Overview
An effective treatment for low back pain ?
Prolotherapy (also called sclerotherapy) involves injecting painful ligaments and tendons with sugar solutions that are intended to stimulate production of connective tissue. The theory is that prolotherapy can strengthen these ligaments and tendons, and reduce pain. Studies of prolotherapy have reported conflicting evidence regarding its effectiveness in treating chronic back pain.
A review of five well-designed studies involving 366 participants concluded that prolotherapy alone was ineffective in treating chronic low back pain. However, when combined with other treatments such as spinal manipulation and exercise prolotherapy may improve chronic low back pain.
A typical course of prolotherapy treatment is six to 10 sessions, sometimes with multiple injections at each session. Prolotherapy is known to cause some pain at the injection site, but this is typically mild and temporary. As with any injection, there is a risk of infection, bruising, bleeding or tissue damage.
More research is needed to clarify what role, if any, prolotherapy plays in the treatment of chronic low back pain.
Cause
Tarlov cysts are an uncommon cause of back pain.
Tarlov cysts are fluid-filled sacs that most often affect nerve roots at the lower end of the spine (sacrum). Such cysts typically cause no symptoms and are found incidentally on magnetic resonance imaging (MRI) studies done for other reasons.
However, in some cases, the cysts expand, compressing or distending the affected nerve root. This irritation of the nerve root results in pain, weakness or numbness. Rarely, the cysts enlarge so much that surrounding bone is eroded, which may cause localized pain as well.
In most cases, Tarlov cysts require no treatment. Experimentally, painful Tarlov cysts have been treated successfully with oral or injected corticosteroids. Innovative surgical treatments such as draining the cyst or amputating the affected nerve root have not been highly successful and are usually reserved for cases in which conservative treatments have been ineffective.
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