Ligaments in the spine and pelvis provide stability to the joints and discs. These ligaments can be overstretched or torn putting extra stress on the spine which causes pain. Prolotherapy (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 guidance.
• 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. A course of treatment usually comprises three procedures.
• Local Anaesthetic – injected into the joint.
• Irritant solution – this may be a strong sugar-based solution 10 –20% glucose 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 spinal instability. 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 or radiology department for about 1 - 2 hours. 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 cold or have any kind of infection.
You must inform us if you are taking any of the following tablets – antibiotics, aspirin, warfarin or clopidogrel before attending 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 ChakravertyWest Midlands Spinal Medical Clinic Birmingham Nufﬁeld Hospital22 Somerset RoadEdgbastonBirminghamB15 2QQ
Nufﬁeld Outpatients t: 0121 452 2810 Elizabeth Jones, Secretary to Dr Chakraverty t: 07919 38738