In March 2015, David and I travelled to Honduras, to the village of Tela, to spend 2 weeks at a medical mission for people with chronic pain. We gave prolotherapy injections to many needy and willing recipients. The people of Honduras are so gracious: first the support team to run these clinics is second to none, and the patients who have so little (and line up for long hours and often travel many miles to come) are so grateful for anything we can do to help relieve their pain. We treated many people with arthritis, injuries, and poorly healing conditions and also benefited ourselves by being surrounded by other fantastic volunteering physicians, including a first rate teaching team. We are all better injectors as a result of these experiences. We salute the Hackett Hemwall Foundation who has been running humanitarian relief work in Honduras (prolotherapy, vein clinics and an ear, nose and throat team) for many, many years. We had the privilege of working under Dr Carl Osborn from Oregon, who celebrated his 20th year of this volunteer work. He is an excellent teacher! (see photo below - Carl is in the brown scrub top below). OK, so we had a bit of time to relax too...
Sometimes we recommend the use of topical Mannitol cream at home after you have had a treatment at the clinic. Mannitol's chemical structure is a sugar alcohol, and works in the same way dextrose or glycerine injections do: by turning off pain receptors in the body and allowing nerve inflammation to rapidly diminish, so that nerves begin to function and move normally rather than getting tightly caught on openings in the fascia. This means pain goes away. Mannitol was originally discovered in the 14th Century. It comes from the sap of the European Flowering Ash tree, and was named after the Biblical food, manna, which God provided in the wilderness. The beauty of this cream is that it is extremely safe, and can be applied as often as you like, and unlike dextrose cream it is not sticky. However it does need to be compounded at a pharmacy to break up the tiny crystals, and placed into a carrier cream in order to be absorbed. You need to ask us for a prescription for a compounding pharmacy. A colleague is working on an over-the-counter cream which is not yet available.
Jannice is a family physician with an interest in the treatment of pain. Anything to help the process is added to this blog.