Chronic pain is a pain that persists for weeks, months or even years. Sometimes the pain is triggered by an injury. But the symptoms persist long after the injury has supposedly healed. In some cases, the cause of chronic pain can't be identified.

According to the American Pain Foundation, chronic pain affects 76.2 million people in the U.S. - more than one-fourth of all Americans. It's more common than diabetes, heart disease, stroke and cancer combined. Chronic pain affects women more often than men. The cost of the condition, in terms of healthcare, lost productivity and lost income, is about $100 billion yearly.

Ligament Injuries as a Source of Chronic Pain

Ligaments are the tough bands of tissue that attach one bone to another in a joint. They provide support for the joint and are somewhat flexible to allow for movement. But ligaments are not elastic and can tear or fray when overstretched.

A ligament can be injured when a person twists too quickly or suddenly, during forceful maneuvers, after an injury (like whiplash or a sprain) or during heavy lifting. Inflammation signals the first stage of the body's healing process. Specialized white blood cells clean out bacteria and cellular debris at the site of the injury. Then growth factors are released to stimulate growth of new blood vessels, a matrix for tissue growth and cells to make new sections of the ligament.

A ligament that heals correctly will have normal strength. If the healing is incomplete, the strands of tissue may stretch or remain broken. The fibrous connection between the two bones becomes "loose," reducing stability in the affected joint. Patients may experience pain and discomfort when moving the affected area of the body. Numbness and tingling may occur in the area of the joint or some distance away from the joint.

Prolotherapy for Chronic Pain

Prolotherapy is a method in which substances are injected into a site to produce a controlled, intentional injury. Some commonly used materials include phenol, hypertonic glucose, dextrose, a local anesthetic and finely ground pumice or calcium chloride. The injections can be painful. But the process initiates the body's natural healing process, hopefully enabling production of new fibers and restoring the strength and length of the affected ligament.

Prolotherapy is not a new therapy. Ancient writings suggest a form of prolotherapy was used by Hippocrates. Today, it is considered to be a form of alternative medicine. One survey found nearly six percent of respondents have used prolotherapy in the past year. More than eight percent had ever used the therapy.

Orthopedic Surgeon, Alvin Stein, M.D., recommends patients try prolotherapy before resorting to surgery. In some cases, the treatment may promote enough healing to alleviate pain and restore function, eliminating the need for surgery. More than one injection may be needed and patients typically require multiple sessions (as many as 10) until the symptoms resolve.

There aren't a lot of large studies to back up claims of healing with prolotherapy. However, some research suggests up to 82 percent of all patients are able to return to work and resume normal activities after receiving prolotherapy injections. The National Center for Complementary and Alternative Medicine is currently conducting Phase I/II clinical trials of prolotherapy for knee pain caused by osteoarthritis.

Prolotherapy is not covered by all insurance companies. However, it is sometimes covered by Workers Compensation. The treatment is also not recommended for patients with allergies to any of the injected materials, patients with bleeding disorders and those taking anticoagulant medication. Side effects of the treatment are usually temporary and can include: pain at the injection site, stiffness, bruising and numbness.

Dr. Stein provides information about prolotherapy on his website at www.proloshot.com. For more information on prolotherapy:

American Association of Orthopedic Medicine

For information about chronic pain:

American Chronic Pain Association

American Pain Foundation

National Institute of Neurological Disorders and Stroke