Prolotherapy, Pots and cervical instability

What is prolotherapy?
Prolotherapy is an injection treatment for muscle and joint pain. The treatment involves repeated injections of an irritant solution into part of a joint — the joint's interior, for example, or a supporting tendon or ligament. The irritant, usually a sugar solution, is thought to trigger growth in the connective tissue of the joint, eventually leading to reduced pain. Through prolotherapy injections hypermobility around joints can be diminished. Prolotherapy with injections with a solution of glucose is also called Dextrose prolotherapy. There are also other kind of prolotherapy treatments such as PRP and Stem cell (Biocellular) Prolotherapy. 

Prolotherapy can be effective after a few treatments for certain injuries, such as back or knee pain. However with more complicated conditions such as with Ehlers Danlos or Hypermobility syndrome it can require many treatments and patience in order to achieve relieve of symptoms. It is not always  a quick fix.
Prolotherapy for EDS patients additionally is not without controverse. Some EDS experts warn for this kind of injection therapy because of the vascular problems EDS patients may suffer from. At the other side, there have also been reported positive testimonials among EDS patients with prolotherapy, also for cervical instability problems. Please inform yourself well before you consider prolotherapy.

Cervical instability and the link with dysautonomia

Pots can be linked to hypermobility in the neck. The upper discs in the neck are held in proper position by ligaments, helping to protect the spinal cord, brain stem, and nervous system from excess movement in the upper cervical spine. When these ligaments are lax and elongated from hypermobility, the upper cervical spine is not protected anymore against excess movement. Cervical instability can provoke irritation of both the vertebral and sympathetic nerves. Damage to ligaments and irritation to the surrounding nerve endings may alter the firing patterns from these nerve endings, which may cause increased activation of the sympathetic nervous system. Researchers have determined that even minor damage to ligaments and/or other musculoskeletal tissues can cause an over-stimulation of the sympathetic nervous system resulting in dysautonomic symptoms. Pots is a form of dysautonomia.

One of the first doctors to recognize symptoms of dysautonomia in relation to joint instability was Dr. George S. Hackett, MD, who found that ligament relaxation (or laxity) activated the autonomic nervous system. Dr. Hackett found that in correcting the underlying joint instability by treating injured ligaments with Prolotherapy, not only did the local pain resolve, but so did the dysautonomia.When minor or moderate spinal instability occures, treatment with prolotherapy may be of benefit in alleviating symptoms and restoring normal cervical joint function. For more severe spinal instability a spinal fusion may be necessary.
(Text copied from the following article  "dysautonomia and Pots" , written by dr. R. Hauser, Caring Medical.Com).


For more detailed information concerning prolotherapy: http://prolotherapycollege.org/what-is-prolotherapy or in Dutch:www.doktermulder.nl


As I experienced that my neck was instable I wanted to try prolotherapy as a treatment for my Pots. I could feel and hear the discs in my neck slipping away when I moved my neck. Also I had the tendency to crack my neck in order to solve an unpleasant pressure coming from my neck.

Starting with prolotherapy

From September 2017 untill now (June 2019) I received on a regular basis prolotherapy injections with a solution of glucose in my neck and back. Although I started prolotherapy with the hope of healing Pots, I was happy with every result I could achieve for my back. Even though I did not suffer any more from a lot of nerve pain my back stayed quite vulnerable. After a days work, I had to lay down otherwise I got nerve pain in my leg. Carrying  heavy weight also provoked this nerve pain. And I still had the coordination problem in my both legs after making a long walk. (see also: Me and my hypermobile body.


Worsening of Pots
During the first months of prolotherapy injections I did not notice any difference for my neck and back. Normally it takes some time for the injections to be effective. In the mean time my Pots symptoms slowly worsened. Blood tests revealed that I had an inflammation of my thyroid. But when this inflammation was over, my Pots symptoms did not improve. In December 2017 I was not able to stand up longer than 10 minutes without becoming dizzy and walking was limited to 20 minutes. Making movements with my arms, kneel down and stand up, walking up the stairs all led to dizziness, sleepiness and brainfog.

I developped increasing neurological problems. I have had several moments when I was driving in the car and became disorientated and did not know how to reach the supermarket or shops (While I was just in the town where I am living...). I had increasing problems with answering questions because it was sometimes completely empty in my head and I could not find words to answer. I experienced more and more difficulties in doing my job. When I came home from work, the only thing I wanted to do was sleep. On my free days  I hardly did anything. If I tried doing some housework, I very quickly became dizzy. So finally I sat the whole day on the couch or slept. My life slowly stopped and I started to be anxious for dropping out from work again for the third time.

I still had hopes that prolotherapy could work for me, but I also knew that it would take time. I felt some panick coming up. I had to do something. I was scared of not being able to work again.That foresight was unbearable to me. As the cardiologist once had suggested that a change in diet could relieve Pots symptoms, I started searching on the internet what kind of diet might be helpful.
I finally found out about the Medical medium protocol. I will tell more about it later. So in January 2018 I started with this protocol, which had immediate effect.

                         
Prolotherapy started inproving my back

After a few months of prolotherapy treatment I slowly felt improvement in my neck and back.  I could feel that my joints slowly became more stabilized. Normally I heard joints clicking in my neck and back, but this occurred less and less. Also the nerve pain in my leg which was still present at times, has almost completely disappeared. After a days work, I do not need to lay down anymore because of my back. I can just sit upright during the evening. And I am able to carry some weight without nerve pain in my leg.

I am able to walk longer without my back starting to hurt and causing problems with the coordination of the movements of my legs. This coordination problem has disappeared completely! I still do not completely understand what was the exact cause but since my ligaments in my back have been strengthened through prolotherapy,  I assume that the coordination problems may have been linked to my hypermobility.

So prolotherapy has pleasantly surprised me. To be honest I had not expected to achieve so much improvement on my back related issues. I am very happy with prolotherapy and Dr. Mulder!

What has prolotherapy done for my Pots?
Did prolotherapy cause an improvement of my Pots symptoms?
I am tempted to say 'Yes', but I do not know for sure. I started with the Medical Medium protocol a few months after Prolotherapy. Since the start of of it I slowly made an incredible improvement in my health. This could be due to the Medical Medium protocol, but it could also be that Prolotherapy was becoming effective in the period that I also started the Medical Medium protocol.

I have read stories of patients having healed themselves with the Medical Medium protocol. Unfortunately I have not read yet many stories from Pots patients who have healed themselves (partially) with Prolotherapy. Prolotherapy is not yet a very well known treatment method.

There are however positive results with patients with severe Pots symptoms and severe instability of the neck who recovered by a operation which stabilized the neck. This severe instability could be caused by Ehlers Danlos or an accident. A dutch girl called Amy suffered from Pots very severely. She could barely function. An upright MRI assessed cervical instability.  After she had an operation who stabilized her neck (fusion) her Pots symptoms quickly faded away. She has not yet recovered completely, but she has her life back. For her story (unfortunately only in Dutch) click the following link.

These positive results strengthen my view that reducing the hypermobility of the neck might be a possible treatment for Pots. For severe instability an operation might be required, but for less severe instability prolotheray might be appropiate.

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