Question
First off, i will start with how my pain began. I had gotten into a collision accident going around 25-30 miles per hour and had to slam on my breaks extremely hard. I did get some whiplash with this, and my back seemed tight, but no immediate pain. 2 days later, my back almost went out, I had to leave work and go home early. Cut a very long story short, I have been seeing my chiropractor for around 5 weeks now. He had taken xrays and sent them off to get measured to determine if anything tore. Xrays came back and come to find out there is a tear in my c2 and c4 in my neck and there was some major stretching in my l3,l4,l5 almost to the point of tearing in l5. So, he has been adjusting me 3 times a week, and i am seeing a massage therapist 3 times a week as well. The worst pain i feel in my back is the SI joint on my left, and some on the right as well. It is especially the worst when i sit, and has been somewhat improving, but is still irritated very easy. My neck is still pretty sore and stiff, kind of feels like a burning sensation sometimes and the massages will sometimes help, but I think sometimes irritate as well. My chiropractor wants to have the sugar water injected into my neck muscles to irritate and cause my body to start self healing. I can not remember what it is called off the top of my head, polo something. Either way, i am not sure if my insurance will cover this, and I am looking for another doctor's opinion on this. Any and all thoughts are welcome, i would love to get out of pain :)   also, just for a little background, i have had back issues since i was around 15 but never around the sI joints. I have been going to chiropractors on and off since I was 17, usually with success until now.

Answer
Hi Sean,

Sorry to hear about this.

First, it does take time to get better. I know its frustrating, but keep a good attitude and expect to get better. Its good to hear that there is improvement and this is typical of a gradual progression towards healing.

Now, It is good to hear that your Chiropractor is referring out to have your films analyzed. I'm not sure what you mean by tearing. Muscles, ligaments, discs can all tear. There can be indications from motion studies on x-rays regarding hypermobility, however, I would prefer methods like MRI for this.

Prolotherapy. I am not a fan of prolotherapy, however, some are and I would not stand in between what your doctor recommends and feels you need. Having said this, if it were me, I would not. It may be beneficial, although, at this point, I am not sure there is sufficient diagnostic criteria to warrant this type of invasive therapy. Ultimately it is your decision. If this is a doctor you have been seeing for years, it may come down to a matter of trust you have in the doctor. I am not an expert on prolotherapy, but am not an advocate of it. In fact, although it goes against a more natural metod, I would lean more towards localized steroid injections to help reduce what sounds like a great deal of inflammation. Any type of severe tearing of ligaments would usually require a surgical consult.

Massge therapy is nice, however, there are methods of tissue therapy that are more specific and detailed regarding evaluation and treatment. I prefer Active Release as a method for resolving any poorly healed scar tissue in the muscles. You are still in a sub-acute stage, so treatment should be progressing from passive to more active methods. I assume a re-evaluation would be scheduled at perhaps 6 and 12 weeks.

Anyway, if you are hesistant about the prolotherapy, I would seek a second opinion or discuss the matter further with your doctor. I would not push a treatment on a patient that is hesistant and there are other methods of approach that would be reasonable.

I hope this helps and I do wish you a speedy recovery Sean.

Kind Regards,

Dr. Steve