Is there a long-lasting, little risk, minimal side-effect solution to chronic joint pain for the Muscular Dystrophy (MD) patient? The answer is yes, and the main “medicine” in this treatment is sugar. Muscular Dystrophy, sports related injuries, and injuries related to years of wear and tear all share in common that the chronic joint pain they cause is a degenerative disease. In cases of Muscular Dystrophy, muscle weakening and atrophy can accelerate joint and spinal degeneration and cause pain when unstable bones trap, pinch, wear at and tear at the soft tissue of the spine and joints.
Treating the pain
There are not many answers to treating degenerative joint disease in MD. The goal of any treatment should be to choose options that the patient will well tolerate and see an improvement in quality of life. This is why in our practice we are very reluctant in prescribing both narcotic pain medications and/or recommending over-the-counter pain relief medications. Our reluctance stems from the obvious and serious side effects that these medicines have been documented to cause. Even low dose Tylenol has recently been cited in studies in accidental overdose.
Sometimes surgical intervention is sought especially in cases of excessive and painful spinal curvature, impingement syndrome, or simply when the pain of a joint seems to suggest no other options. Surgeries have their complications and should always be considered after more conservative options have been explored.
Many physicians and health care professionals will offer options other than the prescription, surgical route. These include a stretching program to keep muscles flexible and prevent muscle contracture that can reduce range of motion. An exercise program based on the patient’s individual ability to perform regular exercise routines can also be very helpful.
The key to physical therapy and exercise is not only to promote movement and flexibility but to keep blood circulating to the area to help prevent degeneration and deterioration of the soft connective tissues of the spine and joints.
In patients with MD, emphasis of treatment targets the muscles and tendons. Tendons are the connective tissue that hold muscle to bone. Sometimes tendons are severed or cut to allow a contracted muscle to stretch again. There are also ligaments, soft connective tissue that hold the bones to other bones that provide joint stabilization and a treatment that creates accelerated circulation to the joints.
What is Prolotherapy? Prolotherapy treatments were first developed in the 1940s but did not gain a larger following among physicians until the Mayo Clinic began to offer it as a treatment and noted success with it in the past few years. Prolotherapy addresses the ligaments, sheets or bands of connective tissues made out of collagen that provide stability to the joints of the body by connecting two or more bones together. When ligaments become weak or damaged, joints become unstable, move out of place and cause pain. The ligaments themselves contain many nerve endings that can exacerbate the pain a person feels when ligaments are injured or loosened.
A physician trained in Prolotherapy will perform a careful physical examination to the joint area to isolate “hot spots,” or “pain triggers.” Once determined, injections of dextrose, a simple sugar will be administered into the joint to cause a small, controlled, inflammatory response. When performed under ultrasound guidance, the physician can isolate the ligament with great accuracy insuring a higher rate of success. Prolotherapy treatments offer less risks and a quicker healing process to damaged ligaments because they capitalize on the body’s natural ability to heal itself. The body’s immune response to the inflammation results in increased blood flow to the area and rebuilding of the tissues. The new ligaments are stronger and over time remove stress from the bone.
For the MD patient, it is important that the Prolotherapy option be explored with a physician well experienced in the technique.