A Treatment for Subluxation of the Temporomandibular Joint

Schultz, Louis W.

doi:10.1001/jama.1937.02780390034012

Cited by 76 publications

(23 citation statements)

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“…Case series have documented the efficacy of prolotherapy for many ligament injuries: the sacroiliac joint [187][188][189], lower back [190,191], neck [192,193], shoulder [194], elbow [195], knee [196,197], temporomandibular joint [198,199], and other articulations [200,201]. …”

Section: Prolotherapymentioning

confidence: 99%

Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics

Hauser¹

2013

TOREHJ

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Ligament injuries are among the most common causes of musculoskeletal joint pain and disability encountered in primary practice today. Ligament injures create disruptions in the balance between joint mobility and joint stability, causing abnormal force transmission through the joint, which results in damage to other structures in and around the joint. The long-term consequence of nonhealed ligament injury is osteoarthritis, the most common joint disorder in the world today.Ligaments heal through a distinct sequence of cellular events that take place in three consecutive stages: an acute inflammatory phase, a proliferative or regenerative phase, and a tissue remodeling phase. The process can take months to resolve itself, and despite advances in therapeutics, many ligaments do not regain their normal tensile strength.Various diagnostic procedures have been used to determine and assess ligament injury. Traditionally, MRI and X-rays have been the most utilized techniques; however, because ligaments do not show up clearly with these devices, there have been many false positives and negatives reported due to inconclusive or inaccurate readings. Newer technologies, such as ultrasound and digital motion X-ray, are able to provide a more detailed image of a ligament's structure and function.Numerous strategies have been employed over the years attempting to improve ligament healing after injury or surgery. One of the most important of these is based on the understanding that monitoring early resumption of activity can stimulate repair and restoration of function and that prolonging rest may actually delay recovery and adversely affect the tissue's response to repair. Likewise, there is a shift away from the use of steroid injections and nonsteroidal antiinflammatory medications. Although these compounds have been shown effective in decreasing the inflammation and pain of ligament injuries for up to six to eight weeks, their use has been shown to inhibit the histological, biochemical, and biomechanical properties of ligament healing. For this reason their use is cautioned against in athletes who have ligament injuries. Such products are no longer recommended for chronic soft tissue injuries or for acute ligament injuries, except for the shortest possible time, if at all.Regenerative medicine techniques, such as prolotherapy, have been shown, in both case series and clinical studies, to resolve ligament injuries of the spine and peripheral joints. More research and additional studies are needed to better assess ligament injuries and healing properties.

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Section: Prolotherapymentioning

confidence: 99%

Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics

Hauser¹

2013

TOREHJ

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“…10 Prolotherapy has been used in a form recognizable to contemporary pracDavid Rabago, MD 1 titioners for at least 75 years; the earliest substantive report appeared in the allopathic literature when the technique was referred to as sclerotherapy as a result of the scar-forming properties of early injectants. 13 Contemporary injection techniques were formalized in the 1950s, when the more commonly used term prolotherapy (from proliferant therapy) was adopted based on the observation that a larger cross-sectional area of ligamentous tissue was seen after prolotherapy injection in animal models.…”

Section: Introductionmentioning

confidence: 99%

Dextrose Prolotherapy for Knee Osteoarthritis: A Randomized Controlled Trial

Rabago

Patterson

Mundt

et al. 2013

The Annals of Family Medicine

154

150

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PURPOSE Knee osteoarthritis is a common, debilitating chronic disease. Prolotherapy is an injection therapy for chronic musculoskeletal pain. We conducted a 3-arm, blinded (injector, assessor, injection group participants), randomized controlled trial to assess the effi cacy of prolotherapy for knee osteoarthritis. METHODSNinety adults with at least 3 months of painful knee osteoarthritis were randomized to blinded injection (dextrose prolotherapy or saline) or athome exercise. Extra-and intra-articular injections were done at 1, 5, and 9 weeks with as-needed additional treatments at weeks 13 and 17. Exercise participants received an exercise manual and in-person instruction. Outcome measures included a composite score on the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 100 points); knee pain scale (KPS; individual knee), postprocedure opioid medication use, and participant satisfaction. Intention-to-treat analysis using analysis of variance was used.RESULTS No baseline differences existed between groups. All groups reported improved composite WOMAC scores compared with baseline status (P <.01) at 52 weeks. Adjusted for sex, age, and body mass index, WOMAC scores for patients receiving dextrose prolotherapy improved more (P <.05) at 52 weeks than did scores for patients receiving saline and exercise (score change: 15.3 ± 3.5 vs 7.6 ± 3.4, and 8.2 ± 3.3 points, respectively) and exceeded the WOMAC-based minimal clinically important difference. Individual knee pain scores also improved more in the prolotherapy group (P = .05). Use of prescribed postprocedure opioid medication resulted in rapid diminution of injection-related pain. Satisfaction with prolotherapy was high. There were no adverse events.CONCLUSIONS Prolotherapy resulted in clinically meaningful sustained improvement of pain, function, and stiffness scores for knee osteoarthritis compared with blinded saline injections and at-home exercises. Ann Fam Med 2013;11:229-237. doi:10.1370/afm.1504. INTRODUCTIONK nee osteoarthritis is a chronic disease resulting in joint pain, stiffness, and decreased function.1 It is common, expensive for patients 2 and society, and age-related 3 ; by age 65 years, most of the population has radiographic evidence of osteoarthritis. 4 Sources of pain include intra-articular and supportive extra-articular structures. 5,6 Standard-of-care is multidisciplinary; however, a recent systematic review reported no clear benefi t of any one therapy. 4 Conservative therapies 7 and oral supplements 8,9 have been evaluated but are without clear effi cacy. The Agency for Healthcare Research and Quality has called for the development of new therapies to prevent and treat knee osteoarthritis. 4 Prolotherapy is an injection therapy for chronic musculoskeletal injury, including knee osteoarthritis. [10][11][12] A core principle is the injection of small volumes of an irritant solution at multiple painful ligament and tendon insertions and in adjacent joint spaces over several treatment sessions. 10Prolotherapy has be...

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“…It emerged in 1937; the first substantive allopathic report referred to ''sclerotherapy'' due to the scar-forming properties of early injectants. 9 Current injection techniques were formalized in the 1950s; the term ''prolotherapy'' (from ''proliferant therapy'') was adopted when early researchers noted that ligamentous tissue exhibited an enlarged cross-sectional area after prolotherapy injections in animal models. 10 Literature of modest methodological rigor from the 1930s to the early 2000s reported positive clincal outcomes.…”

mentioning

confidence: 99%