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The ligaments that insert into the L4 and L5 vertebrae (which are the most common to herniate in the lower back), actually are contiguous structures with the sacroiliac joint, coccyx, and insert into the ischium (sit bones). Retrospective case series on patients with chronic spinal pain treated with dextrose prolotherapy. Therefore, dysfunction in any part of this ligament structure can impact what happens with the L4 and L5 disc and vertebrae. Unfortunately, most patients who have chronic lower back pain sometimes give up, and are told to “deal with it”, or end up on large amounts of opiates like Oxy Contin.So why would prolotherapy, stem cells, and PRP work so well for this large subset of patients? The disc is a shock absorber for vertebrae, and while this shock absorber can become defective, there are so many other parts of the lower back and support structure for the lower back that can cause pain.Their release has an effect on the behavior of cells around them.
All it takes is a careful history, physical examination of the back, pelvic tilt, feet, hips, reflexes and strength in skilled and experienced hands to determine if someone has an excellent chance at being cured of their back pain with prolotherapy and/or platelet rich plasma. There isn’t a week that goes by when a patient who has experienced relief of chronic lower back pain asks, “why did it take so long for me to find out about Stem Cell Therapy or prolotherapy?” This is often followed by, “I can’t believe prolotherapy was not the first treatment recommended for my back – it was the only treatment that works.” Most patients that seek either prolotherapy, platelet rich plasma (PRP) treatment, or stem cell therapy of their lower back pain come to us as a last chance effort.Not only can this joint become arthritic, but all of the ligament and tendon structures that hold this joint together can become stressed, strained, or torn but may appear normal on MRI (which is not very accurate at diagnosing sacroliliac pain).Research published in the medial journal Spine, states “ligament laxity in the sacroiliac joint is the number one reason for sciatica, or pain radiating down the side of the leg, and is one of the most common reasons for chronic low back pain.” (4) Additionally, most back pain patients have a functional leg length discrepancy / tilted pelvis which further exacerbates sacroiliac joint pain.