Prolotherapy is an injection technique that stimulates growth of cells and tissue that stabilize and strengthen weakened joints, cartilage, ligaments and tendons. The injected solution intentionally causes controlled irritation in the injected tissue. This irritation is an inflammatory response, which increases the blood supply and thereby stimulates the tissue to heal and regrow new tissue.


GetProlo is happy to be the web’s largest listing of Prolotherapy doctors. GetProlo.com is a referral and informational site only. If you would like to know if you are a good candidate for Prolotherapy or other Regenerative Injection Therapy, please contact a Prolotherapy physician’s office directly for an opinion. Thank you for using GetProlo.com!

Pain Killers Prevent Healing

Marc Darrow, MDMarc Darrow, MD

As chronic pain specialists, our office sees many new patients looking for an alternative to a lifetime of pain killers and anti-inflammatories because of the risks associated with habitual use of these medications.

These risks including:
■ ulcers,
■ gastrointestinal distress,
■ liver and other major organ damage,
■ and overdose.

Patients also come to see us because they do not want to live their life in a drug induced “stupor.” Sometimes patients even become more sensitive to the pain and require higher doses of narcotics.   Here is another risk: They don’t let you heal! A study in the American Journal of Bone and Joint Surgery said that not only does chronic use of opioid medications can lead to dependence but they can adversely affect perioperative and postoperative pain management, rehabilitation, and clinical outcomes after total knee arthroplasty. In patients they studied, a significantly higher prevalence of complications was seen in the opioid group. Patients who chronically use opioid medications prior to total knee arthroplasty may be at a substantially greater risk for complications and painful prolonged recoveries.

Most patients we see, visit us because they have already been given the surgical ultimatum – live with the pain or get the surgery. These patients want another choice to their knee replacement prognosis and diagnosis that include osteoarthritis (bone-on-bone caused by cartilage disintegration), weakness or tears in the meniscus and the ligaments. Supportive of this diagnosis will usually be a long history of MRI images, failed physical therapy and other conservative treatments. Many times they bring in a shopping bag filled with prescription pain-killers and anti-inflammatories and the long-list of over-the-counter remedies they take.   Three options they have usually never tried or been informed of are Prolotherapy, Platelet Rich Plasma therapy, and Stem Cell Therapy. These treatments are injection therapies designed to rebuild cartilage, repair torn meniscus and ligaments, and reduce swelling and pain.   They work similarly. First a proliferant, something in the injection that will cause tissue to regrow is introduced. The treatments work at growing new cells, Chondrocytes, the cells that comprise knee cartilage, and fibroblasts, the most common cells in the connective tissue (those that make up ligaments and tendons.)

Weight gain after joint replacement

Scott R. Greenberg, MDScott R. Greenberg, MD

When examining patients who have thought of getting a knee replacement, two of the main reasons they give in favor of the procedure is that is can reduce pain, and secondly, it can help them be more active and they can maintain an ideal body weight.

Research is suggesting that knee replacement patients actually gain more weight after the surgery. Worse, the younger the patient, the greater the risk for substantial weight gain following the surgery! 1

This new research goes against older research that says the opposite – usually joint replacement patients lost weight.2

In other research, it becomes a little more clear “Total hip or knee replacement patients who are overweight or obese often consider their disabling joint disease a cause for their increased weight”. . . BUT…”Postoperatively, both hip and knee replacement patients gained weight. Younger hip patients gained a significant amount of weight.3

All three studies seemingly confirm the same thing, it is up to the doctor and patient who are predisposed for weight gain, to work together to form a non-weight gaining plain following treatment.

Of course, inactivity may lead to the weight game following a joint replacement surgery. This is why Prolotherapy is a sought after option. Under a doctor’s care a patient during treatment, may continue normal activity and avoid the problems of inactivity.

1. Riddle DL, Singh JA, Harmsen WS, Schleck CD, Lewallen DG. Clinically important body weight gain following knee arthroplasty: A five-year comparative cohort study. Arthritis Care Res (Hoboken). 2012 Nov 30. doi: 10.1002/acr.21880. [Epub ahead of print]

2. Stets K, Koehler SM, Bronson W, Chen M, Yang K, Bronson M. Weight and body mass index change after total joint arthroplasty. Orthopedics. 2010 Jun 9;33(6):386. doi: 10.3928/01477447-20100429-13.

3. Heisel C, Silva M, dela Rosa MA, Schmalzried TP. The effects of lower-extremity total joint replacement for arthritis on obesity. Orthopedics. 2005 Feb;28(2):157-9.

Cervical Spine Pain

Jay W. Nielsen, MDJay W. Nielsen, MD

Cervical Spine Pain (Pain in the neck and arms) Just as the back is mostly a mixture of many causes of pain, so it is true with the neck. Arthritis, disc injury, herniation, facet arthritis are all co-mingled just as with the back. Attention to the lower cervical disc narrowing with surgery is occasionally fraught with failure to relieve pain though surgery in the neck is safer and more effective than in the low back. When the neck is injured in an extension/flexion injury such as whiplash, the maximum disc injury is to the lower cervical area where movement is maximum. For this reason, most neck surgery occurs between C5, C6 or C6-C7. The maximum ligament injury occurs much higher at the attachment of the skull to the first two vertebrae. Since the nerves supplying the skin and muscle are at a minimum in this area, symptoms tend to be neck surgery and head heaviness rather than numbness and pain at a distance.

More important, the spinal cord and base of the brain lose protection and cause symptoms more suggestive of other diseases such as Multiple Sclerosis or migraines. This syndrome called Barre-Lieou syndrome is rarely diagnosed today. It is not possible to correct these delicate ligaments as they are surgically inaccessible and fail to show on MRI.

Cervical Disc Disease can cause herniation with nerve root pressure. The symptoms include numbness and tingling of the forearm or part of the hand. This is true because three separate nerves supply the arm. Pain from a C4-C5 disc refers to the outside of the shoulder. C5-C6 affects the forearm and thumb. C6-C7 refers to the hand. These symptoms can be relieved with surgery, which is surprisingly simple. An incision is made over the front of the neck just above the collarbone. No serious structures are cut, rather they are moved aside. The vertebrae are separated with a special clamp and the disc is removed. Donor bone is taken from the iliac bone just below the boney prominence above the hip with a device like a cookie cutter and placed in the gap. The bones then grow solid. The patient complains more of hip than neck pain post op. The biggest complication of the surgery is that the fusion makes for a long segment of immobile bone that now throws the movement into the next disc causing it to deteriorate over years resulting in more surgery. Prolotherapy has the advantage that it stabilizes the weak disc without limiting its movement. The disc is still herniated but because the motion is more naturally, there is less swelling and arthritis and subsequently less nerve pressure.

Prolotherapy for Plantar Fasciitis, Foot and Heel Pain

Ross Hauser, MDRoss Hauser, MD

Is Prolotherapy effective for plantar fasciitis?

Many people think injections into the heel are painful, typically patients tolerate the injections very well.

Prolotherapy is very successful for foot pain such as pain from the medial arch, plantar fascia, various ligament injuries, bunion pain, and pain that runners have in the feet secondary to all of the pounding.

Prolotherapy treatments need to focus on the the spring ligament which is also called the plantarcalcaneonavicular ligament. This is one of the most important ligaments in the arch that supports the arch. But whether someone has a high arch, normal arch, or flat arch, or pes planus, if they have pain and tenderness to palpation, typically they’ll respond great to Prolotherapy because Prolotherapy stimulates the repair of the injured areas. It causes the proliferation of injured soft tissue so they repair. As you can see, here I am again palpating the hee lbut in a different location where we injected before because I want to make sure I am getting all the areas where the person has pain.

What is Plantar Fasciitis?

Plantar fasciitis is an inflammation of the plantar fascia, a thin layer of tough tissue supporting the arch of the foot. Repeated microscopic tears of the plantar fascia cause pain. Plantar fasciitis is sometimes also called “heel spurs,” but this is not always accurate since bony growths on the heel may or may not be involved. Although plantar fasciitis is most common in middle-aged men, it can occur in all age groups.

How does plantar fasciitis develop?

The plantar fascia is a layer of ligamentous connective tissue that runs from the heel bone to the ball of the foot. It not only maintains the arch of the foot, it is also one of the major transmitters of weight across the foot as we walk or run. The stress placed on the plantar fascia is tremendous, and when inflammation occurs it can be quite painful. The inflammation can result from excessive stretching, too much pressure or trauma. If the plantar fascia becomes partially detached at the heel, a heel spur results. A number of possible causes, often working in combination, result in plantar fasciitis. They include tightness of the foot and calf, improper athletic training, stress on the arch or weakness of the foot. Shoes that don’t fit, certain play or work actions or overuse (running too fast, too far, too soon) may also be involved. People with low arches, flat feet or high arches are at an increased risk of developing plantar fasciitis.

What are the symptoms of plantar fasciitis?

Symptoms of plantar fasciitis can occur either suddenly or gradually. When they occur suddenly, intense heel pain on taking the first morning steps, known as first-step pain, is usually involved. Although this heel pain often subsides as the individual begins to walk around, it may return in the late afternoon or evening. When symptoms occur gradually, a more chronic form of heel pain causes individuals to shorten their stride while running or walking. Individuals may also shift their weight toward the front of the foot, away from the heel.

Conventional medical treatments may help relieve the symptoms of plantar fasciitis, but they do not address the root of the problem. By strengthening structural weaknesses in the body, as natural medicine treatments like Prolotherapy do, pain associated with plantar fasciitis may be alleviated permanently.

Prolotherapy for Spinal Stenosis

Scott R. Greenberg, MDScott R. Greenberg, MD

We see many patients who come in with a diagnosis of spinal stenosis. Their doctors have told them that they have a narrowing of the spinal column and that is causing pressure on the spinal cord, and/or a narrowing of the openings where spinal nerves leave the spinal column. In new research, doctors found that while stenosis was common on MRI, its cause as the pain source was described as “relatively uncommon.” 1

Spinal stenosis usually occurs as a person ages and the disks become drier and start to shrink. At the same time, the bones and ligaments of the spine swell or grow larger due to arthritis or long-term swelling (inflammation).

Often, symptoms will get worse slowly over time. Most often, symptoms will be on one side of the body or the other. These symptoms include:

Numbness

Cramping, or pain in the back, buttocks, thighs, or calves

Tightness and pain in the neck, shoulders, or arms

Weakness of part of a leg or arm Symptoms are more likely to be present or get worse when a person stands or walks. They will often lessen or disappear when a person sits down or leans forward. Most people with spinal stenosis cannot walk for a long period of time.

But is it the Stenosis that is causing the problem? The patient is convinced it is because they have an MRI that says so. BUT, a considerable proportion of patients may be classified incorrectly by MRI for HNP (herniated disc) and spinal stenosis. 2

When there is back pain, there is spinal instability. Spinal instability can be caused by weakened, loose ligaments and tendons that allow for excessive movement in the vertebrae.

At the Magaziner Center for Wellness, we rebuild and restructure the damaged ligaments and tendons using innovative regenerative joint therapies. These include prolotherapy, platelet rich plasma (PRP), and stem cell therapy. These techniques help stabilize the spine, which is imperative as unstable joints can lead to – or further exacerbate – the arthritis that causes spinal stenosis. Additionally, by stabilizing the spine with these natural procedures, we reduce the symptoms and treat the underlying disease. In fact, we have successfully treated patients who were previously told that they would never be pain free without spinal fusion – and they’ve been pain free for a decade or more!

In fact, the Center’s own Dr. Greenberg developed one of the most innovative uses for prolotherapy – the correction of a pelvic tilt or functional leg length discrepancy. This disorder produces uneven forces across the joint, thus contributing to its damage. Using prolotherapy, we immediately correct this tilt and help promote the overall healing process.

We also work with our patients to help them identify appropriate physical activity – especially stretching exercises – to help them improve their joint function, while helping them manage the stress often associated with the pain associated with spinal stenosis.

1. Ishimoto Y, et al. Associations between radiographic lumbar spinal stenosis and clinical symptoms in the general population: The Wakayama Spine Study. Osteoarthritis Cartilage. 2013 Mar 5. pii: S1063-4584(13)00706-1. doi: 10.1016/j.joca.2013.02.656. [Epub ahead of print]

2. Wassenaar M, van Rijn RM, van Tulder MW, Verhagen AP, van der Windt DA, Koes BW, de Boer MR, Ginai AZ, Ostelo RW. Magnetic resonance imaging for diagnosing lumbar spinal pathology in adult patients with low back pain or sciatica: a diagnostic systematic review. European Spine Journal 2012; 21(2): 220-227. .