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fivephdten
May 25, 2011, 2:09 PM
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Registered: Oct 15, 2008
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Does anyone have experience with prolotherapy and/or cold laser therapy?
I'm dealing with a chronic injury in my hand. I originally hurt it over 2 years ago crimping on a tiny side pull - resulting in shooting pain into my elbow, lots of swelling and black and blue on the back side of the hand (no popping or snapping and no loss of motion - just loss of strength and lots of pain). After taking 1.5 yrs off i started climbing again slowly, but re-injured it 6 months later. I don't know that the injury has ever truly been correctly diagnosed - although i've seen numerous doctors. Based on all the opinions it sounds like i have two things going on: (1) pain on the back side of my hand between the middle finger and ring finger knuckles. This has been referred to as saddle syndrome - basically there is fluid and/or scare tissue from the original injury stuck between the ligaments and muscles which creates pain and prevents the muscles from working as they should. (2) On the palmer side of my hand I have a deep pain where the tendon connects into the ring finger knuckle. Based on a high-tech ultrasound by a DO it seems like the tendon is partially torn where it connects to the bone (knuckle).
Of course the traditional hand doctor (aka surgeon) wants to cut it open and "fix" it. Obviously, I'm looking for other options. I've tried acupuncture and bowen therapy but they don't seem to be helping. (Of course I tried PT with a certified hand therapist for months first with little to no improvement). So I am currently looking into prolotherapy and cold laser, but I'm not sure which would be best and was wondering if anyone could help me out?
THANKS IN ADVANCE!
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aerili
May 25, 2011, 7:08 PM
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I've had cold laser therapy a long time ago for an elbow injury. There is no way I would pay for anyone to do this for your particular injury. I am almost positive it will do nothing.
As for prolotherapy, well... From what I know, it only helps a narrow range of injuries and its efficacy is also highly dependent on the skill of the doctor doing the injections. It's also pretty expensive (expect to spend several hundred dollars).
If your tendon is torn, I am uncertain any amount of prolotherapy will make the tendon re-attach where it is torn.
Surgery could be your answer, especially if you've tried conservative therapy for as long as you say and it has all failed. That makes you a better surgical candidate, in fact.
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fivephdten
May 25, 2011, 7:39 PM
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Registered: Oct 15, 2008
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Aerili - thanks for responding. I am pretty positive it is NOT fully torn since I have no loss of motion, but unfortunately, I am not sure if it is partially torn or not. The traditional hand specialists in my area say they can't see enough without cutting it open for sure, and the only person that looked at it with an ultrasound is a doctor of osteopathy (DO) with little to no experience with hand injuries. As I mentioned, the DO thinks its partially torn where it connects to the bone. From what I've read online prolotheraphy can heal partially torn tendons, but of course that info comes from sites supporting the use of prolotherapy, which is why I'm looking for more info. Can you elaborate a bit on why you think cold laser won't work - just want to be as informed as i can be before i make an decisions. Surgery sounds supper scary especially considering that the current scar tissue/fluid seems to be causing other problems.Not to mention multiple people have told me for various reason not to let a doc cut on the palmer side of my hand which is exactly where this is =(. Any thoughts on that? Again, thanks for the info!
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aerili
May 25, 2011, 8:43 PM
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I think there isn't really any conclusive evidence to show it works. When I had it, I didn't particularly notice any difference (and this was combined with other therapy on the area, which really tells you something). That was at least 10 years ago, though, and some things may have changed. Apparently, laser therapy outcomes are very dependent on frequency, dose, duration, and number of treatments. So, I could be wrong about it not helping you.
If you have insurance which covers it, it could be worth a shot. Here is a favorable meta-analysis on LLLT for tendinopathy.
In reply to: Surgery sounds supper scary especially considering that the current scar tissue/fluid seems to be causing other problems.
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kyote321
May 25, 2011, 9:03 PM
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Registered: Apr 24, 2005
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Have you tried ultrasound? Or immersing the whole hand in very cold water... repeat? Do you massage the area?
I had an injury that sounds similiar but it took climbing to release the fluid. It would pop, then refill, the pop again when climbing. The injury was in the hand itself. Good luck!
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