Prolotherapy

Hi Susan. I would be curious about this as well

I've heard it could benefit fibromyalgia ( which I also have 😡 But it makes a lot of sense to help with Pmr

I live in Arizona and I don't know if it's well known overseas.

A quick google and reading up on this therapy suggests it is much the same as the "quaddeln" (German term) technique both the pain specialist and my GP have used with me. It is also called needling in English and is quite similar to another technique called intramuscular stimulation. Needles are inserted into various painful areas and it is claimed that this stimulates the nerves to "heal themselves". I have no idea what the physiological basis is but it does seem to have an effect in some situations.

If so, I can tell you now it may help the "add-ons" of PMR, myofascial pain syndrome in particular, but I doubt it will help with PMR itself. This is because it will probably help with muscle spasm and other similar problems. However:

"There are currently no treatment guidelines or protocol for prolotherapy. It is most commonly used for patients with back pain caused by chronic ligament and tendon sprains and strains. Some physicians do use prolotherapy as a first-line therapy.

It is important to note that approximately 90% of people with acute back pain get better with standard conservative (nonsurgical) treatments within 6 to 8 weeks and do not require additional treatment."

i.e. it is used for back pain involving ligaments and tendons (i.e. for things that would very likely improve in similar time spans without any treatment but rest). That is not the cause of PMR symptoms, even if you do have bursitis, synovitis and tendonitis. These are all due to inflammation, not sprains/strains. That is why in most PMR patients the ESR and CRP are raised - they indicate inflammatory processes. It is commonly accepted that this is due to an underlying autoimmune disorder which makes your immune system unable to recognise your body as self and so causes it to attack body tissues as being "foreign" leading to inflammation and damage. When the autoimmune disorder bruns out you will be in remission and no longer need pred. Needling/prolotherapy won't have any effect on the underlying cause of PMR.

IF you have other muscular problems causing back pain alongside the PMR - as I do - it may help. It may not. Four years ago I was given it by the pain clinic and it sorted out the sacroiliacitis I had which was due to my back muscles being very tight and in spasm - because of myofascial pain syndrome which is often found alongside PMR. Those problems do respond to some extent to higher doses of pred but will then return as you reduce the oral pred dose. I have recently had another session of quaddeln done by my GP using lignocaine - a local anaesthetic which did nothing at the time to reduce the pain. The result has come over the following 6 weeks which has made a noticeable difference to my back pain and I have been able to reduce the oral dose of pred by 1.5mg so far.

I don't have to pay for it when my GP does it (she is rheumatology trained). It wasn't particularly expensive when I had it done in the pain clinic but I did have to pay the small co-pay we have here. I suppose it depends how much it will cost you and whether you do have the "add-ons" to PMR that it seems to work for. It won't sort out PMR itself.