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Dr. Maine or Dr. Abaci, would like both of your opinions, please.
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bren_bren posted:
I would like to know your professional opinion regarding narcotic medications and their effects on healing. Surely an impairment is expected as they can slow the body and its processes down, yet at what capacity? I'm undergoing prolotherapy treatments and have read much about the processes involved but would like your opinion as to whether or not the cessation of all narcotic medications is necessary for the desired healing result.

Have you personally witnessed a chronic pain patients' recovery, and/or reduction of pain, after undergoing such treatments?

Any input is greatly appreciated as I have been struggling with titration since the therapy has increased my pain levels. I'm currently weening off of fentanyl (100mcgs), which I have been on for 3 years; yet did not expect such depressive symptoms I am experiencing. I don't want to give up on trying prolotherapy but the prolo doc is insisting that I taper off in order for it to work. Thanks for your time, B
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David Maine, MD responded:
There is some data to suggest that opioids may effect wound healing - particularly in animal models. My experience with prolotherapy is limited and thus I cannot give you an opinion as it relates to that treatment. I do however believe if you are able to wean down on the opioids or perhaps off for a period a time (opioid holiday) that it may provide benefit. Good luck.
 
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Peter Abaci, MD responded:
I also don't have much clinical experience with prolotherapy, but I have come across a few patients who have sworn by its effects. Unfortunately, there haven't been any sound scientific studies done yet to endorse prolotherapy based on evidence-based guidelines for any particular conditions. That doesn't mean it may not have value, but it hasn't really been scientifically demonstrated, yet.

I am also not sure how opioids may interfere with the theoretical effects of prolotherapy on the tissues. Weaning down from 100 mcg/hr of fentanyl can be quite difficult, and you may need further assistance or a medically supervised detox plan to accomplish this.


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