Introduction

Patients with arthritis have been treated with procaine solution since the 1950’s. A Dublin doctor, Dr. Patrick A. Collins, who found that it could alleviate the symptoms of many forms of arthritis, developed the treatment. Today, an increasing number of GP’s around Ireland and abroad use the same treatment. The Lucan practice, run by Dr. Maurice Collins, continues as a specialist centre for this treatment and associated research.

What is it?

A very dilute solution of procaine in saline. Procaine was used in the past as a local anaesthetic, though its effect on arthritis symptoms has nothing to do with its anaesthetic properties.

What is the treatment called?

In order to distinguish the procaine treatment developed by Dr. Patrick A. Collins from other forms of procaine treatment, this treatment is now called ‘PACAINE’ (the initials P A C are taken from his name).

Who can be treated?

Patients with different types of arthritis, including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile chronic arthritis and arthritis associated with SLE. Other conditions such as fibromyalgia may also be treated successfully.

How is the treatment given?

The method of treatment is unusual. Using a glass rod, a measured amount of the solution is applied to the skin of the upper arm (no needles are required). The solution is just allowed to dry for a few minutes.

How often is the treatment needed?

The treatment is repeated every 4 weeks initially. Later, when the arthritis symptoms have responded, the time interval between treatments may be longer than 4 weeks (eg. 8 weeks, 3 months, etc.).

What kind of response is expected from the treatment?

Following a treatment it is not unusual for the patient’s symptoms to get worse temporarily (this is what we call a flare). Normally this will only last a few days and improvement follows. However, if the starting dose is too big the flare may last longer. Benefit may also occur in some patients without any initial worsening, but if the starting dose is too small the benefit will be short-lived.

Patients may also notice an increase in energy levels and general wellbeing after treatment with Pacaine.

Eventually, a general level of improvement in pain and stiffness is maintained and flares, if they do occur, are mild.

How long does it take to get a response to Pacaine?

The speed of response to treatment will vary from patient to patient and while some may improve quite quickly, for most patients it tends to be a slow gradual improvement with some ups and downs on the way.

Approximately 70% of patients will respond to treatment. If no reaction shows after 3 treatments, treatment is stopped. To stop after 1 treatment is a waste of time. The initial reaction may be quite slight and the patient may be expecting much more and hence not notice the slight change.

How Long do patients stay on treatment?

Every patient is different. Pacaine treatment is continued where troublesome symptoms occur. While in the early stages this is every 4 weeks, usually this interval extends to 8 weeks, 3 months or even 6 months in time. It is not possible to predict the speed this will happen.

How does Pacaine work?

It is thought that the treatment in some way stimulates a reaction in the immune system which can then influence the joints affected by arthritis and thereby alleviate symptoms.

Does the treatment have side-effects?

There are no known side-effects to this treatment.

Does the treatment interact or interfere with other medication?

No.

It is important that other medications are not changed at all when treatment with Pacaine has started , otherwise it may not be possible to tell whether a change in symptoms is due to Pacaine or the alteration of other standard medication.

In time, it may be possible to reduce the need for painkillers and anti-inflammatory drugs.

Where is Pacaine treatment available?

Dr. John Dunphy,

Cork Road Medical Clinic, Carrigaline, Co. Cork.

Tel: 021 4371177

I.M.C. 04257

Dr. Maurice Collins,

Crescent View, Spa Hotel Grounds, Lucan, Dublin

Tel: 01 6280240