Joint instability as a cause of chronic pain and arthritis
Joint instability: The common denominator in chronic pain and degenerative arthritis
Ross A Hauser, MD
Why does Prolotherapy involve so many injections? I am commonly asked by our patients, “Why so many shots?” I am glad you asked! The main reason that I administer so many injections is due to the fact that most chronic pain and degenerative arthritis is caused by joint or spinal instability. A good way to give you an example of this is by illustration.
Please see the below illustration:
Description of joint instability in the wrist: Viewing from left to right, it is easy to see the wrist joint going from normal to severely degenerated. Where would you suspect the patient’s wrist pain is located? Yes, the most likely location of the wrist pain is right where the wrist is degenerated, between the radius and scaphoid bone. This is also called the radioscaphoid joint or junction.
What caused the wrist joint degeneration? Was it trauma to that joint? No, the cause was injury to the ulnar side of the wrist. The patient has wrist instability from injury to ligaments that support the ulnar side of the wrist. The connection between the ulna bone and the pisiform and triquestrum bones is not stable. The instability is also most likely due to weakness in the palmar and dorsal ulnocarpal ligaments. Thus, treatment needs to be directed at both the joint instability and the joint degeneration; which in this example are on the opposite sides of the wrist.
Joint instability treatment: Unfortunately for many, some physicians do not realize this very important point regarding relieving chronic pain and/or joint degeneration: The primary cause of the pain is the joint instability, which you can see is on the other side of the joint in this illustration!
As you may or may not know, many doctors have started using a treatment called platelet rich plasma (PRP) injections whereby the patient’s own blood is used as a Prolotherapy proliferant solution. Unfortunately for the patients, many are just receiving one injection into the joint. Just treating the joint degeneration with PRPP (Platelet rich plasma Prolotherapy) or human growth hormone for that matter (with or without x-ray guidance) into the joint is really is not the main issue. What is needed is Hackett-Hemwall Prolotherapy to treat not only the joint degeneration, but the underlying cause of the pain as well, which is ligament laxity causing joint instability in and around the joint! Hence the reason for so many injections!
What kind of Prolotherapy solution is best? I typically individualize a patient’s Prolotherapy solutions based on their medical history and the structures that I am injecting. One type of Prolotherapy solution may be best to heal a ligament injury and another type of solution may be best to heal joint degeneration. In my experience these two solutions are often different! Besides knowing what structures to inject, an experienced Prolotherapy doctor will know the best Prolotherapy solutions to use in each area requiring the injections. We are extremely experienced at Caring Medical – you name it, we have probably seen it here! This is why so many people fly in to receive care in our office – because of our experience, and the care that they receive from every member of our team.
View a video of Hackett-Hemwall Prolotherapy the wrist.
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