Prolotherapy

I'm 99% sure I've got a rotator cuff tear. Does anyone have first hand experience with Prolotherapy?

What is typical for recovery should I decide to go under the knife?

Hey Mike,

I tried prolotherapy this summer for a chronic swollen knuckle on my trigger finger. The finger would alternate between feeling strong, and just useless. After one prolo session, I am very happy to say that the thing hasn't bothered me since, despite the near constant abuse I give it through work and climbing.

I would say give it a shot, it can't hurt to try something a little more alternative before the blade.

JJ

Well, there is a reason not to give it a shot, actually. Or, to think it over carefully at least.

1. It costs a lot of f*cking money for an often very uncertain outcome. If you google prolotherapy you will find hundreds of sites/people/clinics making money off prolotherapy, nearly all claiming that it has been shown (anecdotally) to be 80-90% effective. I know of few scientifically researched treatments that yield 90% effectiveness across the board, so what are the odds that prolo does? Not very.

2. If you don't have an actual, cemented diagnosis by a medical professional yet, why in the world are you thinking of trying anything? You can't figure out treatment without really knowing what's going. (I'm assuming you don't have a diagnosis cause of the way you stated "I'm 99% sure..." but correct me if this is wrong.)

3. Even if you have a rotator cuff tear, I am not sure that prolotherapy would be of any benefit to you. Torn rotator cuffs (depending on how bad the tear is) are not likely to heal by injecting solutions of lidocaine and sugar water, esp. if the tear is large. If you have frayed flaps of tissue sticking into your joint or loose bodies floating around, prolotherapy will do absolutely nothing for the pain that may stem from those problems, either.

To my knowledge, prolotherapy is a better alternative for people with damaged/degenerated ligaments, tendons, and vertebral disks, but typically those structures are still essentially intact--not torn completely.

I would search "prolotherapy" on pubmed and see what real science comes up.

On the anecdotal side, baseball forums and other overhead sports would be sources to search as well. However, keep in mind that just because someone says, "It helped my shoulder a lot" doesn't mean you and they have the exact same things happening in your shoulder of the same magnitude. These differences can be very important. Also, the skill of the doc doing the prolo injection has a huge bearing on outcome, from what I've heard, not to mention that many use different formulations of irritant solution, making it even harder to have any real consensus on "what REALLY works."

Mike Lane wrote:What is typical for recovery should I decide to go under the knife?

I haven't had RC surgery myself, but I've worked in sports medicine assisting in rehabbing patients with them. Not all surgeries are the same. A shoulder debridement will have a far quicker recovery (maybe 6 weeks?) than someone who needs a repair of their biceps tendon or a RC tendon, etc. A repair is looking at 8 month recovery typically.

Eyes of Green, thanks a lot for your thoughtful response (you too Jeremy). I am not fully undiagnosed. I've done some review with my doctor, and he did some preliminary "does it hurt here" stuff; this was followed by an attempt to see if Therabands would help (they don't). My doctor tells me the next step is an MRI, which includes a dye injection.
With what I do for a living, I can't submit to anything involving more than a few days recovery, so surgery is really not an option. This pain is more of an annoyance than anything, so I'll just live with it for now. I'd really like to hear from folks who've had Prolotherapy or the Platelet-rich version, because the proponents just seem a little too eager to sell the benefits which makes me skeptical.

Jeremy Schlick wrote: it can't hurt

You don't know what a big giant pussy I am when it comes to needles....
My understanding is that these are pretty fat needles. Maybe if I got seriously liquored up first.
I tried to get a tat once, all I've got is a tiny blue dot on my shoulder and an assault charge to show for it.

Mike sorry to hear your not feeling well drat ~best wishes for strong fishes

M-
You say that the pain is more of an annoyance? If you can still use your shoulder and it's something like 80%+ functional, inlcuding climbing it seems like a severe injury is pretty unlikely and looking into some conservative care treatment (doing some consistent resistance training, finding a good massage therapist or checking into some myofascial release treatments) might be the better way to go.
Definitely having a more concrete diagnosis would make determining the best treatment options a lot easier.
good luck, BA

Mike,

If you have a rotator cuff tear, prolotherapy, massage or other non-evasive treatments won't do anything they could make it worse. If you decided to go under the knife it could take 3 to 6 months for a full recovery depending on the severity of the tear. I know friends who have had RC tear repairs and that is how long before they could even start climbing.

I thought I had a RC tear too, luckily I don't, and had the MRI w/the dye which is know as a MRA(arthrograph), a few months ago and if you don't like needles, you won't like the one they use to inject the dye!! It may be good to get the scan just to see what the problem with you shoulder before you decide anything.

Chris

Meier Orthopedic Sports Medicine wrote: Yes, Prolotherapy is best treatment ever because it help paitent to heal soon. If any one plaaning to take service of prolotherapy they can go to mosm website read about them you get some help.

Pretty sure this post right here tells you all you need to know about this approach.