Symptoms caused by Spinal Instability
- Condition is progressively worsening.
- Diffculty with unsupported sitting and better with supported backrest.
- Frequent bouts or episodes of symptoms (recurrence, not first episode).
- Frequent episodes of muscle spasms.
- Giving way or back giving out, feeling of instability.
- Greater pain returning to erect position from flexion.
- History of painful catching or locking during trunk motions.
- Inability to “hold” a spinal adjustment.
- Long-term, chronic disorder.
- Need to frequently crack or pop the back to reduce symptoms.
- Pain during transitional activities.
- Pain increased with sudden, trivial, or mild movements.
- Rotational symptoms, different symptoms on different days.
- Temporary relief with back brace or corset.
- Worse with sustained postures or a decreased likelihood of reported static position that is not painful.
Modified from: Biely S, et al. Clinical instability of the lumbar spine: diagnosis and intervention. Orthopedic Practice. 18;3:06. Table 1.
These symptoms can be signs of the following back pain conditions caused by spinal instability that we commonly treat with Prolotherapy.
Chronic Conditions caused by Spinal Instability
Prolotherapy Treatment for Back Pain
Ninety-five percent of low back pain is located in a six-by-four inch area, the weakest link in the vertebral-pelvis complex. At the end of the spine, four structures connect in a very small space, which happens to be the six-by-four inch area. The fifth lumbar vertebra connects with the base of the sacrum. This is held together by the lumbosacral ligaments. The sacrum is connected on its sides to the ilium and iliac crest. This is held together by the sacroiliac ligaments. The lumbar vertebrae are held to the iliac crest and ilium by the iliolumbar ligaments. Any time these ligaments are injured or overstretched, it can create spinal instability. This is typically the area treated with Prolotherapy to stimulate ligament repair. Which specific solution to use is determined during the consultation and exam, and can include traditional dextrose, platelet-rich plasma, or stem cells, among other ingredients.
Almost all chronic low back pain occurs in a 6" x 4" area
Pain in the lower back occurs in the area where the lumbar vertebrae join the sacrum and iliac crest.
But what about my MRI? The reason for developing herniated discs, degenerated discs, spondylolisthesis, or other MRI diagnoses is spinal instability. If the instability is not corrected, a patient is more likely to continue on the course of “pain management” and use therapies and pain pills to temporarily calm the pain or get back into alignment. Remember, spinal instability is a progressive disorder, meaning that the area continues to degenerate until regenerative treatments are used to restore the area. As the structures continue to break down, they pinch on nerves and cause pain that can radiate down the legs and into the feet. It indicates that a patient’s referral pain patterns are being elicited. The sacroiliac ligaments refer pain down the posterior thigh and the lateral foot. The sacrotuberous and sacrospinous ligaments refer pain to the heel. The iliolumbar ligament refers pain into the groin area. Iliolumbar ligament sprain should be considered for any unexplained vaginal, testicular, or groin pain. Seeing spinal instability that causes radiating pain is quite common in our practice and, from a Prolotherapists perspective, easy to understand and correct.
Prolotherapy referral patterns
Ligament laxity can cause localized pain as well as refer pain to distant sites.
Our clinics have specialized in helping some of the toughest cases of chronic back pain since 1993. There is not much that we have not seen when it comes to low back pain. The primary advantage of using the Hackett-Hemwall technique with back pain is that it is more comprehensive. It consists of dozens of injections per treatment, versus only 1-10 as done by others performing less aggressive Prolotherapy (including PRP and Stem Cell therapy). We find that this is the most clinically effective and well-researched technique for long-term effectiveness. This is, in part, why patients travel to our clinics for back pain treatment from all around the United States and internationally. Generally, within just a few treatments, the ligament tissue has strengthened enough to better stabilize the spine, therefore, alleviating the pain.
Prolotherapy of the lower back
Injured capsular, sacroiliac and other ligaments can be thickened and strengthened with Prolotherapy.
Our Research on the use of Prolotherapy for Back Pain
In our own published research, 145 patients with chronic low back pain were interviewed an average of 12 months after their last Prolotherapy treatment. These patients, who had been in pain an average of four years and ten months, were treated quarterly with Hackett-Hemwall dextrose Prolotherapy. This included a subset of 55 patients who were told by their medical doctor(s) that there were no other treatment options for their pain and a subset of 26 patients who were told by their doctor(s) that surgery was their only option. In these 145 low backs, average pain levels decreased from 5.6 to 2.7 after Prolotherapy (scale of 1-10); 89% experienced more than 50% pain relief with Prolotherapy; more than 80% showed improvements in walking and exercise ability, anxiety, depression and overall disability; 75% were able to completely stop taking pain medications. The complete study and results can be read here: Hauser R, et al. Dextrose Prolotherapy for unresolved low back pain: a retrospective case series study. Journal of Prolotherapy. 2009;1(3):145-155.
(› 30 MINUTES OF EXERCISE)
Pain scale is 1-10 where 1 = no pain & 10 = unrelenting pain.
Summary of Results of Hackett-Hemwall Dextrose Prolotherapy Back Study
|Total number of patients||145||55||26|
|Avg. Months of pain||58||53||60|
|# of pain meds used before Prolotherapy||1.0||0.9||1.1|
|# of pain meds used after Prolotherapy||0.3||0.3||0.4|
|Pain level before Prolotherapy||5.6||7.1||6.0|
|Pain level after Prolotherapy||2.7||3.1||2.1|
|Stiffness level before Prolotherapy||6.1||7.0||6.1|
|Stiffness level after Prolotherapy||2.6||3.1||2.0|
|Greater than 50% pain relief||96%||89%||96%|
|Athletic Ability > 30 Minutes of Exercise before Prolotherapy||19%||30%||12%|
|Athletic Ability > 30 Minutes of Exercise after Prolotherapy||78%||81%||90%|
|Prolotherapy changed life for the better||97%||94%||81%|
We get patient satisfaction results. 97% of patients in this study felt that Prolotherapy changed their life for the better and 94% have since recommended Prolotherapy to someone else.
Our other studies on regenerative treatment outcomes for back pain
- Prolotherapy as an Alternative to Surgery
- A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain
- Evidence-Based Use of Dextrose Prolotherapy for Musculoskeletal Pain: A Scientific Literature Review
- Joint Instability Treatment with Prolotherapy
Patient Success Stories using Prolotherapy for Back Pain
KA was seen by a chiropractor for ringing in the ears. The chiropractor’s high velocity manipulations of her pelvis were too forceful, leaving KA with low back pain and spasms she never had before. After enduring 3 years of pain, KA sought Prolotherapy and received 4 treatments over a 4 month period for instability of the lumbar spine, successfully eliminating the lower back pain, spasms and crepitus.
High velocity chiropractic or self-manipulations can cause injuries and instability of the spine. Prolotherapy stabilizes the injured ligamentous structures eliminating pain and symptoms.
Multilevel Spondylosis after Multilevel Laminectomy
Despite chiropractic care and numerous allopathic modalities, JR received a multi-level laminectomy for back pain and sciatic symptoms. However, symptoms continued to progress to the point of “crawling on all fours.” MRI revealed multi-level spondylosis, osteoarthritis and degenerative disc disease, and an EMG showed right-sided radiculopathy confirming why pain radiated down the leg. JR received 3 Prolotherapy treatments, significantly improving all symptoms, including the ability to walk normally.
Laminectomy is an attempt to stabilize an unstable spine, but it is unsuccessful in treating instability long-term. Prolotherapy is effective post-surgery, but it is an even better treatment choice to stabilize the spine before surgery.
Bilateral Sacroiliac Pain
AL, a 41 year-old physician, suffered for 1.5 years with severe, jabbing, shooting low back pains after a sacroiliac (SI) injury. An MRI revealed a herniated and compressed nerve, for which his neurosurgeon recommended immediate microdiscectomy, followed by physical therapy. AL started to run, kayak and lift weights again, while taking Ibuprofen, and ended up re-injuring his SI. A rhizotomy was performed to deaden the sensory nerves, but the SI degenerated further. Five cortisone injections, acupuncture and osteopathic manipulations brought only minimal relief and AL became “fed up” with the traditional medical options. Difficulty lifting his newborn baby and the struggle to continue working led AL to seek Prolotherapy. After three treatments of Prolotherapy with PRP to the bilateral SI joints, AL improved by over 90%, was able to cease taking pain medications. He began to walk, jog, sprint and hold his baby again, pain-free. The amazing results inspired AL to become a student of Prolotherapy for his own practice!
Pain is our body’s way of telling us there is a tissue injury. Cortisone and ibuprofen cover up injury pain and can lead patients to continue training and working just as hard while the joint tissue continues to degenerate. Yet, the patient cannot necessarily “feel” it right away. This, of course, leads to further injury and more pain, and can create a vicious cycle. Prolotherapy does not cover up the pain. Rather, it stimulates repair of the joint tissue, giving patients a true sense of how stable the joint is, and allows for the natural use of the joint as it continues to strengthen over the coming weeks and months after treatment.
Sacroiliac Joint Dysfunction
KT developed low back pain in her early thirties and was diagnosed with fibromyalgia. For many years she dealt with her pain only receiving temporary relief from chiropractic adjustments. She came to Caring Medical at age 55 when her chiropractic adjustments were no longer “holding.” She was experiencing almost constant pain in her back which began to refer down both legs. Katie felt her condition was becoming more debilitating with each passing year. She was diagnosed with sacroiliac joint dysfunction and received 4 rounds of Comprehensive Prolotherapy. After her 4th treatment, she reported being “virtually pain-free” and back to a normal life!
Spinal instability is often worsened by regular spinal manipulation. The ligaments become like overstretched rubber bands that cannot hold the vertebrae in place and must rely more and more on the muscles, which eventually spasm and create tender trigger points. It is paramount in cases of fibromyalgia and back pain to be evaluated for joint instability and history of trauma, such as whiplash, and possible overmanipulation syndrome from constantly cracking the spine.
RV, a 24 year-old, injured his back playing football, but the injury went undiagnosed. Ten years later, he was diagnosed with spondylolisthesis and 2 out of 3 osteopathic surgeons recommended immediate surgery. The constant, diffuse neuropathic low back pain he experienced was exacerbated by lumbar extension and rotation. RV sought regenerative injection therapy as an alternative to back surgery, and after 2 Hackett-Hemwall dextrose Prolotherapy treatments combined with Neural Prolotherapy (Lyftogt Perineural Injection Treatment™), he experienced 100% relief from the nerve pain.
In most cases, surgery should be a last resort. Even though surgery may be the only option offered by a surgeon, the patient may be a very good candidate for Prolotherapy when examined by a Prolotherapist who specializes in spinal treatments. A comprehensive treatment various Prolotherapy techniques can effectively resolve neuropathic pain from spondylolisthesis.
More Information about Prolotherapy for Back Pain
Articles about Prolotherapy for Back Pain
- Why physical therapy and yoga did not help your low back pain
- Sacroiliac joint dysfunction and focus on spinal ligaments instability | Prolotherapy and PRP Prolotherapy treatments
- MRI causes Failed Back Surgery | Positive Spinal MRI readings in pain negative patients
- Piriformis muscle syndrome and sciatica
- Prolotherapy sciatica treatments
- Have you been diagnosed with wear and tear lumbar spondylosis?
- Lumbar spinal stenosis surgery alternatives | Comprehensive Prolotherapy
- Prolotherapy non-surgical treatment of a herniated or bulging disc
- Spondylolisthesis | Spondylolysis | Spondylisis | A problem of disc degeneration or ligament degeneration?
- Hip-spine syndrome leads to failed hip replacement and lumbar spinal fusion
- Surgery for degenerative disc disease compared to Prolotherapy for ligament instability
- Alternatives to Epidural Steroid Injections | why do patients still get epidurals?
- A shorter leg can cause joint degenerative disorders of the back, pelvis, and hip | Comprehensive Prolotherapy Treatment
- When Lumbar decompression surgery makes sacroiliac joint-related pain worse
- Prolotherapy and non-surgical treatment of lumbar radiculopathy
- Failed back surgery syndrome treatment options | Comprehensive Prolotherapy
- Abdominal fat causes back and nerve pain
- Post-laminectomy syndrome
- Controversy surrounding the diagnosis and treatment of Thoracic outlet syndrome | Is it really Thoracic outlet syndrome?
- Worsening pelvic pain in women treated with a spinal fusion
- Understanding spinal fusion surgery complications before the surgery
- Stem Cell Prolotherapy effective in halting and reversing degenerative disc disease
- Spinal instability and back pain
- Minimally invasive spinal surgery procedures research
- Iliolumbar Syndrome | iliac crest pain syndrome
- Does treating back pain also treat symptoms of anxiety and depression?
- Spondylolisthesis in the athlete | Vertebrae misalignment due to ligament weakness
- The longer you wait for back pain treatment, the worse your situation becomes
- Facet Joint Injections
Videos about Prolotherapy for Back Pain
Books about Prolotherapy for Back Pain
Read about treating back pain with Prolotherapy in our free E-book, Prolo Your Pain Away! Curing Chronic Pain with Prolotherapy, 4th Edition. This edition explains all about Prolotherapy and how it is used to permanently alleviate pain from arthritis, sports injuries, and all types of chronic pain conditions! Plus, it takes an expanded look at the medical literature and patient studies on Regenerative Medicine: Prolotherapy, Platelet Rich Plasma, Stem Cell Therapy, and more!
We Get the Best Results
In 9/10 cases we meet or beat the patients expectations. Our results are long lasting and provide permanent pain relief. This is why for 25 years, patients have been traveling from all over the world to see our providers. Give us a call, or fill out the form below to get started.