Regenerative Injection Therapies
WHAT IS PROLOTHERAPY & HOW WAS IT DEVELOPED?
Andrew Taylor Still M.D., the founder of Osteopathic Medicine, started a new field of medicine based on the concept that God designed our bodies with a natural tendency to heal. So one could say it was natural for an Osteopathic physician, namely, Earl Gedney, D.O. to consider and develop the concept of Prolotherapy. Dr. Gedney, a surgeon, in 1936 had an unfortunate accident on the way to surgery where he severely injured his thumb forcing him to give up surgery. He heard of an approach by doctors using irritating sclerosing solutions to non-surgically repair hernias and thought it might also stimulate repair of damaged muscles and ligaments. Feeling he had nothing to lose he injected his injured thumb with sclerosing solutions and had such dramatic improvement of his thumb that he was able to get back to surgery. He became so excited that he started a lifelong career researching and developing sclerosing solutions which eventually led to what is now known as the American Osteopathic Association of Prolotherapy.
The name Prolotherapy comes from two words; prolo to proliferate (reproduce tissue) and therapy (to heal). So Prolotherapy, or Proliferative Therapy, is designed to stimulate natural healing to weak or previously injured tendons and ligaments allowing for joints to again become stable. I feel it is most important to realize that most of the problem is weakness in the muscles and tendons around the joint then the joint itself. When this weakness becomes chronic then nerves are pinched (pain) and joints are injured and worn down (arthritis).
One of the initial and most basic solutions which is commonly used consists of procaine (anesthetic) and concentrated dextrose solution (D50W). Over the years many different formulations have been developed and successfully used to strengthen and heal weak or damaged muscles and ligaments. As with other areas of medicine it is a combination of the agents used and the physician’s skill on where to inject them.
SO WHAT IS REGENERATIVE THERAPY?
Regenerative therapy combines various treatment modalities that have been found to regenerate or heal tissues and organs in order to restore lost function from aging, disease, damage or defects. The best-known modalities include Prolotherapy, Ozone Therapy, Platelet Rich Plasma (PRP) Therapy. Prolotherapy and Ozone Therapy through local irritation stimulate one’s body to send growth factors to the weak or injured ligaments or tendons. Whereas, with Plasma Rich Platelets (PRP) the growth factors are captured from one’s own blood, then concentrated, and injected directly into weak or injured ligaments and tendons. Although these therapies can be used individually, they can be combined to get a more robust healing effect of the weak or injured ligaments and tendons.
WATCH A PATIENT'S TESTIMONIAL HERE
SO WHAT IS PROLOZONE THERAPY?
Prolozone therapy is a combination of Prolotherapy and Ozone Therapy in order to get a more robust stimulation of the body to send growth and healing factors to weak or injured ligaments or tendons. The specific formula I use is a combination of Procaine, D50W, B vitamins, and magnesium that is followed by the oxygenating effect of ozone. Sometimes, a Homeopathic dose of steroid is additionally added to reduce pain especially if there is acute swelling.
SO WHAT IS PRP (PLATLET RICH PLASMA) THERAPY?
Platelet Rich Plasma (PRP) Therapy, involves capturing and concentrating the growth and healing factors especially concentrated in one’s own blood platelets. Red blood cells (RBC’s), White Blood cells (WBC’s) and Platelet Cells are all specialized cells made in one’s bone marrow. Platelets naturally contain up to 100 different growth factors which God designed to clot, heal, and repair damage and injury in our body when it occurs. Unfortunately, sometimes extenuating circumstances overwhelm the body’s healing potential as with either continual “wear and tear” or extensive trauma to the body. Also, some areas of the body like bone, cartilage, ligaments, and tendons naturally have little blood supply which lend them to develop into more chronic instability and pain.
Initially, surgeons found that putting platelets into the surgical site at the end of a surgical procedure assisted in the healing process after surgery. Physicians already working with Prolotherapy surmised that both stimulating the body to send growth factors would only be enhanced by actually injecting some growth factors at the same time. In simplified form, after your blood is drawn it is spun down in order to concentrate the platelet cells which are then injected into those weak or injured ligaments and tendons to facilitate healing. These platelets along with their healing growth factors can be directly injected either alone or in combination with other solutions. I will typically use PRP Therapy either alone or in combination with Prolozone Therapy in those patients which have failed to get the desired level of healing with just Prolozone therapy alone.
CAN REGENERATIVE THERAPIES REPLACE THE NEED FOR SURGERY?
The best indicator for surgery is when the level of pain and or dysfunction is creating an inability of a person to either perform their daily activities or interferes with their overall quality of life. The benefit of Regenerative Therapies is that patient is often able to get relief of pain and the dysfunction that is interfering with their life. Although one often does not see as much improvement on X-rays or Imaging studies, again, the rationale for surgery is patient functioning not just a better-looking X-ray or MRI! In fact, the very reason I started doing Regenerative Therapy injections years ago was seeing some of my patients saying: Hey Doc, look at me, my pain has gone away and I’m back to doing things.”
WHAT ABOUT THE ROLE OF MUSCULOSKELETAL THERAPY OR OMT WITH HEALING?
The biggest misunderstanding is that most people consider either they are a candidate from non-surgical modalities like musculoskeletal therapy or they need surgery. I have found that patients benefit either with just primarily musculoskeletal therapy or need a combination of both musculoskeletal therapy and surgery. The main reason why musculoskeletal therapy is the primary treatment modality is that it deals with increased circulation, improved body alignment, and the reduction of muscle tension on the joint.
If one looks at musculoskeletal problems from a whole-body perspective it becomes evident that the tight muscles and connective tissue cause the malalignment of the body which causes joint so be worn down. Surgery is meant to take care of the effect of trauma and malalignment not the cause. Additionally, musculoskeletal therapy is especially beneficial after surgery to help with the desired healing and reduction of post-op swelling which allows one to get back to their activities sooner.
WATCH MORE PATIENTS' TESTIMONIALS HERE
SO WHAT ABOUT ME & MY CHRONIC PAIN AND PROBLEM?
Regenerative Therapy is helpful for a wide range of health problems and as you would expect works better the sooner it is used to the tie of initial injury. Commonly it is used for injuries involving the strain of ligaments and tendons around joints such as one’s TMJ, neck, shoulder, golfer/tennis elbow, low back, hip, knee, and foot as with plantar fasciitis.
These injections are typically done as a trial of therapy every two to four (2 to 4) weeks for four injections. The goal is to create a moderate amount of inflammation for one to two (1-2) days to stimulate a natural healing response of the body. Therefore, ice and anti-inflammatory medication, which slows down the healing response should be avoided. Instead, heat or pain medication such as Tylenol ES, Tramadol, or Vicodin can be prescribed. At this time any normal daily activity is fine to do, but any working out exercise should be avoided to avoid strain and allow the body to maximize the natural healing response.
Over and over again I continually see hope and improvement when natural therapies are used to treat the causes of one’s health problems. This is why I came up with the “trial of treatment” approach where if one has a chronic condition to do a trail of six (6) treatments ideally one to two (1-2) times per week. The intended goal is for you, as the patient, to see enough improvement that you see a benefit of continuing with therapy. The main thing I want to leave you with there always is hope!