individuals who have had back pain for many months or years, epidural injection will not help at all. Other individuals who have back pain from muscle pain, joint problems or arthritis generally do not respond to these injections.
How is the injection done?
The injection is done in an office setting and does not take more than 30 minutes. You will be asked to lie down flat on the table and bring your knees to your chest area. This opens up the epidural space. The physician will numb the skin with an anesthetic and then may use an x ray to guide the needle into the epidural space. An x ray is not always needed. Once the correct position is obtained, the corticosteroid is injected into the space.
Once the injection is done, you are monitored for 30 minutes and most patients can be discharged in 1-2 hours. The majority of individuals will feel numbness or a mild weakness in the arms or legs after the injections. Sometimes one may even feel dizzy. After an epidural injection, one cannot drive home.
One of the treatments for back pain is to inject corticosteroids in the spine- in an area called the epidural space. Most of the nerves which transmit pain signals to the brain run in the spinal cord-so it makes sense to block the nerves here. The epidural space is the inner canal in the spinal cord and can only be accessed with a long thin needle.
Can anyone receive an epidural injection for back pain?
Definitely not. In some patients, the nerve may be pinched and irritated by pressure. When the nerve is pinched, it may cause pain, numbness or, tingling in the neck, arms, legs or buttocks. Sometimes the pain may also radiate down to the back of the foot. In most cases, individuals who have recent onset of back pain generally respond to epidural injections. Other individuals who have back pain which radiates to the back of the legs may be helped. For those individuals who have had back pain for many months or years, epidural injection will not help at all. Other individuals who have back pain from muscle pain, joint problems or arthritis generally do not respond to these injections.
How is the injection done?
The injection is done in an office setting and does not take more than 30 minutes. You will be asked to lie down flat on the table and bring your knees to your chest area. This opens up the epidural space. The physician will numb the skin with an anesthetic and then may use an x ray to guide the needle into the epidural space. An x ray is not always needed. Once the correct position is obtained, the corticosteroid is injected into the space.
Once the injection is done, you are monitored for 30 minutes and most patients can be discharged in 1-2 hours. The majority of individuals will feel numbness or a mild weakness in the arms or legs after the injections. Sometimes one may even feel dizzy. After an epidural injection, one cannot drive home.
Thursday, March 19, 2009
post herpetic neuralgia part 3
Anti depressants are widely used to treat post herpetic neuralgia. These drugs are quite effective in decreasing the pan sensation in at least 40% of individuals. The doses of the anti depressant selected are much lower than the actual dose used to treat depression. To date, all classes of antidepressant have been shown to have some benefit in relieving the pain of post herpetic neuralgia but the tricyclic anti depressants seem to work the best.
Anti convulsants. Some drugs used to treat seizures have also been found be useful in the treatment of post herpetic neuralgia. The classic anti convulsant is Gabapentin or neurontin today. Another related drug is called lyrica and it is also useful in the treatment of post herpetic neuralgia. These drugs do relieve pain in close to 30-40 percent of individuals but the duration of pain relief is not long lasting. In some cases, the drug does work initially but fails to work in the long run.
Some physicians have tried to inject corticosteroids around the spinal cord. The results of corticosteroid are not always reproducible but when it works the pain relief is long term. However, less than 5% of patients respond to these injections. Steroid injections are never first choice treatment for this disorder. Only individuals who fail the above drug therapies should receive steroidal injections.
Narcotics. Over the counter pain pills are useless for Post herpetic neuralgia. Narcotics like oxycontin, hydrocodone, and percocet do work but long-term use of these narcotics has been associated with physical dependence and addiction. With many cases of overdose, many physician s have become hesitant about writing prescriptions for such medications.
Transcutaneous electrical nerve stimulation involves insertion of tiny electrodes into the painful skin areas; the electrodes are then stimulated to deliver painless electrical impulses to the nerves. It is believed that these impulses can block the pain fibers or stimulate the nerves to release pain-relieving chemicals. While the treatment is effective, it does not work in everyone. Some individuals combine TENS with drug therapy to get the maximal benefit.
Spinal cord or peripheral nerve stimulation. Devices similar to TENS are now being placed underneath the skin for long-term use. These devices can be turned off or on as needed to control the pain. At the time of implantation, the doctor will test the device to see if it works. The electrodes are placed in the vicinity of the spinal cord and the small stimulator is placed in the upper buttock area but can be placed in the chest or abdomen. This method of pain control is quite expensive and does require a minor surgical procedure.
Lidocaine patches are small bandage like patches that do relieve only the mild pain. The patches are available with a prescription and can be applied on to the skin. They do not always work and are not recommended for moderate or severe pain.
As far as pain relief is concerned, no method provides complete relief. Some people do have little relief but many obtain no relief. The majority of patients live with the pain for many years. Luckily, in most cases, the pain of post herpetic neuralgia disappears within 3-6 months. In some unlucky individual, the pain may last a few years
For more on TENS, please visit www.medexsupply.com
Anti convulsants. Some drugs used to treat seizures have also been found be useful in the treatment of post herpetic neuralgia. The classic anti convulsant is Gabapentin or neurontin today. Another related drug is called lyrica and it is also useful in the treatment of post herpetic neuralgia. These drugs do relieve pain in close to 30-40 percent of individuals but the duration of pain relief is not long lasting. In some cases, the drug does work initially but fails to work in the long run.
Some physicians have tried to inject corticosteroids around the spinal cord. The results of corticosteroid are not always reproducible but when it works the pain relief is long term. However, less than 5% of patients respond to these injections. Steroid injections are never first choice treatment for this disorder. Only individuals who fail the above drug therapies should receive steroidal injections.
Narcotics. Over the counter pain pills are useless for Post herpetic neuralgia. Narcotics like oxycontin, hydrocodone, and percocet do work but long-term use of these narcotics has been associated with physical dependence and addiction. With many cases of overdose, many physician s have become hesitant about writing prescriptions for such medications.
Transcutaneous electrical nerve stimulation involves insertion of tiny electrodes into the painful skin areas; the electrodes are then stimulated to deliver painless electrical impulses to the nerves. It is believed that these impulses can block the pain fibers or stimulate the nerves to release pain-relieving chemicals. While the treatment is effective, it does not work in everyone. Some individuals combine TENS with drug therapy to get the maximal benefit.
Spinal cord or peripheral nerve stimulation. Devices similar to TENS are now being placed underneath the skin for long-term use. These devices can be turned off or on as needed to control the pain. At the time of implantation, the doctor will test the device to see if it works. The electrodes are placed in the vicinity of the spinal cord and the small stimulator is placed in the upper buttock area but can be placed in the chest or abdomen. This method of pain control is quite expensive and does require a minor surgical procedure.
Lidocaine patches are small bandage like patches that do relieve only the mild pain. The patches are available with a prescription and can be applied on to the skin. They do not always work and are not recommended for moderate or severe pain.
As far as pain relief is concerned, no method provides complete relief. Some people do have little relief but many obtain no relief. The majority of patients live with the pain for many years. Luckily, in most cases, the pain of post herpetic neuralgia disappears within 3-6 months. In some unlucky individual, the pain may last a few years
For more on TENS, please visit www.medexsupply.com
post herpetic neuralgia part 2
Why post herpetic neuralgia occurs is a mystery. There is evidence that the virus damages the nerves, which results in intense pain that is long lasting. In most cases the pain can last anywhere from a few months to several years.
Post herpetic neuralgia is somewhat more common after the age of 60. Almost 50% of adults who develop shingles go on to experience post herpetic neuralgia.
There is no one standard treatment for all patients with post herpetic neuralgia. In most cases, the physician prescribes one drug and if that fails, another drug is selected. A trial and error philosophy is the classic method of treating this awful disorder.
Post herpetic neuralgia is somewhat more common after the age of 60. Almost 50% of adults who develop shingles go on to experience post herpetic neuralgia.
There is no one standard treatment for all patients with post herpetic neuralgia. In most cases, the physician prescribes one drug and if that fails, another drug is selected. A trial and error philosophy is the classic method of treating this awful disorder.
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