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in the spine
provide stability to the joints and
discs. These ligaments can be overstretched or torn putting extra stress
on the spine which causes pain.
(also called Sclerosant injections
) work by causing minor
ligament injury through injection of an irritant solution, thereby causing
mild inﬂammation of the injected tissues. This is thought to stimulate a
healing process leading to the body producing new ﬁbres, making the
affected ligament thicker and stronger.
• You will be lying on your front for the procedure, which usually takes 10 - 20 minutes
. Local anaesthetic
is injected to numb the skin and
a ﬁne needle is passed toward the ligaments of the back under x-ray
• Once the needle is conﬁrmed to be in place, the injection takes place. Often several sites are injected during the procedure.
• Traditionally, the injection is repeated at intervals of 1 – 4 weeks
course of treatment usually comprises three
• Local Anaesthetic
– injected into the joint.
• Irritant solution
– this may be a strong sugar-based
or a mixture of phenol, glycerine and glucose
On average between 50 – 70%
of patients ﬁnd that their symptoms
are improved by a half or more
for a year or more
following an initial
course of treatment. Injections may need to be repeated on occasion,
usually as a single top-up procedure. This may be required after a few
months or even a few years. Prolotherapy
appears to be particularly
useful in patients with sacroiliac pain, postural low back ache or mild
Due to the procedure:
• More discomfort for the ﬁrst few days after your injection.
• A feeling of skin sensitivity in part of the buttock occurs rarely and takes some months to settle.
What Happens on the Day of My Appointment?
• You can eat and drink.
• Take all your tablets as normal. Bring a list of your tablets with you.
• A nurse will take some details from you to check that you are ﬁt for your procedure.
• You will be asked to sign a consent form. The doctor will be able to answer any questions you may have at this time.
• You will be at the Day Unit
department for about 1 - 2
. This time may vary depending on unforeseen circumstances.
• Please bring a dressing gown
and sensible footwear
with you. You
will be asked to walk to the treatment room on the Day Unit.
• After you have had your procedure, you will need to stay with us for
about 30 minutes
before you can go home.
You must NOT
drive home or go home on public transport.
Please arrange for someone to collect you from the Day Unit.
You are allowed to go home by taxi.
• Take things easy for the rest of the day. Do not do any excessive
exercise or heavy work for the ﬁrst few days.
• Remove the dressing the next morning.
• Continue to take your pain tablets till you notice any improvement in your symptoms.
Please inform the Day Unit if you are diabetic
, have a cough
or have any kind of infection
You must inform us if you are taking any of the following tablets – antibiotics
as some of these may need to be stopped some days before.
Information for females
- We will need to know the start date of
your last menstrual period due to the use of x-ray equipment. If you
think you might be pregnant, contact the Day Unit for advice.
Dr Robin Chakraverty
West Midlands Spinal Medical Clinic Birmingham Nufﬁeld Hospital22 Somerset RoadEdgbastonBirminghamB15 2QQ
Nufﬁeld Outpatients t:
0121 452 2810Elizabeth Jones
, Secretary to Dr Chakraverty t:
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Journal of Medicine and Medical Sciences Vol. 1(10) pp. 447-452 November 2010 Available online http://www.interesjournals.org/JMMS Copyright ©2010 International Research Journals Prevalence and treatment outcome of vulvovaginal candidiasis in pregnancy in a rural community in Enugu State, Nigeria P. A. Akah1, C. E. Nnamani1,2 and P.O. Nnamani3* 1Department of Pharmacology and Tox