The 4-Hour Body_ An Uncommon Guide to Ra - Timothy Ferriss [131]
But ART isn’t perfect.
As Charles noted: “ART is 100% effective in 70% of patients.”
Fixing chronic pain often requires a combination of therapies. Sometimes that involves needles, which brings us to the next stage: medication.
5. PROLOTHERAPY. AREAS FIXED: LEFT KNEE, RIGHT WRIST.
In prolotherapy (so named for the “proliferation” of collagen fibers it’s supposed to produce), a mixture of irritants are injected into tendons, ligaments, and inside joints themselves. The objective is to create a mild inflammatory response that stimulates tissue repair.
The simplest of prolotherapy cocktails, and the one with the longest track record, was developed by the founder of the technique, George Hackett MD. His mixture is, in effect, “sugar water”: dextrose mixed with a local anesthetic (lidocaine) and saline (saltwater).
Dr. C. Everett Koop, the 13th surgeon general of the United States, opened the doors for wider research on prolotherapy when he publicly endorsed it:
Prolotherapy, unless you have tried it and proven its worth, seems to be too easy a solution to a series of complicated problems that afflict the human body and have been notoriously difficult to treat by any other method.…
When I was 40 years old, I was diagnosed in two separate neurological clinics as having intractable (incurable) pain. My comment was that I was too young to have intractable pain. It was by chance that I learned that Gustav A. Hemwall, M.D., a practitioner in the suburbs of Chicago, was an expert in prolotherapy.… To make a long story short, my intractable pain was not intractable and I was remarkably improved to the point where my pain ceased to be a problem.
The nice thing about prolotherapy, if properly done, is that it cannot do any harm. How could placing a little sugar-water at the junction of a ligament with a bone be harmful to a patient?
In 2005, doctors at the Mayo Clinic began testing prolotherapy and identified the most responsive injury sites as the knees, elbows, ankles, and the sacroiliac joint in the low back. They concluded in their newsletter that “unlike corticosteroid injections—which may provide temporary relief—prolotherapy involves improving the injected tissue by stimulating tissue growth.”
The prolo cocktail I used at the clinic mentioned at the opening of this chapter had a few additional ingredients:
Dextrose
Marcaine (anesthetic)
B-12
Proline
Lysine
Glucosamine sulfate
My first session entailed 12 prolo injections. It wasn’t all fun and games. For 45 minutes after the first session, I had vertigo and a cold, numb right hand.
On the positive side, decade-old pain in my right wrist (from impact in gymnastics) and my left knee (wrestling) both disappeared approximately 21 days after the last session.
The dangers of the ingredients are minimal, particularly when a simple dextrose-based version is used, but there is always the risk, albeit small, of infection. If a needle passes through the skin, it can carry bacteria from the skin into the target site. This is most serious when the infection occurs inside a joint and turns it septic, a process that can cause the joint cartilage to deteriorate in as little as 72 hours.
A survey in France reported an overall risk of sepsis of 13 per 1 million injections, with a much lower incidence if prepackaged syringes are used.
That said, after one staph infection, I was eager to explore less invasive injections, which led to the next therapy: biopuncture.
6. BIOPUNCTURE. AREAS FIXED: INFRASPINATUS, ACHILLES TENDON.
“Can you hear that?”
I could, and it was disgusting. Dr. Lee Wolfer was in the process of giving me between 40 and 60 injections1 with small needles commonly used for tuberculosis tests. Each injection was no more than half an inch under the skin, but the noise emanating from my infraspinatus, one of the rotator cuff muscles in the shoulders, sounded like someone walking on hard snow: audible crunching.
“That’s calcium deposited where it shouldn’t be.”
Lee, one of the foremost spine and back specialists in the United