Reduction in pain levels & increased functional abilities were seen in excess of

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TREATMENT OF CONSECUTIVE SEVERE FIBROMYALGIA PATIENTS WITH PROLOTHERAPY

K. Dean REEVES,M.D.

ABSTRACT

The potential of tendon and ligament triggers as primary nociceptors in

fibromyalgia led to treatment of primary fibromyalgia patients with tendon

and ligament strengthening injection. Trigger injection of ligament and

tendon with proliferant (TILT therapy or prolotherapy) offers the advantage of

creating increased strength of the connective tissue in the region of

injection as well as affecting the pain cycle. Reduction in pain levels and

increased functional abilities were seen in excess of 75 % of patients with

severe fibromyalgia in this study. The implications of this for further study

are considered.

_http://www.getprolo.com/fibromyalgia_and_prolotherapy_reeves.htm_

(http://www.getprolo.com/fibromyalgia_and_prolotherapy_reeves.htm)

 

excerpt below

 

All regions of the body were noted to have less average pain after

injection.

 

Region

Average Pain before RX

Average Pain after RX

Head

5.81

3.77

Neck

7.00

4.45

Front of Shoulder

4.52

3.03

Top of Shoulder

5.68

3.55

Back of Shoulder

7.03

4.26

Elbow/Forearm

3.52

2.26

Wrist/Hand

3.00

2.00

Upper Back

6.23

4.03

Front of Chest

4.10

2.81

Mid Back

6.71

4.77

Low Back

6.77

4.90

Buttock/Hip

5.42

4.26

Thigh

3.94

2.81

Knee/Calf

3.10

2.42

Ankle

2.19

1.81

Foot

2.68

1.7

Whole Body

(average of above)

4.86

3.30

 

Table 1

Pain before and after tendon/ligament strengthening injection

(prolotherapy)

Table 2 depicts the functional outcome of injection. 21/31 patients

indicated their pain frequency was better, much better or gone, and 18/31

indicated their pain intensity was better, much better, or none. The

questionnaire

asked for an explanation of 'worse' or 'much worse' responses, with

reasons given of stress in 3/5, work in 2/5, needing to follow-up with no

insurance in 2/5, and don't know in 1/5. Two of these patients had only one

treatment. Improvement in sitting, standing, walking and sleeping ability in

minutes was noted to be about the same for each. Of particular interest from a

functional point of view was that of the 30 patients indicating problems

with tolerating light work,18 indicated they were better or much better at

tolerating light work, and 2 indicated they tolerated light work less. The

results were not so favorable for heavy work, with 9 indicating they tolerated

heavy work better and 6 less. The 6 indicating they were worse again gave

" stress " , " work " , " had to stop treatment " , or " don't know " as the reason.

AND

SUMMARY

The improvements in pain levels and functional ability after injection is

supportive of tendon and ligaments being a major source of symptomatology

in fibromyalgia. In order to make this treatment more practical further

studies to determine the relative importance of various ligament/tendon

nociceptors in fibromyalgia will be important. In addition it is hoped that

this

study will encourage basic science investigators to further research

homeostasis of connective tissue in fibromyalgia, as even microtrauma of daily

living in the presence of impaired homeostasis may sufficient to explain onset

of symptoms. The tendency of ligaments and tendons to refer pain and

numbness in non-radicular patterns and to inhibit muscular function to create

such symptoms as give-way weakness and a feeling of non-specific fatigue

could go a long way in explaining why physicians tend to mis-diagnose these

patients as having somatisation disorder. The lack of evidence for primary

psychiatric disorders as the cause for fibromyalgia has been set out in the

literature in a convincing fashion, but until the symptomatology of ligament

and tendon pathology is more widely recognized, the symptoms of fibromyalgia

will remain an enigma to most practicing physicians. 1

REFERENCES

1 Ahles TA, Khan SA, Yunus MB et al Psychiatric status of patients with

primary fibromyalgia, patients with rheumatoid arthritis, and subjects

without pain: a blind comparison of DSM-III diagnoses. Am J Psychiatry 1991

148(12):1721-1725

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