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When Dr. Koop was in his forties, he was diagnosed with intractable back and leg pain. One evening at a banquet in Chicago, he complained about his pain to the person next to him. The individual pointed to a man seated at the end of the banquet table and told him there was a the doctor who could help him. Later that evening, Koop introduced himself to Gustav Hemwall, M.D. Koop told him about his condition and the pain he experienced. "I can help you" Dr. Hemwall said. After listening to Hemwall's explanation about prolotherapy, Koop underwent the treatment and has no longer been troubled with pain. Based on his personal experience, Dr. Koop became an advocate of prolotherapy. He relates that as a practicing pediatric surgeon, he would sometimes observe the back and joint pain of the parents of his young patients. One day in particular he recalls noticing a young mother having difficulty putting on her coat. He asked about her problem and she responded she had bursitis in her shoulder. He asked is she would allow him to examine her. After doing so, he told her she did not have bursitis; rather the pain was from the nerves in her neck and shoulder. He told her about prolotherapy which eventually resolved the pain in her shoulder. Koop treated scores of parents in his pediatric practice with prolotherapy, never charging them.
By the time Les Hibdon has reached his late twenties, he had already experienced years of extreme back pain. Attributing the pain to a "bad back" he never realized he had strained the ligaments in his back through repeated sports injuries. He went to a prominent back clinic on the West coast in June 1995, where he was diagnosed with back instability and a herniated disc. He was given a cortisone injection and a regimen of exercises to strengthen his back muscles. But for the next five months he was bedridden. Surgery to fuse the spinal vertebrae was then postponed. At this point Hibdon contacted The Health Resource, Inc. for an individualized report on his severe back condition. His report contained information about prolotherapy. He admits that at first he thought the therapy sounded a "little quacky". However, he decided it might be worth trying before he consented to surgery. Hibdon located a physician in Houston, TX, experienced in prolotherapy. The severity of his condition necessitated long-term treatment. In December, 1995, he received treatments every other week. After the second set of injections, his condition was improved to the point that he was able to go shopping in a huge Houston mall for several hours. He said, "I'm reluctant to tell you of this dramatic improvement because it sounds like one of those 'miraculous cure' stories, but it is exactly what happened". Hibdon is now involved in stress reduction techniques, rather than prolotherapy. He relates, "I reached a plateau where I was no longer improving with prolotherapy. I decided to try something different, and so far, I am doing great!"
Ligaments, cable-like structures similar in design to a rope, hold joints and bones together. Auto accidents, falls, or repetitive movements can cause ligaments to become slack or tear, much as a rope stretches, separates, or frays. Over time, the consequences may be joint damage, disk degeneration, and pain. Prolotherapy involves injections of an irritant-usually concentrated glucose-into areas where ligaments are weak or damaged. The injection must be precisely at the junction of a bone with a ligament. Dr. Koop stresses that injections that are not given at this junction could be inetteclual and even dangerous. Multiple injections are given in one sitting because one injection affects an area limited to 5mm (3/16 in) in diameter. Koop says he has injected as many as twenty sites in the same sitting. The body responds to the irritant solution with inflammation, although Koop stresses this inflammation is a "sterile" inflammation and should not be confused by an infection. This "sterile" inflammation, in turn, triggers the development of healthy new ligament tissue. Usually the patient feels fine for four to eight hours after the injections because a local anesthetic is given with the irritant. Discomfort from the injections slowly disappear over the next several days. For some, a single treatment of multiple injections is adequate; for others, it is necessary to extend treatments over a period of weeks or months. Length of treatment depends on the severity of the patient's condition as well as the patient's response to the treatment. Prolotherapy is covered by many major health insurance companies.
Patients with chronic back pain who have not responded to physical therapy, medication, chiropractic manipulation, and other conservative measures may be candidates for prolotherapy. In fact, any condition involving loose or slack ligaments may be treated effectively with the therapy. Conditions that have responded to this treatment include spine instability, scoliosis, degenerated discs, sciatica, arthritis, temporomandibular joint (TMJ), and some hip, shoulder, wrist, elbow, knee, and ankle pain.
Approximately 300 orthopedic and osteopathic physicians in the U.S. and Canada use prolotherapy in their practices. To obtain a list of prolotherapists in your area, contact : American Association of Orthopedic Medicine in Colorado (719-475-0032) or American Osteopathic Association in Illinois (312-280-5800 or 800-621-1773).
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pain as 'incapacitating". "My pain was so severe when I lay down" said Koop, "that many nights I would go to sleep propped up with pillows leaning against a window sill".