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Kas İskelet Sistemi Ağrılarında Proloterapi Enjeksiyonları

Yıl 2019, GETAT Özel Sayı, 91 - 114, 30.09.2019

İlker Solmaz

https://doi.org/10.34084/bshr.571715
Cited By: 2

Öz

Proloterapi, az
miktarda irritan solüsyonun normal hücre ve doku büyümesini uyarmak amacıyla ağrılı,
hasarlı veya dejenere olmuş tendon ve ligamentlerin yapışma bölgelerine
(entezis) uygulandığı enjeksiyonları içeren rejeneratif bir tedavi yöntemidir.
Bu yöntem kas iskelet sistemi kaynaklı ağrıların tedavisinde 80 yıldan uzun
süredir kullanılmaktadır. Proloterapi’nin kas iskelet sistemi sorunlarında
kullanımı, ağrının ligamentlerdeki zayıflama sonucu ortaya çıkan relaksasyona bağlı
olduğu ve bu ligamentlerin tahriş edici, hücre proliferasyonunu uyarıcı
solüsyonların enjeksiyonları ile güçlendirilebileceği düşüncesine
dayandırılmaktadır.Ligament
relaksasyonu; genel olarak ligament içeriğindeki liflerin dayanıklılığının
bozulduğu durum olarak tanımlanmaktadır. İrritan solüsyonların enjeksiyonları
ile tendon ve ligamentlerde fibroblast hiperplazisi, hücre proliferasyonu,
kollojen lif çapında artış gibi histolojik yapısal değişikliklerin yanısıra
tendon ve ligament gücünde artış da gözlenmektedir. Bu etki, yara iyileşme
mekanizmasının tetiklenmesine bağlı oluşmaktadır.Proloterapi
enjeksiyonlarının eklem ağrıları ve eklem laksitesi, kronik bel ağrısı,
epikondilit, tendinopatiler, aşırı kullanım yaralanmaları gibi kas iskelet
sistemi sorunlarındaki etkinliğini araştıran çalışmaların artması ile birlikte
son dönemde bu rejeneratif tedavi yöntemine ilgi giderek artmaktadır. 

Anahtar Kelimeler

Proloterapi kas iskelet sistemi ağrısı tendon ligament laksite

Kaynakça

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Prolotherapy Injections for Musculoskeletal Pain

Yıl 2019, GETAT Özel Sayı, 91 - 114, 30.09.2019

İlker Solmaz

https://doi.org/10.34084/bshr.571715
Cited By: 2

Öz

Prolotherapy is a regenerative treatment method that involves
injections of small amounts of an irritant solution to the site of painful,
injured or degenerated tendon and ligament insertions (entheses) to promote
growth of normal cells and tissues. It has been used in clinical practice for
more than 80 years to treat various musculoskeletal pain. The use of
prolotherapy in musculoskeletal problems is based on the idea that pain is due
to relaxation caused by attenuation of the ligaments and that these ligaments
can be strengthened by injections of irritating, cell proliferation stimulating
solutions.Ligament relaxation; generally described as a condition in which the
strength of the ligament fibers has become impaired. Histological structural
changes such as fibroblast hyperplasia, cell proliferation, increase in
collagen fiber diameter are observed in tendons and ligaments after injections
of irritant solutions. İn addition to histological changes, increase in tendon
and ligament strenght is also observed. This effect is due to triggering of
wound healing mechanism.

With the increasing
number of studies investigating the efficacy of prolotherapy injections in
musculoskeletal problems such as joint pain and joint laxity, chronic low back
pain, epicondylitis, tendinopathies, and overuse injuries, there is an
increasing interest in this regenerative treatment method.

Anahtar Kelimeler

prolotherapy musculoskeletal pain tendon ligament laxity

Kaynakça

  • 1. Yelland MJ, Glasziou PP, Bogduk N, et al. Prolotherapy injections, saline injections, and exercises for chronic low-back pain: a randomized study. Spine. 2003;29:9-16.
  • 2. Hackett, G.S. , Hemwall, G.A. , Montgomery, G.A. Ligament and Tendon Relaxation Treated by Prolotherapy. 5th edition. Oak Park (IL): Gustav A. Hemwall; 1993.
  • 3. Schultz L. A treatment for subluxation of the temporomandibular joint. JAMA. 1937;25:1035-7.
  • 4. Schultz L. Twenty years’ experience in treating hypermobility of the temporomandibular joints. American Journal of Surgery. Vol. 92, December 1956.
  • 5. Loeser JD, Treede RD. The Kyoto protocol of IASP basic pain terminology. Pain 2008;137: 473–7.
  • 6. Cailliet R: Soft tissue pain and disability, Philadelphia, FA Davis, 1997
  • 7. HACKETT GS. Joint stabilization through induced ligament sclerosis. Ohio State Med J. 1953 Oct;49(10):877-84.
  • 8. Liu YK, Tipton CM, Matthes RD, et al: An in situ study of the influence of a sclerosing solution in rabbit medial collateral ligaments and its junctional strength. Connec Tissue Res 1983;11:95– 102)
  • 9. Maynard JA, Pedrini VA, Pedrini-Mille A, Romanus B, Ohlerking F. Morphological and biochemical effects of sodium morrhuate on tendons. J Orthop Res.1985;3(2):236-48.
  • 10. Klein RG, Dorman TA, Johnson CE. Proliferant injections for low back pain: histologic changes of injected ligaments and objective measurements of lumbar spine mobility before and after treatment. J Neurol Orthop Med Surg 1989;10:141 –144
  • 11. Meisenbach, R. O.: Sacro-Iliac Relaxation With Analysis of Eighty-four Cases. Surg., Gynec., & 0bst. 1911;12:411-434
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  • 81. Hauser R. A Retrospective Study Shows Prolotherapy is Effective in the Treatment of MRI-Documented Meniscal Tears and Degeneration. Journal of Prolotherap. 2010;2(3):416-437
  • 82. Reeves KD and Hassanein K. Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity. Alternative Therapies. March 2000. 6(2):68-80.
  • 83. Reeves, K. Dean, and Khatab M. Hassanein. "Long-term effects of dextrose prolotherapy for anterior cruciate ligament laxity." Alternative therapies in health and medicine 9.3 (2003): 58-63.
  • 84. Kırdemir Vecihi, Aslan A. Ankle Ligament injuries. Turkiye Klinikleri J Surg Med Sci 2007;3(39):22-7
  • 85. Tsatsos G, Mandal R. Prolotherapy in the treatment of foot problems. J Am Podiatr Med Assoc 2002;92:366-8.
  • 86. Hauser RA, Hauser MA, Cukla J. Dextrose Prolotherapy injections for chronic ankle pain. Pract Pain Manag 2010: 70-76.
  • 87. Rivello Gj. McGlamry's Comprehensive Textbook of Foot & Ankle Surgery 4th Edition. Chapter 35, 181-86
  • 88. Yelland MJ, et al. Prolotherapy injections and eccentric loading exercises for painful Achilles tendinosis: a randomised trial. Br J Sports Med 2011;45:421-8.
  • 89. Maxwell NJ, Ryan MB, Taunton JE, et al. Sonographically guided intratendinous injection of hyperosmolar dextrose to treat chronic tendinosis of the Achilles tendon: a pilot study. AJR Am J Roentgenol 2007;189:W215-20.
  • 90. Lyftogt J. Prolotherapy and Achilles tendinopathy: a prospective pilot study of an old treatment. Australasian Musculoskeletal Medicine. 2005;16–19
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  • 92. Ersen Ö, Koca K. A randomized-controlled trial of prolotherapy injections in the treatment of plantar fasciitis. Turk J Phys Med Rehab 2018;64(1):59-65.
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  • 94. Kurtz S. Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am. 2005 Jul;87(7):1487-97
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  • 96. Agency for Healthcare Research and Quality (AHRQ). Agency News and Notes: Musculoskeletal procedures account for over 10 percent of all hospital care in the United States.
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  • 100. Lennard T. Pain Procedures in Clinical Practice. 2nd ed. Philadelphia, PA: Hanley & Belfus, Inc.;2000.
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  • 102. Hauser A, Orlofsky A. Regenerative Injection Therapy (Prolotherapy) for Hip Labrum Lesions:Rationale and Retrospective Study. The Open Rehabilitation Journal, 2013, 6, 59-68
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  • 104. Holmich P, Uhrskou P, Ulnits L, et al. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes; randomized trial. Lancet 1999;353:439-43.
  • 105. Topol GA, Reeves KD, Hassanein KM. Efficacy of dextrose prolotherapy in elite male kicking-sport athletes with chronic groin pain. Arch Phys Med Rehabil 2005;86:697–702.
  • 106. Hauser A. A Retrospective Study on Hackett-Hemwall Dextrose Prolotherapy for Chronic Hip Pain at an Outpatient Charity Clinic in Rural Illinois. Journal of Prolotherapy. 2009;2:76-88.
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  • 109. Seven MM, Ersen O, Akpancar S, Ozkan H, Turkkan S, Yıldız Y, Koca K. Effectiveness of prolotherapy in the treatment of chronic rotator cuff lesions.Orthop Traumatol Surg Res. 2017 May;103(3):427-433
  • 110. Koca K, Kürklü M. Karpal instabilitelerin radyolojik değerlendirilmesi. TOTBİD Dergisi 2013;12(1):47-53
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  • 115. Pecar D and Avdic D. Efficacy of tennis elbow (Epicondylitis humeri radialis) treatment in CBR “Praxis.” Bosn J Med Sci. Feb 2009. 9(1): 25-30
  • 116. Alternative treatments: Dealing with chronic pain. Mayo Clinic Health Letter. April 2005. 23(4).
  • 117. Lennard, T. Pain Procedures in Clinical Practice. Second Edition. Hanley & Belfus, Inc. Philadelphia, PA. 2000.
  • 118. Hauser R, Hauser M, Holian P. Dextrose prolotherapy for unresolved wrist pain. Practical Pain Management. 2009;Nov/Dec:72-79.
  • 119. Jobe F, Ciccotti M. Lateral and medial epicondylitis of the elbow. J Am Acad Orthop Surg 1994;2:1-8.
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  • 123. Carayannopoulos A, Borg-Stein J, Sokolof J, Meleger A, Rosenberg D. Prolotherapy versus corticosteroid injections for the treatment of lateral epicondylosis: a randomized controlled trial. PM R. 2011 Aug;3(8):706-15
  • 124. Scarpone M, Rabago D, Arbogest J, Snell E, Zgierska A. The efficacy of prolotherapy for lateral epicondylosis: A pilot study. Clin J Sports Med 2008;18:248-254.
  • 125. Shin J, Seo K-M, Kim D-K, Kim B-K, Kang S-H. The effect of prolotherapy on lateral epicondylitis of elbow. J Korean Acad Rehabil Med. 2002;26:764–8.
Toplam 125 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Derleme
Yazarlar

İlker Solmaz Bu kişi benim 0000-0002-1959-8159

Yayımlanma Tarihi 30 Eylül 2019
Kabul Tarihi 10 Temmuz 2019
Yayımlandığı Sayı Yıl 2019 GETAT Özel Sayı

Kaynak Göster

AMA Solmaz İ. Kas İskelet Sistemi Ağrılarında Proloterapi Enjeksiyonları. J Biotechnol and Strategic Health Res. Eylül 2019;3:91-114. doi:10.34084/bshr.571715

Cited By

POPÜLER BİR TAMAMLAYICI TIP TEDAVİSİ: PROLOTERAPİ
SDÜ Tıp Fakültesi Dergisi
https://doi.org/10.17343/sdutfd.1162009
Bilecik İlinde Yapılan Geleneksel ve Tamamlayıcı Tıp Uygulamalarında Karşılaşılabilecek Risk ve Tehlikelerin İş Sağlığı ve Güvenliği Açısından Değerlendirilmesi
Bütünleyici ve Anadolu Tıbbı Dergisi
https://doi.org/10.53445/batd.1074021

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