Trigger Point Injections/Prolotherapy

Prolotherapy

Prolotherapy, also called proliferation therapy, is an injection-based treatment used in acute and chronic musculoskeletal conditions. It has been characterized as an alternate medicine practice. According to the American Osteopathic Association, it is recognized orthopedic procedure that stimulates the body's healing process to help strengthen and repair injured and painful joint, muscles, and connective tissues. The Mayo Clinic defines prolotherapy (Proliferation Therapy) as "an injection procedure, in which, an irritant solution is introduced into a joint, tendon, ligament, and/or muscle as a complementary treatment for pain. The irritant, usually, a sugar solution, is thought to trigger growth in the connective tissue leading to healing". There are several natural injectable options available, such as Dextrose (sugar water), saline (salt water), vitamin B, and plant and/or mineral extracts.

TRAUMEEL

TRAUMEEL, a preparation with bio-regulatory effects is the most common injectable. It helps to reduce symptoms associated with acute and chronic musculoskeletal injuries, including, pain and swelling. TRAUMEEL is a fixed combination of 12 biological and 2 mineral extracts which aims to apply stimuli to multiple targets to restore normal functioning of regulatory mechanisms. A paper presented in the International Journal of General Medicine (03/25/2011) states "the accumulating evidence of TRAUMEEL action on the inflammatory process, and it's efficacy and tolerability in randomized trials, as well as, observational and surveillance studies for the treatment of musculoskeletal injuries, has shown comparable effectiveness to non-steroidal anti-inflammatories in terms of reducing symptoms of inflammation, accelerating recovery, and improving mobility, with a favorable safety profile".

What to expect following PROLOTHERAPY:

The treated trigger points will be sore for a few days. Most patients feel significantly better about the fourth morning post-injection. Fair-skinned and older patients may experience slight bruising. Be aware that treating one set of Trigger Points might "awaken" another set of latent Trigger points to become symptomatic. Limit physical strain of the upper back and neck for 3 days post-injection (no weight lifting, upper body workout or lifting about shoulder height). Gentle stretching exercises will be of great value after therapy.

Trigger Point Injections:

At the Remedy Clinic, we understand the complex relationships between musculoskeletal trigger points andreferred pain. We use a number of treatment options to greatly reduce or eliminate discomfort.

In 1942, Dr. Janet Travell first described myofascial trigger points as focal “knots” located in a taut band of skeletalmuscle. When the taut band is palpated, it produces a characteristic referred pain in conjunction with local pain.

Trigger points should not be confused with tender points (tender points produce a focal nodule that producespain directly under the palpation but do not refer pain to a different area).

Trauma, or repetitive micro-trauma, leads to stress of muscle fiber and trigger points may develop. Micro-traumas are caused by repetitive motion, including forward head posture (stiff raised shoulders and neck compression), poor sleeping posture, and raising arms for an extended period of time (construction workers, hairdressers and dentists). Pain and tightness at trigger points may cause decreased range of motion, stiffness, tinnitus, head, neck, ear and shoulder pain, TMJ pain, eye symptoms, wakening from sleep, and torticollis. Trigger points may also be associated with chronic musculoskeletal system disorders.

Patients can present with several trigger points throughout the musculoskeletal system. Different treatment modalities include physical manipulation, ultrasonography, and the Spray and Stretch techniques, all of which may be used to relive stress at the trigger pint, thereby reducing referred pain.

Injections made directly into the trigger point (Trigger Point Injections, TPI) can greatly reduce or eliminate pain both at the injection site and at the referred location. TPIs cause a temporary relaxation of the taut muscle cord, which allows for improved perfusion, ATP replenishment (causing lengthening of muscle fiber), and the removal of metabolite waste. TPIs disrupt the taut band and increase vascular supply can so the body can heal the muscle. Lidocaine or Prolotherapy such as, sterile saline can be injected into the taut band. Trigger Point Injections using Lidocaine are performed at the Remedy Clinic so there is minimal to no discomfort for the patient.

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