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Joseph Valdez, MD and Prolotherapy

In many cases, doctors treating patients for back problems arrive at a diagnosis of nonspecific back pain after several types of treatments diagnostic tests have revealed little positive findings. Nonspecific back pain means that the cause of back pain cannot be precisely determined.

There are many things about the spine that don't easily lend themselves to testing for structural abnormalities that cause back pain. Many of the structures involved with causing chronic back pain are not easily viewed on medical imaging studies such as X-rays, CT scans, and MRI's. Exams such as X-Rays are good at observing degenerative disc disease, vertebral fractures, and abnormal curvatures of the spine. On the other hand, X-rays are rather poor at imaging soft tissues of the spine, such as the facet joints, tendons, and ligaments. X-rays can show rather conclusive evidence of degenerative disc disease, as evidenced by the narrowed spaces between the vertebral bones of the spine, but they are less likely to show related back conditions such as disc bulges and herniated discs. Other types of medical imaging are much better at displaying soft tissues and joint on films. If certain ligaments, tendons, or cartilage in joints were town, MRI images would likely show this pathology.

Based on high resolution images of back injuries such as herniated discs, the doctor may prescribe several treatments to correct the problem, including physical therapy, injections, and possibly surgery. Patients may or may not recover from one of these treatments. Back surgery is unsuccessful often enough that there is a medical name for it - Failed Back Syndrome.



If the medical imaging studies are so good at providing definitive causes of back pain, and spine surgery is able to successfully correct spine problems identified in medical tests, then why don't people get better? Many doctors, including Joseph Valdez MD support the idea that many cases of nonspecific low back pain may result from chronic injury to the ligaments and muscles.

While medical images are good at detecting degenerated discs and structures of the spine that have torn or ruptured, they may not be sensitive enough to detect minor changes to tendons and ligaments that have become stretched and made lax as a result of one of many factors. The ligaments and tendons of the spine are very strong and not prone to tearing unless in severe traumatic events, such as bad falls or car accidents. Yet, these soft tissues can become chronically stretched as a result of bad posture and unsafe working conditions for the back. Eventually, ligaments and tendons may become loose as a result of this repeated stretching of the ligaments.

Joseph Valdez, MD is a proponent of a back pain treatment known as Prolotherapy. With Prolotherapy, a chemical irritant is injected into ligaments and soft tissues in order to stimulate tightening of these structures. The theory behind Prolotherapy is that the tightening of the ligaments may help to stabilize the spine by bringing the vertebrae of the spine back into proper alignment.

Patients who may be candidates for prolotherapy are those with continued lower back pain despite back surgery to correct chronic joint location, fractures, and herniated discs. In a typical Prolotherapy protocol, a person would have four to six treatments over a six month period.