Neck Pain Issues can be Treated With Prolotherapy

Neck pain is a common condition affecting 70% of the population at some time over their lifetime.
a woman suffering neck pain

While there is some agreement on how to treat acute neck pain, there is much debate on how to treat chronic neck pain. Current conventional therapy for unresolved neck pain such as medications and steroid injections have high side effect and uncertain outcomes. Therefore many patients are searching for alternative treatments such as Prolotherapy.

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“Dextrose Prolotherapy for Unresolved Neck Pain"
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Doctor Hackett's - Head and Neck Referral Pain Patterns 

Even though the average human head weighs 11 lbs. it is seemingly almost weightless when the neck's weave of muscle, tendons, ligaments and cervical vertebra are healthy. If this intricate balance is affected by injury or trauma this weight will put a lot of stress on the entire body and more than just neck pain can occur. The instability stimulates nerves triggering "referring" pain into the extremities.

One of the pioneers of prolotheerapy protocol, George Hackett, MD, developed pain referral patterns during his research into treating joint instability. As Dr. Hackett discovered, when ligaments and tendons are compromised with laxity and tearing, the weight of the skull on the destabilized cervical vertebra can put unusual pressures on the spinal nerves triggering sensations of pain throughout the upper-body, head and, in many cases, causing weakness in the hands and arms. Dr. Hacket developed the referral patterns guide as a way to know where to use injection therapy to heal connective tissue and re-stabilize the heavy weight of the head on the cervical column, taking pressure off the nerves. Due to the complexities and intricacies of the neck's anatomy Dr. Hackett, by using prolotherapy techniques, was trying alternative methods rather than invasive surgery of this area which can sometimes lead to bigger problems if not done successfully.

Hackett Referral Paterns of the Neck Ligaments
Pain Referral Patterns, charted by George Hackett MD, showing how cervical vertabrae ligament issues can transfer "refer" weakness and feelings of pain far into other areas away from the issue causing it.

Barré-Liéou Syndrome

A specific problem that may occur as a result of ligament instability in the neck is “Barré-Liéou syndrome,” named after the doctors who first described it in 1928. This syndrome may occur after a neck whiplash injury or a long period of repetitive strain that slowly stretches out the neck ligaments. Over the years, there has been controversy about the existence of this syndrome, primarily because this type of ligament instability only shows up with motion and is not seen on magnetic resonance imaging (MRI), where the patient is not moving. For that reason, it might not be suspected, so missed initially as a diagnosis. Increased scientific evidence has brought attention back to Barré-Liéou and its validity[1].

When ligaments holding neck bones (called “vertebrae”) together become chronically over-stretched, there will be excess vertebrae motion. After a period of time, if the neck continues to experience this low level, but constant, slight excess motion every time the person moves his/her neck, nearby nerves become irritated, causing a wide range of symptoms, such as headache, allergy-type phenomena, ringing in the ears, dizziness, and head fogginess. Fortunately, Prolotherapy has been shown to improve neck ligament stability in the neck for not only average cases of whiplash or repetitive strain, but even this more complex syndrome[2].

Symptoms of
Barré-Liéou Syndrome

Symptoms commonly increase with neck motion

  • Headache/Migrane
  • Clicking in neck
  • Dental pain
  • Ear pain
  • Eye tearing
  • Facial pain
  • Fatigue
  • Horseness
  • Loss of voice
  • Memory problems
  • Nausea
  • Neck pain
  • Disturbed vision
  • Sinus congestion
  • Thinking impairment
  • Tinnitus
  • Vertigo
Trauma and/or repetitive injury results in ligament micro-tears, instability, and pain, often treatable with Prolotherapy.
Trauma and/or repetitive injury results in ligament micro-tears, instability, and pain, often treatable with Prolotherapy.

Case Report: Executive, Nonprofit Organization

My pain started in 2013 after a severe auto accident that caused a whiplash injury in my upper neck. The pain, headaches, dizziness, and loss of concentration gained momentum in my life gradually, and although I would try to stay engaged in work and home life, it was becoming more difficult. The pain kept me in bed some days, and I was not able to keep work commitments. Simple things like conversing with family and friends were getting to be more difficult.

I saw a spine orthopedic doctor after the accident who treated me with physical therapy, chiropractic, and medications (muscle relaxers, anti-inflammatories) when needed, but when those didn’t work, I received epidural injections for what I was told were cervical herniated discs. The decision to have an epidural was extreme for me; however, I was in pain and could see my symptoms were getting worse with more frequent headaches and dizziness, missing more work, and staying in bed longer. However, unfortunately, the epidurals did not bring me relief. At that point, the spine orthopedic doctor recommended I see a neurologist because I was complaining of dizziness. Upon my first visit, the neurologist requested an EEG and a CT scan, and then prescribed an antidepressant, but I wasn’t depressed (yet). I was in pain! Once the tests were completed, I went back to the neurologist to consult about the results. He said they were negative, and there was nothing abnormal, and he prescribed an anti-seizure medication, Depakote, for migraine headaches. I didn’t return to that doctor or fill the prescription.

I felt I was getting nowhere; my quality of life was no longer what I remembered. I was in bed daily, lying flat to relieve the pain in my head and to prevent the dizziness. Somedays, I couldn’t drive myself, and now I was actually becoming depressed. I then heard about Prolotherapy and went for a consultation.

Dr. Alderman listened to me and understood what I was explaining when I told her what had happened to me. She showed me an illustration after my explanation of symptoms that depicted where/how/why this was happening. She explained about Barré-Liéou syndrome, where movement of the stretched ligaments causes pressure on the nerves going to the head, and that this problem does not show up on an MRI or CT because it happens with neck movement, and there is no neck movement during an MRI or CT. It made sense to me that the force of a whiplash could make the ligaments in my upper neck become stretched and weaker, and then normal movement could irritate surrounding nerves, which then could impact my head and focus, I knew at that point that I was going to be receiving the right treatment and embarked on a course of PRP Prolotherapy.

It was a long process, but a necessary process, and it worked! After three treatments, six weeks apart, I was 50 percent better and knew I was on the right track. After six treatments, I was 90 percent improved and back to my prior self. I am again doing the things I love and enjoy. Prolotherapy changed my life forever.

Name withheld for reasons of privacy.

Bibliography

[1] Li Y, Peng B. Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo. Pain Physician. 2014 Dec; 18(4): E583–E595

[2] Hauser RA, Steilen D, Sprague IS. Cervical instability as a cause of Barré-Liéou Syndrome and definitive treatment with prolotherapy: A case series. European Journal of Preventive Medicine. 2015; 3(5): 155–166.