Men in general take pride in strenuous working and sporting activities that place tremendous stress on the musculoskeletal system. Working in the construction industry, manufacturing, forestry, the military and other high physical demand jobs are areas where men excel. The masculine gender also shows an inclination toward physically demanding recreation and sporting activities such as boxing, wrestling, football and other physical contact sports. Men are therefore at risk for suffering a variety of musculoskeletal injuries, and their life demands often do not permit for enough downtime to allow injuries to heal or for the long recovery period following surgical interventions.

Prolotherapy is a recognized nonsurgical treatment alternative for painful conditions that stimulates the body's natural healing processes to strengthen joints weakened by trauma or arthritis. Joints weakened when ligaments and tendons are stretched, torn or fragmented become hypermobile and painful. Men commonly suffer from pubic symphysis (a fibrocartilaginous fusion between two bones) pain following a previous injury or while playing contact sports. The pubic symphysis joint may be stressed whenever the leg is pulled out from underneath a person, as can occur during a hit or a tackle. Swimmers that do the breast stroke often suffer groin pain from a pubic symphysis injury. Traditional approaches with anti-inflammatory drugs and surgery often fail to stabilize the joint and relieve pain permanently.

Regenerative medicine such as prolotherapy is the wave of the future because it stimulates the body to repair itself naturally, leaving stronger cartilage, tendons, ligaments and fascia. The treatment is 80 to 90 percent successful in treating a number of musculoskeletal conditions, and can be used to treat any painful joint or spine condition that involves damage or overstretched ligaments and tendons. Historically, it is the same treatment which Julius Caesar and his gladiators used to heal themselves centuries ago.

The treatment leads to growth of new ligament or tendon tissue in areas where these structures have become weakened. Ligaments hold bone to bone, whereas tendons hold muscle to bone. Ligaments and tendons can become weakened with overuse or be injured when exposed to excess stress. Ligaments and tendons only have so much ability to stretch before they tear, and are then slow to heal because of a low blood supply. Resultant pain from the damage to these structures is common because of the high number of nerves involved. Old injuries to ligaments and tendons can be a common source of chronic pain years after the injury.

Prolotherapy, at the simplest level, uses a solution of dextrose (sugar) and a local anesthetic  such as procaine or lidocaine that is injected into the ligament and/or tendon where it attaches to the bone. The sugar in the solution triggers a localized inflammatory response that stimulates blood flow into the area. As new blood flow enters the old injury, growth factors, nutrients and fibroblast cells stimulate healing of the tissue. The dextrose is the stimulant, but the body has the innate ability to do the healing itself.

In some instances, where a stronger healing response is needed, the patient will require platelet-rich plasma therapy or stem cell prolotherapy. Stem cells are extracted from the bone marrow or from fatty tissues. Some patients may require techniques such as trigger point therapy, neural prolotherapy and acupuncture, in addition to prolotherapy.

There is also another form of prolotherapy called prolozone prolotherapy, which utilizes medical-grade ozone injected into the joints, along with other healing homeopathic solutions to promote cartilage growth and to reduce pain.

Most patients typically require three to six treatments, administered from two to four weeks apart, depending on the severity of the condition and the patient’s overall healing ability. Occasionally, a patient may require more than six treatments as well as other therapies.

All joints in the body can be successfully treated with prolotherapy. Anyone with a history of injury and unresolved pain should consider it. If they have pain that arises after standing too long and then goes away briefly while sitting, only to force them to get up again, awake with pain that gets better with movement or have pain that gets worse when they put stress on a joint, prolotherapy should be considered.

Sheila Mohammed, M.D., Ph.D., is the owner of Industrial Medicine Institute, located at 4542 Alba St., in Pace. Contact her at 850-736-8401.