Prolotherapy Vs. Surgery
Why Prolotherapy Is a Better Treatment Option Than Surgery
Chances are you know someone who’s had a hip replacement, or someone who’s had knee surgery. And chances are many of these people are younger than you’d expect. Total hip replacements used to be reserved for people in their mid-60s to mid-70s, but now individuals in their mid-40s, and even some in their 20s, are receiving joint replacements. Why is that? Although it’s hard to say definitively, there does seem to be a strong correlation between the traditional medical approach to injuries and chronic pain and surgery.
Let’s say you’ve sprained your ankle, either while playing sports, or maybe when you tripped over your toddler’s toy trains. The typical treatment is RICE, which stands for rest, ice, compression and elevation. If this doesn’t help, non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen or Motrin may be prescribed. This leads to stronger NSAIDs, cortisone shots, arthroscopy and, eventually, an ankle fusion. Now your ankle has limited mobility, and over the years you find out you’ve developed arthritis in your ankle joint.
The number of people needing joint replacement surgery is directly correlated to the number of people who are developing arthritis, which is directly related to the number of people receiving cortisone injections, arthroscopy, RICE treatments and anti-inflammatory medicines over the past 40 years. These treatments all accelerate cartilage breakdown tremendously, and thus also accelerate the arthritic process. Welcome to the cartilage crisis!
The surgery option
So what types of surgery are we talking about, and where does cartilage fit in? Most of the joints in the body are synovial joints, or freely movable joints. These joints function as a result of the unique properties of the articular cartilage that covers and protects the ends of the bones. If the cartilage is damaged or removed, so is the functioning of the joint, which suffers as bone rubs against bone instead of cartilage over cartilage. In other words, healthy cartilage means healthy joints. Unfortunately, traditional medical treatments for injuries, including surgery, almost always compromise cartilage.
Surgery can be broadly classified into open repair, in which a surgical incision is made for direct access and visualization of the injury site, and closed, or arthroscopic, repair, in which a miniature camera is used to look into the joint through a small hole, and specially designed tools are used to repair the tissue. Surgery almost always involves the removal of bone, ligaments and tendons. Many different types of surgery are common, including:
- rotator cuff surgery: arthroscopic surgery done to clean scar tissue and damage to the joint surfaces, as well as repair the tear of the rotator cuff
- hip replacement: replacement of the joint in which the diseased bone tissue and cartilage is removed from the hip joint, replacing the head of the femur (the ball) and the acetabulum (the socket) with new, artificial parts; the healthy parts of the joint are left intact
- knee surgery, also called arthroscopy: although intended to “explore” the knee joint to determine the cause of the problem, it usually involves some scraping, burning and/or cutting of valuable cartilage
- laminectomy: the most common back surgery, which involves the surgical removal of the posterior arch of a vertebra; results in problems similar to those of a discetomy (see below)
- lumbar spinal fusion: fuses vertebrae together, which often leads to ligament laxity and spinal instability as other parts of the spine attempt to compensate for this new, rigid section
- ankle fusion: similar to a spinal fusion, it fuses the shinbone to the talus, immobilizing an area to eliminate pain, but often leading to more pain due to ligament laxity and compensation in other areas and joints
- discectomy: a disc is removed to alleviate lower back pain; this often results in more back pain as the surgery causes ligament laxity and instability of the spine
How surgery hinders healing
Unfortunately surgery usually does not fix problems; it creates them. Taking a scalpel and slicing open muscles and fascia, and removing disc, cartilage and ligament tissue weakens the injured joints. Nevertheless, athletes with pain often succumb to surgical procedures, even drastic ones. A good example of drastic surgery is the recommendation to surgically remove the patella (kneecap) in order to eliminate the pain. Although this sometimes does in fact relieve the pain, it does so at a significant cost to the body. The strength to extend the knee is reduced by about 30 percent, and the force exerted in the knee is increased.
Few injuries, and especially sports injuries, all of which almost always involve the ligaments and tendons, require surgery. High-tech diagnostic tools, such as MRIs and CT scans, are used to determine the need for surgery, yet do not accurately diagnose ligament and tendon injuries. A common myth is that MRIs will show the problem and that surgery will fix the problem. Not true. In addition, MRIs have frequently shown problems when there are none. The result: unnecessary surgery fraught with all kinds of complications. Read on for a convincing list of why to avoid surgery.
Reasons to avoid surgery of the ankle or other joints:
- Surgery is traumatic; it puts stress on the body and could cause the individual to feel less confident using the surgerized limb. This particularly applies to athletes.
- Surgery irreversibly alters the individual’s anatomy.
- Surgery potentially involves all kinds of complications. For example, one study of arthroscopic ankle fusions showed an overall complication rate of 55 percent, including infections and continued pain.
- Surgery can lead to long-term arthritis due to the removal of significant tissue that is needed to help the body bear weight, such as cartilage, meniscus and disc tissue.
- Rehabilitation is much longer after surgery than for more conservative measures, such as Prolotherapy.
- The cost of surgery is astronomical compared to Prolotherapy: Prolotherapy of the ankle runs a few hundred dollars versus upwards of tens of thousands of dollars for, for example, an ankle operation and all of the hospitalization and rehabilitation expenses.
- Surgery does not always resolve the pain, which either means it did not address the cause of the pain, or that it caused another problem.
- Because there’s a better way…Prolotherapy.
The consequences of surgery, even “small surgery” such as arthroscopy, can be disastrous. Prolotherapy has been shown to be a much more viable and effective treatment option because it stimulates the body to repair the injured ligament and tendon tissue. In a very short time, the ligaments and tendons are stronger, and the injury pain and weakness are eliminated. Prolotherapy can also significantly decrease the rehabilitation time for an injury to heal. For athletes who have already had surgery, Prolotherapy has a high success rate for strengthening the surgerized area. Let’s look at how Prolotherapy heals.
How Prolotherapy promotes healing
Doctors who are using Prolotherapy to treat injuries have found dramatic results. For example, one doctor newly trained in Prolotherapy discovered an 80 percent drop in the number of arthroscopies of the knee and an almost total disappearance of back surgeries performed since he learned and started doing Prolotherapy. Is it too good to be true? Nope. Read on.
Prolotherapy works because it gets at the root cause of injuries, namely ligament and tendon injury, and it does so without the need for ordering a lot of tests like MRIs, which often lead patients, and especially athletes, to receive treatments like arthroscopies and other surgeries that are unnecessary. Prolotherapy stimulates the body to repair painful areas by inducing a mild inflammatory reaction in the weakened ligaments and cartilage. The inflammation causes the blood supply to dramatically increase in the ligament, alerting the body that healing needs to take place. In the simplest terms, Prolotherapy stimulates healing. As a result, it can help heal injuries and cause the ligaments and tendons to be even stronger than they were before they were injured. Even athletes who have had surgery can have Prolotherapy to the surgical site. And since unhealed sports injuries can lead to arthritis, Prolotherapy can help stop athletes from ever getting traumatic arthritis. Even if some arthritis has already formed, Prolotherapy can help strengthen the arthritic area and help eliminate the pain.
In summary, traditional orthopedic surgery treatments with anti-inflammatories, cortisone shots, arthroscopy and surgery do nothing to repair injured areas, but instead weaken them. Anti-inflammatories and cortisone shots stop the natural healing mechanisms of the body, thus diminishing the chances of healing. When enough deterioration occurs in the tissue, sports medicine specialists, whose treatments encouraged the degenerative process in the first place, will recommend surgical cleaning and scraping of the area—removing such vital structures as articular cartilage and menisci. The result: some 400,000 knee and hip replacements are done in the United States annually, with a good percentage of the patients being former athletes. The choice: surgery that involves the removal of bone, ligaments and tendons or Prolotherapy, which involves the repair, growth and healing of these structures.
Note: Although there are many reasons to avoid surgery, there is a place, albeit small, for surgery when dealing with chronic pain. Patients who have excruciating pain from a truly pinched nerve causing weakness, or in cases where there is evidence of bowel or bladder difficulties along with the pain require a surgical evaluation. In addition, complete tendon repairs usually require surgery as well.
We would love to learn more about your case and see if we can help you avoid surgery with Prolotherapy. Contact us to tell us more about your condition.