Prolotherapy: A great alternative for post-stroke pain
By Ross A. Hauser, M.D., Prolotherapy Doctor
Recently we received the below email at drhauser@caringmedical.com:
Dr. Hauser,
I had a stroke last July, and now have post stroke pain in my left arm. I am curious to know how Prolotherapy might help me. I understand how it may help for injuries to a foot, knee, or neck, but how can it help for post stroke pain? My pain is cause by damaged brain cells, so am I to understand that you can inject this Prolotherapy solution into my brain? Even if you injected into my arm, I don’t think that would work since my pain is originating in my brain.
I look forward to your response.
Kind regards,
EB from CA
FROM DR HAUSER:
Dear EB:
Sorry about your stroke but glad that you emailed. You probably are aware that I am a Physiatrist, which is a specialist in Physical Medical and Rehabilitation, so I’ve cared for a lot of folks post-stroke. About 800,000 folks have strokes every year in the United States. What you probably don’t know is that of those with some left upper extremity weakness, 70-84% of them end up with shoulder pain to varying degrees. So realize your condition is very common. So I am going to give you some of the reasons for this left upper extremity pain and the good news is that Prolotherapy is a great treatment for all or most of them. Please read below.
Shoulder-Hand Syndrome: Shoulder-hand syndrome is a type of complex regional pain syndrome where the pain is mediated through the autonomic nervous system. Often the person has a swollen hand, but mostly they suffer with severe shoulder and hand pain. The pain then causes a rapid loss of range of motion of the shoulder.
While physical therapy to maintain motion is helpful, the results are suboptimal. Personally, I think the weakness in the muscles puts great strain on the ligaments, so what ends up happening to the person is he develops shoulder subluxations and that this is mainly what is aggravating the nervous system. So Prolotherapy to the shoulder I have found is very helpful for strengthening these lax ligaments in the shoulder. Once the ligaments are tight, a lot of the pain remits. So if this is your particular problem, then definitely get an evaluation for Prolotherapy. We would love to see you!
Shoulder Subluxation EB, sometimes the pain is just in the shoulder. If you have a loose shoulder, again because you don’t have the muscle strength yet back in your left upper extremity, then this could be the cause of your pain. Shoulder subluxation is characterized by the presence of a palpable gap between the acromion and humeral head. Again I have found Prolotherapy extremely helpful at tightening the structures that support the shoulder and the shoulder subluxation pain starts to remit. I should state that getting Prolotherapy doesn’t preclude you from using physical therapy, some medications, and other physical medicine modalities for the pain.
Along with the above, some other conditions that can cause your shoulder pain can include:
· Bicipital Tendinopathy
· Rotator Cuff Tear (have you had an MRI?)
· Impingement Syndrome
· Adhesive Capsulitis
Again, the above conditions can easily be treated with Prolotherapy, along with physical therapy.
Okay, let’s just say that your pain is from the stroke itself. Realize, EB, however, in my experience this is typically not the case. So you are saying that perhaps you have centrally mediated pain.
Can Prolotherapy Help Post Stroke Pain Located in the Brain? My answer might surprise you but the answer is yes. Again the logic of it is the same. When you have a stroke, often weakness accompanies the pain on one side of the body, which in your case is the left side. This left sided muscle weakness puts additional strain on the all the ligaments on the left side of your body. By getting Prolotherapy to tighten up these ligaments, the pain starts to remit. The logic goes this way:
The stroke causes left sided weakness. The stabilizing musculoskeletal structures on the left side of the body such as the joints and ligaments have additional strain put on them. These structures then activate the autonomic nervous system to fire. This is the cause of the pain. Medications are only partially helpful because they do not address the underlying cause of the problem which is ligament laxity or joint instability. Because Prolotherapy addresses the ligament laxity and joint instability, the pain starts to diminish.
How Long Does It Take to Decrease Post-Stroke Pain with Prolotherapy? Generally, I tell patients they should be seen at least monthly for around six visits. Often this is all that is needed, but sometimes a few more sessions are needed. To speed up the healing process often I will recommend Hauser Diet Typing, Food Sensitivity Testing, and a comprehensive hormone panel. The reason for the latter is I have found that strokes cause hormone levels to decline and that by providing natural hormone replacement, that in and of itself decreases pain. It also helps the person heal from Prolotherapy.
EB, thanks for the email and hope the above information helped.
If you or someone you love is suffering from post-stroke shoulder pain, we would love to help you. Give us a call at 708-848-7789 or email us at scheduling@caringmedical.com.
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