Prolotherapy Case – Chronic Shoulder Pain

Pt is a 61 year old white male who presented with ’40 years of shoulder pain.’  The pain started with 2 falls – in while playing baseball, the second while rapelling in the military.  Pain was manageable with exercise until a back injury precluded exercise for a few months, after which the shoulder pain increased considerably.  Patient had chiropractic, acupuncture, physical therapy, and steroid injections all with minimal success.  He consulted with an orthopedic surgeon who told him to return for a shoulder replacement when the pain ‘becomes intolerable.’

Patient complained of essentially constant pain 6/10 which was worse with activity and prevents him from doing his favored activities – shotgun/trap shooting, motorcycle riding for any length of time, and any strenuous upper body exercise or weight lifting.  He states he cannot do a single pushup due to his pain. He is unable to sleep at night without pain, and cannot sleep on the affected shoulder at all.

The patient is generally healthy.

On exam the shoulder was markedly tender to palpation and ROM in flexion and abduction is limited to 90 degrees.

Patients XR showed severe degenerative changes of the glenohumeral joint.

Patient was consulted that he indeed was a candidate for prolotherapy, and so a series of treatment sessions were initiated.

After the first treatment session he had minimal soreness and minimal improvement and so sodium morrhuate was added to the standard 15 percent dextrose solution.

Patient started to note improvement with subsequent treatment sessions and they were continued.  Patient noted no adverse effect from the prolotherapy except severe post treatment soreness with lasted 4-5 days after treatment with sodium morrhuate.

At the end of the patients treatment period (7 sessions starting in April and ending in October) the patient notes vast improvement.  He is now exercising daily lifting weights, can do multiple sets of pushups (his record now being 90 in 1 day), can now shoot his shotgun, sleeps on the affected shoulder all night long with no difficulty, and recently went on a 1000 mile charity motorcycle ride with his wife.  At its worst his pain is now 1/10.  He is very happy with the results of his treatment.