Prolotherapy fixes a problem most people do not know that they have…   My own introduction to the realm of ‘diagnostic issues’ related to pain of connective tissue origin came from my own back.  I injured my back at age 26 by moving a pickup truck load of railroad ties to edge a flower bed.   From this point on, my back would ‘lock up’ half a dozen times a year for a day or two, or a week or two.  This went on for 20 years.  Then, for 5 years, I had symptoms 24/7.  At age 49, I ended up in my own hospital for several days with ‘can’t get out of bed’ back pain.   I had my choice of Orthopedic Surgeons, since I ate lunch with them every day, so I picked the wise old man in the big Orthopedic group.  We looked at my MRI, and he detailed over half a dozen things that were ‘wrong’ with the discs and the bones at several levels.  He summed up by saying that i was looking at a several level fusion in the next few months, and should dramatically curtail my activities in the meantime.

During our discussion, I had not heard something that i, as a surgeon, needed to hear if we were discussing me having a major operation, so I framed the question directly:  “I heard the list of ‘what was wrong’ on the film, but where, exactly, was my pain actually coming from, and what was the proposed spinal fusion going to do to rectify this problem?”  The answer was very candid.  “Mark, there is some debate, some might say confusion, about the actual source of the pain.  But what we do know is that, with this operation, most people feel better, some do not, and some occasionally feel worse, so you want to put off the procedure as long as you can.”

What did he just tell me?  Or, more specifically, what could he apparently not tell me?   WHERE MY PAIN WAS ACTUALLY COMING FROM!  That lack of precision in the diagnosis deeply concerned me, particularly in relation to the recommendation that I undergo a major operation WITHOUT an ironclad diagnosis.  A month later, my flare up had flared down, and I was in Chicago for a weekend.  We happened to meet with an old friend from residency days, Dr. Ross Hauser.  That visit lead to the source of my back pain being accurately diagnosed (ligament damage subsequent to the injury at age 26), and by means of triggering my connective tissue healing system half a dozen times over the next year (Prolotherapy), this 25 year back problem was completely resolved.  Completely.   This was not just a transient improvement in symptoms.  I have had no back pain, except for a few minor injuries, in the last 10 years.  The ligaments were the problem.  And the word ‘ligament’ never occurred in the conversation with my Orthopedic Surgeon.  He was right:  he did not know the source of my back pain.

My wife experienced a related ‘diagnostic problem’.  Around the time that my  back was melting down, Holley was in a serious car accident.  After being struck on the drivers side door by a vehicle that ran a stop sign, impacting her car at 40 mph, she had activity-limiting back and neck pain.  That pain was worsening two years after the accident, after all the medication, exercise, and physical therapy that had been prescribed.  Another round of evaluation by two Orthopedic Surgeons and two Physical Medicine/Rehab physicians, including a CT scan, an MRI, and a 4 limb nerve conduction study, failed to uncover the ‘cause’ of her ongoing, severe pain.  The next recommended stop was a Pain Clinic.    So, rather than ‘something’ seen on film, she had ‘nothing’ seen on film:  she got a blank look, and the gentle inference that this might be more of a psychological issue than a physical issue.  The problem with that scenario is that I am a trained observer and know the physiologic ‘cues’ that someone is, or is not, in significant pain.  Believe me, she was in serious pain most of the time.  How can you explain this failure to diagnose what was CLEARLY a physical problem???  Because the highly trained, experienced, and caring physicians who were evaluating her had no idea that the ligament structure of her cervical and lumbar spine, and pelvic ligaments, were capable of causing the symptoms that she was describing, how to evaluate this possibility, or how to treat such a problem if they became aware of it…in other words, we are back to the ‘diagnostic problem’…

Holley’s neck and back problems were due to unhealed ligament damage from the motor vehicle accident that did not ‘show up’ on imaging.  These problems were, likewise, resolved by a course of Prolotherapy.    While I used imaging studies of all kinds on a daily basis in my Urology practice, I was just beginning to understand how much these studies are NOT the answer in the diagnosis of pain of connective tissue origin.

The source of all of my pain, and the source of all of my wife’s pain, was connective tissue.    What happened when the source of my pain, and my wife’s pain, was correctly diagnosed (by physical examination instead of imaging studies), and correctly treated?  Both of our issues were resolved.  I have not had ANY back pain for the last 10 years, with the exception of a few minor, discrete injuries (which either healed on their own, or received limited Prolotherapy treatment).  In other words, this was not just a transient ‘improvement’, it was a complete repair of the actual problem.  Holley, also, went from being a candidate for a ‘Pain Clinic’, to having a full and very active life without back or neck pain.  This clinical outcome for both of us got my attention as a physician, particularly in light of the discrepancy between the ‘diagnostic results’ of ‘standard’ (imaging based) medical approaches, and a diagnosis based on a simple physical examination.  And the fact that the diagnosis obtained by this exam lead to a common-sense treatment that completely rectified both of our serious problems—a treatment that was completely ‘different than’ the operation proposed to me by a very competent Orthopedic surgeon, and the ‘blank look’, ‘you’ll just have to live with it’ conclusion that Holley received after thousands of dollars worth of testing—this was even more stunning to me…