Archive for September, 2014

Falling through the cracks of Over Manipulation Syndrome (OMS)

Written by Regenerative Health on . Posted in Treatment Discussions

OMS is a condition caused by over manipulation of the joints by oneself or a practitioner, resulting in instability, hypermobility and pain.

A high velocity manipulation can be defined as a violent thrust of a joint to the end of its range, causing a “cracking” sound. This is usually done in order to achieve realignment or adjustment of the joint. A manipulation can be achieved at any joint. Manipulation by a qualified health professional can be a useful and valuable treatment modality, however self-manipulation can often become habitual and excessive, and may lead to the development of OMS. OMS commonly affects the neck and lower back vertebrae. 

Symptoms of OMS

Laxity of the joint ligaments is one of the most important characteristics of OMS, because as they are continually exposed to stress, they slowly start to stretch. Repeated stretching of the supportive spinal ligaments causes them to elongate and deform. Eventually the ligaments reach a point where they are no longer able to provide stability of the spinal vertebrae. As the vertebrae shift, they start to cause pain. When the neck is affected, symptoms such as ringing in the ears, anxiety, blurred vision, dizziness and headaches may be experienced. Muscle spasm may also be associated with OMS as the surrounding muscles start to tighten up in order to support the unstable joints, this may lead to trigger points of the muscle which radiate pain to elsewhere in the body.

Reversing OMS

All forms of manipulation should be stopped immediately and Prolotherapy started on the affected areas. Prolotherapy involves a series of regenerative injections which initiate a local inflammatory response, leading to increased blood flow, increased collagen deposits and healing. This means that the stretched out and injured ligaments may be repaired and regain their ability to stabilise the joints, thereby reducing pain and dysfunction.

Forget ice and NSAIDs, do M.E.A.T

Written by Regenerative Health on . Posted in Regenerative Health

In the early stages of acute traumatic injuries, patients are usually advised to use the R.I.C.E principle – rest, ice, compression, elevation. However, this treatment is currently being criticized, since it has been recently suggested that rest and ice may actually delay healing. This is because ice reduces inflammation, but tissue which is damaged through trauma or vigorous exercise requires inflammation for the healing and recovery of muscle cells and soft tissue regeneration. Ice also has a negative effect on blood flow to the area and can hinder strength, speed, endurance and co-ordination. Complete rest or immobilisation, my also delay the healing of soft tissue, since it deprives the body of the forces it requires to stimulate collagen synthesis and promote correct alignment of fibers.

The principles of M.E.A.T – movement, exercise, analgesics and treatment have been shown to be more effective when it comes to enhancing tendon and ligament healing.

 

Movement

Early and controlled mobilisation has been shown to increase blood flow, thereby reducing muscle wasting, disuse osteoporosis, joint adhesions and stiffness. There may also be associated impovements in pain and swelling. The results can include early return to activity and decreased risk of complications.

Exercise

Strength, range of motion, and stability exercises results in increased strength of the muscles and ligaments, functional mobility and improved balance, leading to hastened return to activities and sport.

Analgesics

Synol and Painstop are safe and effective analgesics which control pain without interfering with the normal inflammatory processes. Non-steroidal anti-inflammatory drugs (NSAIDs), such as neurofen, asprin, voltaren and cataflam are not only associated with nasty side-effects, but once again reduces the essential inflammatory component, delaying tissue healing and should be avoided.

Treatment

According to Dr Ross Hauser from Caring Medical, research indicates that most effective treatment approach is to heal the injured ligament, and this can be achieved by Prolotherapy. This is because Prolotherapy injections cause a localised inflammatory response which will stimulate blood supply and collagen deposits, causing strengthening of the injured soft tissue. Physiotherapy treatment is also an essential component of the treatment approach towards acute soft tissue injury.

Read further on this topic here.

The first STEP to a pain-free ankle: Chronic instability

Written by Regenerative Health on . Posted in Regenerative Health

Acute sprain of the ligaments of the ankle joint is a common medical and socioeconomic problem. The lateral ligaments are relatively less stable than the medial ligaments and are therefore more often involved. Around half of the injuries receive medical treatment and about 40% result in chronic instability.

Chronic instability is usually associated with previous ankle injury and subsequent incomplete rehabilitation. The chronically unstable ankle commonly presents with a feeling of “giving way”, combined with constant swelling, pain, decreased range of motion, or excessive motion. If left untreated, this condition can potentially lead to cartilage degeneration and resultant degenerative arthritis.

Our solution

Pain due to chronic instability of the ankle is often treated medically with the use of anti-inflammatory drugs or cortisone injections. Although this may provide some short-term relief, it does not address the root cause of the problem and therefore does not alleviate pain in the long-term. In addition it cannot prevent the likelihood of surgery for joint fusion or joint replacement further down the line.

Since chronic pain is most commonly caused by tendon and ligament weakness, as is the case with chronic ankle instability, a better approach is to strengthen these structures with Prolotherapy. Dr Ross Hauser advocates that Prolotherapy offers the most curative results in chronic pain, because it attacks the source of pain. Prolotherapy involves injecting a solution into the joint in order to initiate the healing process and create regeneration of the soft tissue.

Click here to read further about Dr Ross Hauser’s opinion on Prolotherapy in chronic ankle instability.

Knee Pain: Meniscal injuries and Chondromalacia Patella

Written by Regenerative Health on . Posted in Regenerative Health

Meniscal injuries 

Meniscal injuries can occur acutely when there is a shear stress within the knee, often caused by a twisting mechanism of the body with the foot anchored on the ground.  This is common in soccer, basketball and tennis players. Small tears in the meniscus may also occur with minimal trauma due to degenerative changes in patients over 35 years old. This might occur as a gradual onset of knee pain.

The management of meniscal tears varies depending on the severity. A large painful tear is usually treated surgically, where the meniscus is repaired or partially removed. However, Dr Ross Hauser advocates that the best option for meniscus repair is Prolotherapy.Treating all the adjacent structures along with a comprehensive rehabilitation program may be successful in helping athletes to return to sport and patients to return to pain free activity. Click here to read more about what Dr Hauser has to say.

Chondromalacia Patella

Chondromalacia Patella is a common cause of pain on the front of the knee, or patellofemoral joint pain. Patellofemoral articular cartilage lesions can cause chemical or mechanical irritation of the synovium of the joint, which can lead to swelling or erosion of the subchondral bone. This also results in altered biomechanics of the patella during activities such as stair climbing. Chondromalacia Patella can occur due to a single maximal load, such as falling onto the knee, or a  lower magnitude repetitive load.

Danielle Steilen describes in this article how Prolotherapy is effective in treating Chondromalacia Patella by stimulating the repair of damaged cartilage, boosting healing and improving patella tracking. Functional rehabilitation is also an important component of treatment, in order to improve motor control, strength, endurance and stability around the knee.

Say no to cortisone!

Corticosteroids are potent anti-inflammatory drugs which are usually administered by local injection or orally. The goal of corticosteroids is to reduce pain and inflammation sufficiently enough to begin a rehabilitation program. However, its use is controversial due to the incidence of side-effects and the concern that it may have an inhibitory effect on healing.

Prolotherapy has been said to be a much more effective treatment option than cortisone, in that it stimulates inflammation and therefore healing. As structures heal, they become more stable and this leads to a decrease in pain. Click here to read further about the benefits of Prolotherapy over corisone injections, and here to read how Prolotherapy can be useful in the knee as an alternative to cortisone.