Prolotherapy an alternative for L4 L5 Spondylolisthesis
Prolotherapy as an alternative treatment for Spondylolisthesis: Prolotherapy is a great alternative treatment for spondylolisthesis. In other words, Prolotherapy is a great surgical alternative treatment for spondylolisthesis because surgery is the usual treatment course for this condition. What prompted the writing of this short article is a picture a patient drew for us. Please see the drawing below. When I saw this picture, I told him that this drawing may be the best representation I have received from a patient describing their symptoms. It was magnificent! Therefore I just want to explain it to you and tell you why Prolotherapy, in my experience, for almost all cases of spondylolisthesis, is the best alternative treatment option. For that matter, it is for sure the best alternative to surgery I have found! Prolotherapy, particularly Hackett-Hemwall Prolotherapy as done in this office, helps stabilize the vertebral segments, thus surgery, physical therapy, and other treatments are not needed.
What is Spondylolisthesis? Spondylolisthesis is the term used when the spinal vertebrae shifts forward or backwards in regards to the adjoining vertebrae. In the illustration below, the patient shows that the L4 vertebrae have slipped forward from the L5. Movement of less than 25% forward is called grade 1 spondylolisthesis. Grade 2 is 25-50% and so on. Typically grades 1 and 2 are treated successfully with Prolotherapy injections. A shift of more than half the vertebrae onto another will often pinch a nerve and when that happens, a surgical consult should also be done, as surgery may be needed. Grades 1 and 2? Definitely opt for Prolotherapy! Grade 4 – probable surgery. Grade 3 – see a Prolotherapy doctor and a surgeon and decide what is best for you!
A patient’s illustration: In the illustration the patient exhibits a sad face or downward angle of the lips, to show that in the extended upright posture, he has more pain. He feels that this is moving his vertebrae more forward which causes more pain. When his back is in the flexed position, the forces are heading backward and this is helping his back be in better position, also decreasing the stress on the spondylolisthesis. He drew a smile when his spine was in the flexed position. I hope his illustration and my explanation makes sense to explain how spondylolisthesis responds.
Treatment of Spondylolisthesis with Prolotherapy: In looking at the illustration, any treatment that helps the vertebrae with the spondylolisthesis move backward will most likely be helpful in alleviating the symptoms. Prolotherapy is given to the ligaments on the back of the spine to make this same correction. By tightening the ligaments in the back of the spine Prolotherapy helps stabilize the area thereby giving pain relief. I have been treating spondylolisthesis with Hackett-Hemwall Prolotherapy since 1993 and would definitely give it very high marks as an alternative treatment option for spondylolisthesis. I do not know of too many cases that have not responded well to Prolotherapy. Typically a patient will require 3-6 visits, although some patients require more visits depending on their overall health status and the extent of their injury.
What is the cause of Spondylolisthesis? Many of my patients will say to me, “Doctor, don’t you need to know the cause of the spondylolisthesis to treat it?” Typically you do not need to know the cause, particularly when it comes to using Prolotherapy. We do know that the area is weakened and lax. Thus, we can treat that. Spondylolisthesis can occur because of degeneration or may be due to genetic causes like pars interarticularis defect (spondylolysis). Bottom line treatment options are to live with it and take pain pills, get physiotherapy which we have not seen resolve the cases but may be somewhat helpful, get surgery (but most of us want to avoid surgery), or get Prolotherapy and have a nice life.
For the person suffering from low back pain, with an X-ray or MRI showing spondylolisthesis, who feels this patient’s illustration describes you, then come see us for a Prolotherapy consultation. Prolotherapy for this patient has been successful and stimulated his healing, and it is likely that it will be successful for you as well!
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