Prolotherapy & Connective Tissue Damage Syndrome

Why am I hurting, and no one seems to know what is wrong?

Mark L. Johnson, MD, FACS

Prolotherapy is certainly an important clinical tool to treat damaged connective tissue—ligaments, tendons, cartilage, meniscus, labrum, fascia, etc. But perhaps a greater contribution made by Prolotherapy is that it sheds light on an important medical mystery. That is, when someone has pain in a joint, or in the neck, or back, or when someone has symptoms going down an arm or leg, or various other distressing symptoms, what disease process is actually causing their symptoms? I see patients on a daily basis who have had the origin of their symptoms misdiagnosed. I hear patients on a daily basis give accounts of lengthy odysseys through the health care system, often involving multiple attempted treatments, including operations, who are not better, and perhaps worse, after all the medical attention they have received. Or I see patients with significant symptoms who have been told that “nothing” is wrong—because all their tests are “negative.” One can read the medical literature and see many purported mechanisms for back, neck, and joint pain. Then read the results of patient treatment based on these proposed mechanisms, and see failure rates that are remarkably high. One can also see in the literature a large group of patients who, at the outset, do not fit into any known “diagnostic category.” Practitioners cannot be exposed to diagnosing and treating patients with musculoskeletal pain for long before a question becomes glaringly obvious. “Are we missing something here—is there a disease process that is right under our noses every day that is poorly understood, or totally misunderstood, by the medical community at large?”

I believe that the answer is “Yes.” Thanks to observations gleaned from successfully treating thousands of painful joints with Prolotherapy, I think I have developed a fairly clear understanding of this disease process. Many of these observations have been made by others in the Prolotherapy community for decades. What has been lacking thus far is assembling these observations into a description of a disease process. That process can then be named and understood by the medical community, and the general community, in a way which explains the mystery of many misdiagnosed and undiagnosed body pains. To that end, here is an introduction to the Connective Tissue Damage Syndrome.