LIGAMENT SCLEROTHERAPY

David E. Teitelbaum D.O.


Ligament Sclerotherapy, also known as Ligament Reconstructive Therapy and Prolotherapy, is a technique of strengthening ligaments naturally. Ligaments are structures that connect bones to each other and provide support for all of the joints of the body, including the spine. Ligaments may stretch and become lax from injury or from wear and tear over time. When this occurs the joint becomes unstable and painful. Rehabilitation and manipulation attempts often fail to provide lasting relief because such attempts cannot strengthen ligaments.

Fortunately, these ligaments can be strengthened through Sclerotherapy. In this approach the effected ligaments are injected with natural substances to deliberately cause inflammation. The ligament responds by laying down collagen tissue which develops over several weeks into mature ligament. The result is a thickened, strengthened ligament and a more stable joint. This is very different from injecting cortisone which lessens inflammation but can actually weaken the ligaments. For most joints of the body, a series of five to twelve injections are necessary to achieve the desired effect.

A diagnosis of ligament laxity is made by taking a complete history combined with physical examination and review of X-rays of the effected area. The classical history would include joint or spine pain of several month's duration where efforts such as physical therapy or manipulation have not provided lasting relief. Limited range of motion is often present. The pain may be the result of an acute injury or it can develop over time from wear and tear. Physical examination reveals very tender focal areas over the painful site. X-rays do not show the ligaments themselves, but are often necessary to rule out other sources of pain or limited range of motion.

Once the diagnosis is made, the effected area is injected with the following substances:
Lidocaine, a local anesthetic to lessen discomfort
Vitamin B 12, to help nourish the developing tissue.
Concentrated Dextrose, a corn sugar, to cause inflammation that leads to collagen deposition.
Sodium Morrhuate, a derivative of Cod liver oil, used to further facilitate the inflammatory process.
Significant improvement is usually noted after the third treatment, although each person will have their own unique response.

There is a Board Certification available for Sclerotherapy offered by the American College of Osteopathic Pain Management and Sclerotherapy. Dr. Teitelbaum received his board certification in 1996.